头皮针在治疗脑卒中过程中脑血流动力学的改变  

Cerebral hemodynamic changes in the treatment of stroke with scalp acupuncture

作　　者：谢蓓菁[1] 杨铭[2] 王松伟[2] 胡永善[2] 

机构地区：[1]复旦大学附属华山医院永和分院,上海200436 [2]复旦大学附属华山医院康复医学科,上海200040

出　　处：《成都医学院学报》2012年第4期540-543,共4页Journal of Chengdu Medical College

基　　金：上海市科委生物医药重大项目(NO:10DZ1950800)

摘　　要：目的观察不同治疗干预下脑卒中患者脑血流速度的变化,探讨头皮针治疗改善脑血流自动调节功能的作用及其途径。方法将60例明确诊断为脑卒中(缺血性脑梗死/脑实质出血)的患者,在应用相同运动疗法进行康复训练的基础上,随机分为两组(头皮针组和对照组),采用经颅多普勒超声(Transcranial Doppler,TCD),观察治疗期间患者颅内脑血流速度、搏动指数等的变化。结果 (1)头皮针组经15次治疗后TCD检测脑血管异常率有显著性下降(P<0.05),对照组虽有下降趋势,但差异无明显统计学意义(P>0.05);(2)两组患者第1次和第15次治疗前、后头皮针PI值均没有上升趋势(P>0.05);(3)头皮针组第1次和第15次治疗前、后大脑中动脉和大脑前动脉的Vm,Vs均显著提高(P<0.05),且第15次治疗前、后血流速度改变幅度较第1次治疗明显(P<0.05);(4)头皮针组第1次和第15次治疗前、后动脉血压无明显变化(P>0.05),但与对照组相比脉率增幅差异有统计学意义(P<0.05)。结论头皮针治疗能刺激脑血流自动调节,使血液循环发生重新分配,提高颈内动脉系颅内分支血流速度,增加脑血流量。Objective To observe the different treatment intervention in patients with cerebral blood flow velocity changes, focusing on scalp acupuncture treatment to improve the cerebral blood flow automatically and the potential mechanisms. Methods 60 cases of a clear diagnosis of stroke（ischemic stroke / brain hemorrhage）with the application of the same exercise therapy conducted on the basis of rehabilitation training, were randomly divided into two groups（parallel scalp acupuncture treatment group and the control group）, adopted by Transcranial Doppler （TCD） ,observed intracranial cerebral blood flow velocity, pulsatility index, and other changes during treatment. Results （1）TCD cerebral vascular anomaly detection in parallel scalp acupuncture treatment group was significant decreased（P〈0. 05）, the downward trend was also observed in the control group, but no significant statistical significance after treatment 15 times （P 〉 0. 05）. （2）PI values are not on the upward trend for parallel scalp acupuncture treatment group before and after the first and fifteenth time（P〉0.05）. （3）The middle cerebral artery and cerebral artery of Vm,Vs were significantly improved in parallel scalp acupuncture treatment group before and after the first and fifteenth time（P〈0.05）. The rate of change in velocity in the scalp acupuncture treatment group was unchanged（P〈0.05）. （4）Parallel scalp acupuncture treatment group showed no significant changes in arterial blood, pressure（P〉0.05）, but compared with the control group pulse rate increases are significant differences before and after on the first and fifth time（P〈0.05）. Conclusion Parallel scalp acupuncture therapy can stimulate cerebral blood flow automatically adjust to a re-distribution of blood circulation,improve the internal carotid artery branch of the intracranial blood flow velocity to increase cerebral blood flow. The mechanism may be to reduce cerebral vascular response, but required further study to confirm.

关 键 词：脑卒中 头皮针 脑血流 针灸 

分 类 号：R246[医药卫生—针灸推拿学]