Department of Traditional Chinese Medicine, Xijing Hospital, the Air Force Medical University, Xi'an, 710032, China.
Acupuncture Research Center, Tianjin University of traditional Chinese Medicine, Tianjin, 301617, China.
Chin J Integr Med. 2021 Aug;27(8):570-577. doi: 10.1007/s11655-020-3093-8. Epub 2020 Sep 11.
To assess the effect and safety of bloodletting puncture at hand twelve Jing-Well points (HTWPs) in acute stroke patients with conscious disturbance.
In this multi-center and randomized controlled trial, 360 patients suffered from ischemic or hemorrhagic stroke with conscious disturbance within 48 h from the onset of symptom were divided into bloodletting (180 cases) and control (180 cases) groups using a block randomization. Patients in both groups received routine Western medicine, and patients in the bloodletting group received additional bloodletting puncture at HTWPs on admission immediately before conventional treatment. The primary outcome measure was Glasgow Coma Scale (GCS) score and the secondary outcomes included blood pressure, respiratory rate and pulse rate. All variables were evaluated at baseline (before bloodletting), 0 (after bloodletting immediately), 15, 30, 50 and 80 min post bloodletting.
At 80 min post bloodletting, the proportion of patients with improved consciousness in the bloodletting group was greater than the control group (P<0.05). In the separate analysis of moderate consciousness disturbance subgroup, bloodletting therapy benefited ischemic patients, and improved the eye and language response of GCS score at 15, 30, 50, 80 min post bloodletting (P<0.05 or P<0.01). No significant differences were observed regarding the secondary outcomes between two groups (P>0.05).
The bloodletting puncture at HTWPs was safe and could improve conscious levels of ischemic stroke patients, highlighting a first-aid intervention for acute stroke. (Registration No. ChiCTR-INR-16009530).
评估在意识障碍的急性脑卒中患者中，十二井穴放血对意识障碍的疗效和安全性。
本多中心、随机对照试验纳入了 360 例发病 48 h 内的缺血性或出血性脑卒中且伴有意识障碍的患者，采用区组随机分组方法将其分为放血组（180 例）和对照组（180 例）。两组患者均接受常规西药治疗，放血组患者在常规治疗前即刻接受十二井穴放血治疗。主要结局指标为格拉斯哥昏迷量表（GCS）评分，次要结局指标包括血压、呼吸频率和脉搏频率。所有变量均在基线（放血前）、放血即刻（0 分钟）、放血后 15、30、50 和 80 分钟进行评估。
放血后 80 分钟，放血组意识改善的患者比例大于对照组（P<0.05）。在中度意识障碍亚组的单独分析中，放血治疗有利于缺血性脑卒中患者，且能改善 GCS 评分的眼部和语言反应，在放血后 15、30、50 和 80 分钟时差异均有统计学意义（P<0.05 或 P<0.01）。两组患者的次要结局无明显差异（P>0.05）。
十二井穴放血是安全的，可改善缺血性脑卒中患者的意识水平，为急性脑卒中提供了一种急救干预措施。（注册号：ChiCTR-INR-16009530）。
