通脑活络针刺疗法对急性脑梗死患者BI、NIHSS评分的影响  

Impacts of Tongnao Huoluo Acupuncture Therapy on BI and NIHSS of Patients with Acute Cerebral Infarction

作　　者：李继英[1] 赵杨[1] 张臻年[1] 王敬卿[1] 范刚启[1] 张晖[1] 黄迟[1] 刘孔江[1] 郭志力[1] 陆艳[1] 顾兆军[2] 顾成光 蒋晓林[4] 张红[5] 全亚萍[6] 陆卫卫 朱建军[8] 程韫炜[8] 蔡忠民 孙菊光 

机构地区：[1]南京中医药大学第三附属医院脑科,南京210001 [2]江苏省第二中医医院针灸科,南京210017 [3]连云港市中医医院脑科,江苏222004 [4]徐州市中心医院康复科,江苏221009 [5]无锡市中医医院神经科,江苏214001 [6]泰州市中医医院神经科,江苏225300 [7]南通市中医医院急诊科,江苏226001 [8]常州市中医医院神经科,江苏213003 [9]扬州市中医医院神经科,江苏225002 [10]徐州市中医院脑病中心,江苏221000

出　　处：《中国中西医结合杂志》2011年第1期28-32,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：南京市重大医学课题资助项目(No.ZKX0309)

摘　　要：目的评价通脑活络针刺疗法对急性脑梗死的疗效。方法采用多中心、随机、对照的研究方法,将10家医院397例脑梗死病例根据起病时间分配至≤6h(138例);6+～48h(140例);48+h～14d(119例)3个时间段。发病≤6h患者随机分为通脑活络针刺(针刺)组、溶栓组(尿激酶溶栓)、降纤组(巴曲酶降纤),其余两个时间段患者随机分为针刺组、体针组、常规治疗(常规)组。评价治疗后1、3、7、14、28、90d的美国国立卫生院卒中量表(NIHSS)评分及治疗后14、28、90d的独立生活能力量表(BI)指数变化。结果≤6h时间段针刺组和溶栓组疗效比较差异无统计学意义(P>0.05),与降纤组比较差异有统计学意义(P<0.01),其中90天时BI>95分的百分比,针刺组与溶栓组比较,差异无统计学意义(P>0.05)。针刺组与降纤组比较,差异有统计学意义(P<0.01);后两个时间段(发病时间6+～48h,发病时间48+h～14d),针刺组分别与体针、常规组比较,差异均有统计学意义(P<0.05),其中90天时BI>95分的百分比,针刺组与体针组比较,差异有统计学意义(P<0.01),针刺组与常规组比较,差异有统计学意义(P<0.01)。结论通脑活络针刺疗法在改善急性脑梗死患者致残程度及提高生活能力方面有较好疗效。Objective To evaluate the effect of Tongnao Huoluo Acupuncture （THA） therapy on acute cerebral infarction （ACI）. Methods Adopting multi-centered,randomized and controlled method,397 ACI patients from 10 hospitals subjected to the study were treated according to the initiating time （IT） of disease during hospitalization：the 138 patients of stage-1 with IT≤6 h,were randomly assigned to three groups,treated respectively with THA （Group A）,thrombolysis with urokinase （Group B） and Batroxobin （Group C）; the 140 patients of stage-2 with IT within 6-48 h,and 119 patients of stage-3 with IT within 48 h-14 d were randomly assigned to three groups,treated respectively with THA （Group D） body acupuncture （Group E）,and conventional treatment （Group F）. Therapeutic effect was evaluated by NIHSS scores estimated at the day 1,3,7,14,28 and 90 of treatment,and the Barthel Index （BI） measured at day 14,28 and 90. Results Effect in Group A was insignificantly different from that in Group B （P0.05）,but was different from that in Group C significantly （P0.01）. At day 90,the percentage of patients with high BI （HBI%,patients with BI95%） was insignificantly different in Group A vs B （P0.05）,but was significantly different in Group A vs C （P0.01）. Comparisons between Group D,E and F showed that the therapeutic effect in Group D was equivalent to that in Group E （P0.05）,but better than that in Group F （P0.01）,and HBI% in Group D was superior than that in the other two groups （P0.01）. Conclusions THA therapy shows favorable effects in reducing the crippling rate and improving the living capacity of ACI patients.

关 键 词：通脑活络针刺疗法 脑梗死 时间窗 

分 类 号：R246[医药卫生—针灸推拿学]