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对侧针刺治疗急性缺血性脑卒中偏瘫

Contra-lateral needling in the treatment of hemiplegia due to acute ischemic stroke.

作者信息

Gao Huanmin, Gao Xia, Liang Guixia, Ma Ben-Xu

机构信息

Department of Neurology, People's Hospital ofNingxia Hui Autonomous Region, PR China.

出版信息

Acupunct Electrother Res. 2012;37(1):1-12. doi: 10.3727/036012912x13831831256041.

Abstract

Contra-lateral Needling, a traditional acupuncture technique, means contra-lateral acupuncture by inserting needles into acupoints on the relative healthy side of the body opposite to the injured side to treat diseases such as apoplexy with high efficacy. However, there are not many well-designed and controlled clinical evidences found in the literature. Therefore the present study was designed to assess its therapeutic responses in the treatment of hemiplegia due to acute ischemic stroke. A clinical study was conducted with randomly selected 106 patients who have acute ischemic stroke confirmed by MRI. The subjects were assigned into 3 groups: 45 in the contra-lateral needling group received acupuncture on the unaffected limbs; 45 in the conventional acupuncture group received acupuncture on the hemiplegic limbs; and 16 in the non-acupuncture group received the similar medical and nursing care as subjects in other two groups but no acupuncture treatment. Acupuncture was given daily for 45 minutes for 30 days. The clinical therapeutic responses rate, Neurological Deficits Score (NDS), Modified Barthel Index (MBI) and Fugl-Meger Assertion (FMA) were used to evaluate the effectiveness of 30 days treatment. The therapeutic response rate of the contra-lateral needling group was 46.67%, while 31.11% in the conventional acupuncture group, and 18.75% in the non-acupuncture group. The NDS of Contra-lateral needling group decreased more significantly than that of the conventional acupuncture group (p < 0.01). The study also found that the MBI and FMA of Contra-lateral needling group increased more significantly than those of the conventional acupuncture group (p < 0.01, respectively). Contra-lateral needling might be more effective than the conventional acupuncture in the treatment of hemiplegia due to acute ischemic stroke in terms of increasing the recovery of neurological functions, promoting ADL (activities for daily living) rehabilitation and the limbs motor function.

摘要

巨刺针法是一种传统针刺技术,是指通过针刺身体患侧相对健康一侧的穴位来进行对侧针刺,以治疗中风等疾病,疗效显著。然而,文献中发现的设计良好且有对照的临床证据并不多。因此,本研究旨在评估其对急性缺血性中风所致偏瘫的治疗反应。对随机选取的106例经MRI确诊为急性缺血性中风的患者进行了一项临床研究。受试者被分为3组:45例在巨刺组,针刺健侧肢体;45例在传统针刺组,针刺偏瘫肢体;16例在非针刺组,接受与其他两组受试者相似的医疗和护理,但不进行针刺治疗。每天针刺45分钟,共30天。采用临床治疗反应率、神经功能缺损评分(NDS)、改良Barthel指数(MBI)和Fugl-Meger评定法(FMA)来评估30天治疗的有效性。巨刺组的治疗反应率为46.67%,而传统针刺组为31.11%,非针刺组为18.75%。巨刺组的NDS下降比传统针刺组更显著(p<0.01)。研究还发现,巨刺组的MBI和FMA升高比传统针刺组更显著(分别为p<0.01)。在促进神经功能恢复、促进日常生活活动(ADL)康复和肢体运动功能方面,巨刺针法治疗急性缺血性中风所致偏瘫可能比传统针刺更有效。

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