急性脑卒中引发心肌酶谱变化及针刺干预效果  

Changes of myocardial zymogram induced by acute stroke and intervention of acupuncture

作　　者：吴敬[1] 傅立新[1] 赵红[1] 高淑红[1] 王伟志[1] 张建立[1] 李萍[1] 赵建国[1] 

机构地区：[1]天津中医学院第一附属医院针灸部,天津市300193

出　　处：《中国临床康复》2006年第7期1-3,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:分析急性脑卒中病变性质、部位与心肌酶谱变化的关系,并观察不同针刺方法对脑卒中引发心脏损伤患者心肌酶谱的影响。方法:①于2000-11/2003-02天津中医学院第一附属医院针灸部住院的急性脑卒中患者126例,纳入急性脑卒中引发心脏损伤患者108例,脑梗死患者72例,脑出血患者36例。均对治疗方案知情同意。随机将脑卒中后心脏损伤患者108例分为2组:针刺观察组和针刺对照组,每组54例。另选本院同期健康体检者50人为健康对照组,均对检测项目知情同意。②两组在常规治疗同时配合针刺治疗,针刺观察组以“醒脑开窍、清心通络”针刺为法,取穴以阴经穴、督脉穴为主,取穴:内关、人中、人迎、三阴交、风池、极泉、尺泽、合谷、委中。且针刺操作严格遵循手法量学标准进行;针刺对照组沿用传统“风取三阳”、“治痿独取阳明”的理论,取穴:神门、通里、膻中、间使、血海、肩、曲池、环跳、阳陵泉、昆仑,随证补泻。两组均从入院当天至第7天进行针刺干预,1次/d,施术后留针30min。③采用全自动生化分析仪测定针刺观察组、针刺对照组新发病及治疗1周后及健康对照组的肌酸肌酶及其同工酶、乳酸脱氢酶、α-羟丁酸脱氢酶活力。④计量资料差异比较采用单因素方差分析。结果:脑卒中后心脏损伤患者108例和健康者50人均进入结果分析。①脑出血患者心肌酶活力明显高于健康对照组(P<0.01);脑梗死患者心肌酶谱中仅肌酸激酶活力明显高于健康对照组(P<0.01);脑出血患者肌酸肌酶及其同工酶、乳酸脱氢酶活力明显高于脑梗死患者(P<0.01)。②左侧基底核、丘脑卒中患者其肌酸激酶及其同工酶活力明显高于右侧(P<0.01);脑干卒中患者的肌酸肌酶及其同工酶活力明显高于除右侧基底核、丘脑外的其他部位(P<0.01)。③治疗前针刺观察组和针刺对照组心肌酶活�AIM：To observe the relationship between character and location of lesion and the changes of myocardial zymogram in patients with acute stroke, and analyze the effects of different acupunctures on the changes of myocardial zymogram of patients with impairment of heart caused by stroke. METI-IODS： ① The experiment was completed in the Department of Acupuncture and Moxibustion, First Affiliated Hospital, Tianjin College of Traditional Chinese Medicine fi＇om November 2000 to February 2003. Among 126 patients with acute stroke, 108 patients had injury of heart, 72 had cerebral infarction, and 36 had cerebral hemorrhage. All patients were informed consent. Totally 108 patients with injury of heart were randomly divided into the acupuncture group and the control group with 54 in each group. Another 50 healthy subjects were selected as the healthy control group in the same hospital, and all subjects were also informed consent. ② Patients in the two groups were treated with general treatment associated with acupuncture at the same time. The manipulation of acupuncture referred to ＂activating brain and restoring consciousness, clearing heart-fire and dredging collaterals＂, and as the main acupunctures of yin meridians and Du meridian, other acupuncture points were selected in acupuncture group, such as Neiguan （PC 6）, Renzhong （DU 26）, Renying （ST 9）, Sanyinjiao （SP 6）, Fengchi （GB 20）, Jiquan （HT 1）, Chize （LU 5）, Hegu （LI 4）, and Weizhong （BL 40）. The manipulation of acupuncture referred to ＂wind selecting from three positive point, treating flaccidity and selecting yangming meridian＂, acupuncture points were selected in eontrol group, such as Shenmen （HT 7）, Tongli （HT 5）, Danzhong （RN 17）, Jianshi （PC 5）, Xuehai （SP 1）, Jianyu （LI 15）, Quchi （LI 11）, Huantiao （GB 30）, Yanglingquan （GB 34）, and Kunlun （BL 60）, Patients in the two groups were treated with acupuncture during the 7 days of administration, once a day, remaining the

关 键 词：针灸学 脑血管意外/针灸疗法 酶类/血液 针刺 

分 类 号：R245[医药卫生—针灸推拿学]