Yu Nian-Tang, Han Wei, Zhang Ling, Zhu Ling-Ling, Wang Qing-Wei, Zhang Guo-Qing, Liu Bai-Yun
Tonglu County Hospital of TCM, Hangzhou 311500, Zhejiang Province, China.
Anhui Provicial Hospital of Acupuncture and Moxibustion, China.
Zhongguo Zhen Jiu. 2013 Nov;33(11):980-4.
To assess the clinical efficacy of acupuncture pretreatment for the prevention of stroke based on promoting the circulation of the Governor Vessel and regulating mentality, and explore its effect mechanism.
Seventy cases of transient ischemic attack (TIA) were randomized into an acupuncture group (35 cases) and a western medicine group (35 cases). In the acupuncture group, acupuncture therapy of promoting the circulation of the Governor Vessel and regulating mentality was applied at Yaoyangguan (GV 3), Mingmen (GV 4), Zhiyang (GV 9), Shenzhu (GV 12), Dazhui (GV 14), Yamen (GV 15), Fengfu (GV 16), Baihui (GV 20) and Neck-Jiaji (EX-B 2). Acupuncture was given 6 times a week, at the interval of one day between two weeks. Totally, 21 days of treatment were taken as a session. In the western medicine group, aspirin enteric coated tablets were prescribed, 25 mg/tablet, 100 mg/day, once a night for oral administration, and 21 days of medication were taken as 1 session. There were 3 days at the interval between two sessions in each group and totally 2 sessions were required. Transcranial Doppler (TCD) was adopted before treatment and in two sessions of treatment to observe, mean flow velocity (Vm) of middle cerebral artery (MCA), vertebral artery (VA), basilar arte ry (BA) and pulsatility index (PI). The standard of the efficacy assessment of stroke aura was taken as the main efficacy index in the assessment of theraputic effect, the adverse reaction was observed.
1In TIA, MCA blood flow was accelerated in internal carotid system, and BA blood flow was accelerated in vertebral-basilar artery system. The treatments in the two groups enabled the blood flow in the responsible blood vessels slow down and the results in the acupuncture group L(60. 54+/-11.76)cm/s, (36. 17+/-8. 65)cm/s] were better than those in the western medicine group [(72. 34+/-9. 15)cm/s,(65. 23 +/-8. 99)cm/s] (P<O. 05). 2The results of clinical efficacy and adverse reactions in the acupuncture group [96. 77% (30/31),6. 45% (2/31)] were superior to the western medicine group [75. 76%(25/33),45. 46%(15/33)] (both P<0. 05). 3Concerning to the recurrence of disease at the different period after treatment, the case number of cerebral infarction was not different significantly between the two groups (P>0. 05).
Acupuncture intervention based on promoting the circulation of the Governor Vessel and regulating mentality achieves the superior efficacy on TIA and less adverse reactions as compared with aspirin. The effect mechanism is related potentially to the improvement of cerebral vascular hemodynamic.
基于督脉通调、调神法评估针刺预处理预防脑卒中的临床疗效，并探讨其作用机制。
将70例短暂性脑缺血发作（TIA）患者随机分为针刺组（35例）和西药组（35例）。针刺组采用督脉通调、调神针刺法，选取腰阳关（GV 3）、命门（GV 4）、至阳（GV 9）\、身柱（GV 12）、大椎（GV 14）、哑门（GV 15）、风府（GV 16）、百会（GV 20）及颈夹脊（EX - B 2）穴。每周针刺治疗6次，每两周间隔1天。共治疗21天为1个疗程。西药组给予阿司匹林肠溶片，每片25 mg，100 mg/d，每晚1次口服，服药21天为1个疗程。两组均间隔3天进行第2个疗程，共进行2个疗程。治疗前及两个疗程治疗中采用经颅多普勒（TCD）观察大脑中动脉（MCA）、椎动脉（VA）、基底动脉（BA）的平均血流速度（Vm）及搏动指数（PI）。以脑卒中先兆疗效评定标准作为疗效评估的主要指标，观察不良反应。
基于督脉通调、调神法的针刺干预对TIA疗效优于阿司匹林，不良反应少。其作用机制可能与改善脑血管血流动力学有关。
