Cui Yinjie, Song Xiaojuan, Wang Qian, Wang Wenchun, Zhang Anren
College of Acupuncture and Massage, Tianjin University of TCM, Tianjin 300193, China.
Department of Acupuncture and Moxibustion, The 309th Hospital of PLA China.
Zhongguo Zhen Jiu. 2018 May 12;38(5):4833-9. doi: 10.13703/j.0255-2930.2018.05.009.
To compare the effects of "paraplegic triple needling" and conventional needling on psychological and daily living ability of patients with spinal cord injury.
A total of 50 patients with spinal cord injury were randomized into an observation group and a control group, 25 cases in each one. Rehabilitation training was applied in the two groups. In the observation group, on the basis of rehabilitation training, "paraplegic triple needling" was added, namely, puncturing the governor vessel (GV) and back- points respectively in the upper and lower segments of the injury plane and locating the key muscle movement points of the lower extremities by the peripheral nerve electrical stimulation device. Electroacupuncture (EA) was given at the points up and down the two sections of the GV points, back- points, the key muscle movement points. In the control group, conventional needling was applied at the points of GV, back- points, Huantiao (GB 30), Zusanli (ST 36), Xuanzhong (GB 39) and Yanglingquan (GB 34). The treatment was given once a day, the treatment for a month as one course and a total of 2 course were required. In addition, 25 health checkers were selected at the physical examination center of General Hospital of Chengdu Military Region as a normal control group. The content of peripheral serum 5-hydroxy tryptamine (5-HT) was tested before treatment, 1 course and 2 courses of treatment, The modified Barthel index (MBI) was used to observe the daily living activities, the Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to evaluate the psychological status.
In the two groups, the content of serum 5-HT was lower than that in the normal control group before treatment (both <0.05). After one course of treatment, the MBI score and content of serum 5-HT were all increase in the two groups; the HAMA score and HAMD score were all reduced (all <0.05); the results in the observation were better than those in the control group (all <0.05). After 2 courses of treatment, the MBI score and content of serum 5-HT were all increased in the two groups, and the HAMA score and HAMD score were all reduced (all <0.05), but the difference was not significant statistically between the two groups (all >0.05). Pearson correlation analysis showed that the content of serum 5-HT in patients with spinal cord injury was negatively correlated with disease course, HAMA and HAMD score (all <0.05), and positively correlated with MBI score (<0.05).
There are differences in the content of serum 5-HT between the normal person and the patients with pinal cord injury. The content of serum 5-HT can early predict the depression and anxiety in patients with spinal cord injury. Compared with the conventional needling, "paraplegic triple needling" can improve depression and anxiety in the early stage and improve the daily living ability of patients with spinal cord injury.
比较“截瘫三联针”与传统针刺对脊髓损伤患者心理状态及日常生活能力的影响。
将50例脊髓损伤患者随机分为观察组和对照组,每组25例。两组均进行康复训练。观察组在康复训练基础上,加用“截瘫三联针”,即分别在损伤平面上下段针刺督脉及夹脊穴,并采用周围神经电刺激仪定位下肢关键肌肉运动点,于督脉上下两段穴位、夹脊穴、关键肌肉运动点处行电针治疗;对照组于督脉、夹脊穴、环跳(GB 30)、足三里(ST 36)、悬钟(GB 39)、阳陵泉(GB 34)处行传统针刺治疗。每日治疗1次,1个月为1个疗程,共治疗2个疗程。另选取成都军区总医院体检中心25名健康体检者作为正常对照组。分别于治疗前、治疗1个疗程、治疗2个疗程检测外周血清5-羟色胺(5-HT)含量;采用改良Barthel指数(MBI)观察日常生活活动能力;采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评估心理状态。
两组治疗前血清5-HT含量均低于正常对照组(均P<0.05)。治疗1个疗程后,两组MBI评分及血清5-HT含量均升高,HAMA评分及HAMD评分均降低(均P<0.05),且观察组各项指标改善情况优于对照组(均P<0.05)。治疗2个疗程后,两组MBI评分及血清5-HT含量均升高,HAMA评分及HAMD评分均降低(均P<0.05),但两组间差异无统计学意义(均P>0.05)。Pearson相关性分析显示,脊髓损伤患者血清5-HT含量与病程、HAMA及HAMD评分呈负相关(均P<0.05),与MBI评分呈正相关(P<0.05)。
正常人及脊髓损伤患者血清5-HT含量存在差异,血清5-HT含量可早期预测脊髓损伤患者的抑郁、焦虑情绪。与传统针刺相比,“截瘫三联针”能早期改善脊髓损伤患者的抑郁、焦虑情绪,提高其日常生活能力。