Abstract: Background　Dystonia caused by central nervous system impairment is a common complication of severe hand-foot-mouth disease（HFMD） in children，and its treatment and rehabilitation have become a focus of attention in clinical practice.Objective　To observe the clinical efficacy of acupuncture combined with electromyographic biofeedback therapy for severe HFMD complicated with dystonia caused by central nervous system impairment，so as to provide a reference for clinical treatment of this disease.Methods　70 cases of severe HFMD complicated with dystonia caused by central nervous system impairment who received treatment from Children's Hospital Affiliated of Zhengzhou University from March 2015 to March 2018 were retrospectively analyzed.They were divided into observation group and control group according to the rehabilitation therapy，with 35 cases in each.Both groups received the conventional rehabilitation training，and the observation group additionally received acupuncture combined with electromyographic biofeedback therapy.The intervention lasted for 8 weeks for both groups.Pre-post intervention data about neuroelectrophysiological indicators 〔sensory nerve conduction velocity（SCV），motor nerve conduction velocity（MCV） of femoral，tibial and peroneal nerves〕，grading of muscle tension，scores of exercise and self-care action domains of Comprehensive Functional Assessment for Disabled Children（CFA-DC ） Scale and clinical efficacy were compared between the two groups.Results　After treatment，the SCV and MCV of femoral，tibial and peroneal nerves were much faster than the baseline levels in both groups（P<0.05）.Moreover，intergroup comparison showed that，they were much faster in the observation group compared with those of the control group（P<0.05）.Post-intervention grading of muscle tension improved significantly compared with the baseline level in both groups（P<0.05）.Furthermore，the grading of muscle tension after treatment in observation group was better than that of the control group（P<0.05）.Post-intervention scores of exercise and self-care action domains increased significantly in both groups compared with the baseline levels（P<0.05）.Moreover，intergroup comparison showed that，they were significantly higher in the observation group than those of the control group（P<0.05）.The overall response rate in observation group was significantly higher than that in control group 〔94.3%（33/35） vs 77.1%（27/35）〕（P<0.05）.Conclusion　Acupuncture combined with electromyographic biofeedback therapy for children with severe HFMD complicated with dystonia caused by central nervous system impairment can improve the neuroelectrophysiological indicators，muscle strength and motor function，showing remarkable efficacy.

Key words: Hand, foot and mouth disease；Central nervous system；Muscle hypertonia；Muscle hypotonia；Acupuncture points；Electromyographic feedback

摘要： 背景　中枢神经系统受损致肌张力异常是小儿重症手足口病（HFMD）常见并发症，其治疗及康复已成为临床关注重点。目的　观察针刺联合肌电反馈疗法治疗重症HFMD并中枢神经系统受损致肌张力异常的临床疗效，旨在为临床提供参考。方法　收集郑州大学附属儿童医院于2015年3月—2018年3月收治的70例重症HFMD并中枢神经系统损害致肌张力异常患儿的临床资料。根据不同康复治疗方式将患儿分为观察组与对照组，各35例。对照组进行常规康复训练；观察组在对照组基础上，采用针刺结合肌电反馈治疗。连续观察8周，比较两组患儿治疗前后神经电生理指标〔股神经、胫神经、腓神经感觉神经传导速度（SCV）、运动神经传导速度（MCV）〕，肌张力分级，残疾儿童综合功能评定（CFA-DC）量表中的运动、自理动作评分，临床疗效。结果　治疗后观察组患儿股神经、胫神经、腓神经SCV、MCV快于对照组（P<0.05）；两组患儿治疗后股神经、胫神经、腓神经SCV、MCV快于同组治疗前（P<0.05）。治疗后观察组患儿肌张力分级优于对照组（P<0.05）；两组患儿治疗后肌张力分级优于同组治疗前（P<0.05）。治疗后观察组患儿运动、自理动作评分高于对照组（P<0.05）；两组患儿治疗后运动、自理动作评分高于同组治疗前（P<0.05）。观察组患儿总有效率为94.3%（33/35），高于对照组的77.1%（27/35），差异有统计学意义（P<0.05）。结论　针刺联合肌电反馈疗法用于重症HFMD并中枢神经系统受损致肌张力异常患儿，能改善患儿神经电生理指标、肌张力及运动功能，疗效显著。

关键词: 手足口病, 中枢神经系统, 肌张力过强, 肌张力过低, 针刺穴位, 肌电反馈