应用醒脑开窍针刺法对急性脑梗死超早期患者神经功能缺损的影响  

Influence of Xingnao Kaiqiao acupuncture therapy on neurologic impairment in super early acute cerebral infarction patients

作　　者：熊杰 陶盟[2] 张果忠 路明[3] 李兰原[3] 石学敏[3] 

机构地区：[1]武装警察部队医学院附属医院中医科康复理疗科,天津市300162 [2]天津中医学院中医系,天津市300193 [3]天津中医学院第一附属医院,天津市300193

出　　处：《中国临床康复》2005年第37期4-5,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨“醒脑开窍”针刺法对急性脑梗死超早期患者神经功能恢复的干预作用。方法:选择2004-08/12于天津中医学院第一附属医院针灸科病房住院的脑梗死患者69例,均自愿参加观察。依据发病时间分为2组,超早期组38例(发病时间≤6h)、急性期组31例(发病时间24～72h)。两组患者在西医对症治疗基础上,均加用“醒脑开窍”针刺法,以″醒脑开窍、滋补肝肾为主,疏通经络为辅″为治则,主穴为人中、内关、三阴交、极泉、尺泽、委中。2次/d,10d为1个疗程,休息1天,共治疗2个疗程。分别观察两组患者治疗前及治疗7,14,21d后的疗效、中医辨证分型及发病次数与疗效间的关系,根据治疗后缺损分值的降低率进行疗效评定。显效:神经功能缺损评分减少46%～100%;好转:神经功能缺损评分减少18%～45%;无效:神经功能缺损评分减少≤17%。结果:69例脑梗死患者全部进入结果分析,无脱落。①两组患者的临床疗效比较:治疗后14d,超早期组的显效率显著高于急性期组犤42.11%,12.90%(χ2=5.60,P﹤0.05)犦;超早期组的有效率显著高于急性期组犤77.32%,58.06%(χ2=5.51,P<0.05)犦。治疗后21d,超早期组的显效率显著高于急性期组犤76.32%,51.61%(χ2=5.51,P<0.05)犦。②两组患者临床证型及发病次数与疗效的关系:各证型间疗效比较差异无显著性意义(P>0.05);首次发病患者与复发患者疗效比较,差异无显著性意义(P>0.05)。结论:急性脑梗死超早期患者在发病6h内应用“醒脑开窍”针刺法有助于神经功能缺损的恢复。AIM：To explore the intervention effect of Xingnao Kaiqiao therapy on neural functional restoration in patients with super early acute cerebral infarction. METHODS：Sixty-nine patients with cerebral infarction,who were hospitalized at the Department of Acupuncture and Moxibustion,First Affiliated Hospital, Tianjin University of Traditional Chinese Medicine from August to December 2004,were selected,and they all agreed to take part in the experiment. According to the courses of the disease, 69 cases were divided into two groups, 38 cases in super early period group （course of disease ≤ 6 hours） and 31 cases in acute period group （course of disease between 24 and 72 hours）.Xingnao Kaiqioo therapy was applied on the basis of symptomatic treatment of western medicine in patients in the two groups, which the principle was activating the brain and opening the orifice, nourishing both the liver and kidney mainly, and smoothing the channel and collateral secondarily,and its main points were Renzhong （DU 26）, Neiguan （PC 6）, Sanyinjioo （SP 6）, Jiquan （HT 1）, Chize （LU 5）, Weizhong （BL 40）, two times each day, ten days as one course, resting for 1 day, totally for two courses. The curative effects, dialectic typing of traditional Chinese medicine with relation between number of episode and curative effects in patients of the two groups were observed before treatment, after treatment for 7,14 and 21 days. Effect was evaluated according to the decrease rate of deficit scale post- treatment. Effective： The scale decreased by 46%-100%; Improvement： decreased by 18%-45%; Invalid： decreased by ≤ 17%. RESULTS： Totally 69 patients with cerebral infarction were involved in the result analysis,without drop. ① Comparison of clinical effect： Apparent effect was higher significantly in the super early period group than that in the acute period group[42.11%, 12.90% （x^2=5.60,P〈0.05 ffter treatment for 14 days;Efficiency in the super early period grtp was higher significantly than tha

关 键 词：脑梗塞 醒脑开窍 针刺疗法 

分 类 号：R743[医药卫生—神经病学与精神病学]