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[交叉电项针疗法对脑出血气管切开术后患者咳嗽反射的重塑:一项随机对照试验]

[Remodeling of cross electro-nape-acupuncture on cough reflex in patients with tracheotomy after cerebral hemorrhage: a randomized controlled trial].

作者信息

Cai Guo feng, Shang Lilii, Liu Kai, Zhao Hui, Quan Aijun, Yan Chenghai, Sun Hong, Li Xinjian, Zhuang Zhe

出版信息

Zhongguo Zhen Jiu. 2015 Jan;35(1):3-6.

Abstract

OBJECTIVE

To observe the effects of cross electro-nape-acupuncture on reflex remodeling of airway protective reflex cough in patients with tracheotomy after cerebral hemorrhage.

METHODS

With the method of completely random design, according to treatment order, 60 patients who received tracheotomy after cerebral hemorrhage accompanied with cough reflex difficulty were randomly divided into a cross electro-nape-acupuncture group and an acupuncture group, 30 cases in each group. Both groups were treated with basic treatment, including anti-inflammation, eliminating phlegm, improving cerebral metabolism and so on. The acupuncture group was treated with acupuncture at Yifeng (TE 17), Fengchi (GB 20), Lianquan (CV 23), Baihui (GV 20), Touwei (ST 8), Dicang (ST 4) through Jiache (ST 6), Hegu (LI 4), Quchi (LI 11), and motor area on the affected side, and the needles were retained for 30 min. Based on the treatment of acupuncture group, the cross electro-nape-acupuncture group was additionally treated with cross electro-nape-acupuncture (continuous wave) for 30 min per treatment. The treatment was both given twice a day from Monday to Friday and once a day on Saturday and Sun day for 4 weeks. Tracheostomy cough reflex grading score (TCRGS) and clinical pulmonary infection score (CPIS) were observed before and after treatment in the two groups, and the clinical efficacy of two groups was evaluated.

RESULTS

Compared before the treatment, TCRGS and CPIS were both reduced in two groups (both P < 0.01); after treatment, there were significant differences of TCRGS and CPIS between two groups (both P < 0.01), indicating cross electro-nape-acupuncture group was superior to acupuncture group. Regarding the effects of cough reflex remodeling, the cured and markedly effective rate was 96.7% (29/30) in the cross electro-nape-acupuncture group, which was significantly different from 55.2% (16/29) in the acupuncture group (P < 0.01).

CONCLUSION

Cross electro-nape-acupuncture could effectively improve the remodeling of cough reflex and promote the recovery of lung infection in patients with tracheotomy after cerebral hemorrhage, leading to an increased quality of life.

摘要

目的

观察交叉电项针治疗脑出血后气管切开患者气道保护性反射咳嗽反射重塑的效果。

方法

采用完全随机设计方法,按照治疗顺序,将60例脑出血后气管切开伴咳嗽反射障碍的患者随机分为交叉电项针组和针刺组,每组30例。两组均给予基础治疗,包括抗炎、祛痰、改善脑代谢等。针刺组针刺翳风(TE 17)、风池(GB 20)、廉泉(CV 23)、百会(GV 20)、头维(ST 8)、地仓(ST 4),通过颊车(ST 6)、合谷(LI 4)、曲池(LI 11)及患侧运动区,留针30分钟。交叉电项针组在针刺组治疗基础上,加用交叉电项针(连续波)治疗,每次30分钟。治疗均为周一至周五每天2次,周六和周日每天1次,共4周。观察两组治疗前后气管切开咳嗽反射分级评分(TCRGS)和临床肺部感染评分(CPIS),并评价两组临床疗效。

结果

与治疗前比较,两组TCRGS和CPIS均降低(均P<0.01);治疗后,两组TCRGS和CPIS比较差异有统计学意义(均P<0.01),表明交叉电项针组优于针刺组。在咳嗽反射重塑效果方面,交叉电项针组治愈显效率为96.7%(29/30),与针刺组的55.2%(16/29)比较差异有统计学意义(P<0.01)。

结论

交叉电项针能有效改善脑出血后气管切开患者咳嗽反射重塑,促进肺部感染恢复,提高生活质量。

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