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十二经筋肌肉区与对侧针刺疗法交互治疗中风后动眼神经麻痹的临床观察

[Clinical observation on post-stroke oculomotor nerve palsy treated with the interaction of twelve meridian muscle regions and contralateral needling therapy].

作者信息

Liu Xiao-Xin, Wu Jiang-Ying, Zhao Ying

机构信息

Clinic Department of Acupuncture-Moxibustion, First Teaching Hospital of Tianjin University of TCM/National Clinical Medical Research Center of Acupuncture-Moxibustion in TCM, Tianjin 300000, China.

Department of TCM, Tianjin Huanhu Hospital.

出版信息

Zhongguo Zhen Jiu. 2020 Aug 12;40(8):805-9. doi: 10.13703/j.0255-2930.20190514-k0006.

Abstract

OBJECTIVE

To observe the clinical effect on post-stroke oculomotor nerve palsy treated with the interaction of twelve meridian muscle regions and contralateral needling therapy.

METHODS

A total of 46 patients with post-stroke oculomotor nerve palsy were randomized into an observation group and a control group, 23 cases in each one. In the control group, the intramusclar injection of mecobalamine at the buttock region was given, 1 mL each time, once every two days, 3 times weekly. Besides, citicoline sodium capsules were prescribed for oral administration, 0.2 g each time, 3 times daily. In the observation group, on the base of the treatment as the control group, the interaction of twelve meridian muscle regions and contralateral needling therapy was supplemented. Acupoints on the health sides included Juliao (ST 3) and Hanyan (GB 4), acupoints on the affected side included Jingming (BL 1), Sibai (ST 2), Yangbai (GB 14), Cuanzhu (BL 2), Shangming (Extra), Sizhukong (TE 23), Tongziliao (GB 1) and bilateral Fengchi (GB 20), Quchi (LI 11), Pianli (LI 6), Waiguan (TE 5), Hegu (LI 4) were selected. The needles were retained for 30 min in each acupuncture treatment, once a day, 5 times weekly. The treatment for 4 weeks was required in the two groups. Before and after treatment, the score of cervical range of motion (CROM), pupil size, eye fissure width and eyeball mobility were observed in the patients of the two groups. The clinical effect was evaluated in the two groups.

RESULTS

After treatment, CROM scores and pupil size were reduced in the patients of the two groups (<0.05), and the values in the observation group were lower than the control group (<0.05). The eye fissure width and eyeball mobility were increased in the two groups (<0.05), the eye fissure width and the mobility of the muscles of rectus internus, inferior rectus and inferior oblique in the observation group were larger than the control group (<0.05). The effective rate was 82.6% (19/23) in the observation group, higher than 65.2% (15/23) in the control group (<0.05).

CONCLUSION

The interaction of twelve meridian muscle regions and contrallateral needling therapy effectively relieves diplopia, pupil dilation, narrow eye fissure and limited eyeball mobility in the patients with post-stroke oculomotor nerve palsy.

摘要

目的

观察十二经筋肌区与对侧针刺疗法交互应用治疗中风后动眼神经麻痹的临床疗效。

方法

将46例中风后动眼神经麻痹患者随机分为观察组和对照组,每组23例。对照组在臀部肌内注射甲钴胺,每次1 mL,每两天1次,每周3次。此外,口服胞磷胆碱钠胶囊,每次0.2 g,每日3次。观察组在对照组治疗的基础上,补充十二经筋肌区与对侧针刺疗法。健侧穴位选取巨髎(ST 3)、颔厌(GB 4),患侧穴位选取睛明(BL 1)、四白(ST 2)、阳白(GB 14)、攒竹(BL 2)、上明(奇穴)、丝竹空(TE 23)、瞳子髎(GB 1),双侧选取风池(GB 20)、曲池(LI 11)、偏历(LI 6)、外关(TE 5)、合谷(LI 4)。每次针刺留针30分钟,每日1次,每周5次。两组均需治疗4周。观察两组患者治疗前后颈部活动度(CROM)评分、瞳孔大小、睑裂宽度及眼球活动度,并评价两组临床疗效。

结果

治疗后,两组患者CROM评分及瞳孔大小均降低(P<0.05),且观察组低于对照组(P<0.05)。两组睑裂宽度及眼球活动度均增加(P<0.05),观察组睑裂宽度及内直肌、下直肌、下斜肌的活动度大于对照组(P<0.05)。观察组有效率为82.6%(19/23),高于对照组的65.2%(15/23)(P<0.05)。

结论

十二经筋肌区与对侧针刺疗法交互应用能有效缓解中风后动眼神经麻痹患者的复视、瞳孔散大、睑裂狭窄及眼球活动受限。

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