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[不同针刺治疗对脑梗死所致偏瘫患者患侧大脑中动脉平均血流速度及偏瘫康复的影响]

[Effects of different acupuncture treatment on mean blood flow velocity of middle cerebral artery on the affected side and rehabilitation of hemiparalysis caused by cerebral infarction].

作者信息

Lei Long-Ming, Wu Lin, Hu Yue-Qiang, Luo Ben-Hua, Huang Jin-Jun, Su Sheng-Yong, Tang Hong-Liang

机构信息

Hubei College of TCM, Wuhan 430065, China.

出版信息

Zhongguo Zhen Jiu. 2009 Jul;29(7):517-20.

Abstract

OBJECTIVE

To observe the effects of two different acupuncture treatment on cerebral blood flow velocity and early rehabilitation of hemiparalysis caused by cerebral infarction.

METHODS

Eighty patients were randomly divided into an alternate acupuncture group (n = 40) and a routine acupuncture group (n = 40). Both of the groups were treated with routine neurology medicine and application of good limb position combined with acupuncture. The patients in the alternate acupuncture group were treated by opposing needling and non-opposing needling, i. e. acupuncture at acupoints on both the healthy and affected sides alternately, twice each day, respectively. The routine acupuncture group was treated by acupuncture at the affected side, once daily. Scores of Scandinavian Stroke Scale (SSS) were evaluated before and after treatment in the two groups, and the mean blood flow velocity of middle cerebral artery (MCA) on the affected side was monitored during two different acupuncture treatment by using Transcranial Doppler (TCD).

RESULTS

The cured and markedly effective rate was 65.0% in the alternate acupuncture group and 37.5% in the routine acupuncture group with a significant difference between the two groups (P < 0.01). After treatment, the SSS score in the alternate acupuncture group was significantly lower than that in the routine acupuncture group (P < 0.01). The mean blood flow velocity of MCA during two different acupuncture treatment was both decreased significantly (both P < 0.05) and the mean blood flow velocity of MCA before the last treatment was decreased significantly in the alternate acupuncture group than those in the routine acupuncture group (P < 0.05).

CONCLUSION

The therapeutic effect of the alternate acupuncture program for hemiparalysis caused by cerebral infarction is superior to that of the routine acupuncture program. It is suggested that the mechanism of acupuncture in treating hemiparalysis caused by cerebral infarction is to dilate cerebral blood vessels and improve cerebral perfusion.

摘要

目的

观察两种不同针刺疗法对脑梗死所致偏瘫患者脑血流速度及早期康复的影响。

方法

将80例患者随机分为交替针刺组(n = 40)和常规针刺组(n = 40)。两组均给予神经内科常规药物治疗,良肢位摆放,并配合针刺治疗。交替针刺组采用对侧与非对侧针刺法,即双侧穴位交替针刺,每日各2次。常规针刺组仅针刺患侧穴位,每日1次。两组治疗前后均采用斯堪的纳维亚卒中量表(SSS)评分,并在两种不同针刺治疗期间,应用经颅多普勒(TCD)监测患侧大脑中动脉(MCA)平均血流速度。

结果

交替针刺组总有效率为65.0%,常规针刺组为37.5%,两组比较差异有统计学意义(P < 0.01)。治疗后,交替针刺组SSS评分明显低于常规针刺组(P < 0.01)。两种不同针刺治疗期间,两组患侧MCA平均血流速度均明显下降(均P < 0.05),且交替针刺组末次治疗前患侧MCA平均血流速度下降幅度明显大于常规针刺组(P < 0.05)。

结论

交替针刺方案治疗脑梗死所致偏瘫的疗效优于常规针刺方案。提示针刺治疗脑梗死所致偏瘫的机制可能是扩张脑血管,改善脑灌注。

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