电针与手针治疗脑卒中痉挛性瘫痪效应差异研究  

Comparative study on effects between electroacupuncture and acupuncture for spastic paralysis after stroke

作　　者：岳增辉[1] 李良[1] 常小荣[1] 姜京明[1] 陈乐乐[1] 朱小姗[1] 

机构地区：[1]湖南中医药大学针灸推拿学院,长沙410208

出　　处：《中国针灸》2012年第7期582-586,共5页Chinese Acupuncture & Moxibustion

基　　金：湖南省自然科学基金项目:11JJ6080;湖南省高校创新平台开放基金项目:10K046;湖南省科技计划项目:2010JT4015;湖南省中医药科研计划重点项目:2008004;湖南省研究生科研创新项目:CX2011B344

摘　　要：目的:比较电针与手针治疗脑卒中痉挛性瘫痪的疗效差异,并探讨其作用机制。方法:将64例患者随机分为电针组(33例)和手针组(31例)。两组均采用Bobath易化技术康复和药物治疗,均穴取偏瘫侧曲池、合谷、阳陵泉、三阴交等,留针30min,手针组在留针期间行手法运针1min,电针组在手针针刺基础上行电针疗法。运用脑卒中残损评定法(Stroke Impairment Assessment Set,SIAS)评定脑卒中后整体功能状况,观察治疗前后血清谷氨酸(Glu)、γ-氨基丁酸(GABA)的含量,并比较两组疗效。结果:治疗后两组SIAS评分均显著提高(均P<0.01),且电针组优于手针组(P<0.01);两组治疗后血清Glu的含量及Glu/GABA值均降低(均P<0.01),血清GABA的含量均升高(均P<0.01),且电针组指标的改善程度优于手针组(P<0.01,P<0.05);电针组总有效率为90.9%(30/33),手针组为83.9%(26/31),电针组疗效优于手针组(P<0.05)。结论:在手针基础上加用电针可提高脑卒中痉挛性瘫痪的临床疗效,其作用机制可能与调节血清中的Glu、GABA含量有关。Objective To observe the differences of therapeutic effect of spastic paralysis after stroke between electroacupuncture and acupuncture and explore the mechanism. Methods Sixty-four cases were randomly divided into an electroacupuncture group （n=33） and an acupuncture group （n=31）. Both groups were treated with Bobath facilitation techniques and medicine treatments. Quchi（LI11）, H egu （LI 4）, Yanglingquan （GB 34）, San yinjiao（SP 6） ,et al. on the affected side were selected in each group. The needle was retained for 30 min, and the manipulation was applied for 1 rain in the acupuncture group, and electroacupuncture was added in the electroacupuncture group. Stroke Impairment Assessment Set （SIAS） was adopted to assess the whole function status af ter sroke, and the contents of glutamate（Glu） and 7-aminobutyric acid（GABA） in serum and clinical efficacy were observed in the two groups. Results The SIAS score increased after treatment as compared with that before treatment in either group（ both P〈0.01）, and the electroacupuncture group was superior to the acupuncture group （P〈0.01）： the content of Glu in blood serum and ratio of Glu/GABA reduced ,while the content of GABA in serum increased after treatment as compared with those before treatment in either group（all P〈0.01）, but the improvement of above indices were much more apparently in the electroacupuncture group as compared with those in the acupuncture group（P〈0.01, P〈0.05）the total effective rate of 90.9%（30/33）in the electroacupuncture group was superior to that of 83.9%（26/31）in the acupuncture group （P〈0.05）. Conclusion Electroacupuncture can improve therapeutic effect of spastic paralysis after stroke, it＇s mechanism may be ralated to ajusting the contents of Glu and GABA in serum.

关 键 词：脑卒中 痉挛性瘫痪 针刺疗法 电针 

分 类 号：R246.6[医药卫生—针灸推拿学]