针刺对脑出血初期患者血压及血肿的影响  

Impacts of acupuncture on blood pressure and hematoma in patients of cerebral hemorrhage at the early stage

作　　者：陶文强[1] 方海云[2] 邹佐强 罗翌[1] 李尹凤[2] 

机构地区：[1]广州中医药大学,广东广州510450 [2]广州中医药大学附属北碚中医院

出　　处：《中国针灸》2014年第5期426-430,共5页Chinese Acupuncture & Moxibustion

摘　　要：目的:探讨针刺对高血压脑出血初期患者的治疗作用。方法:将54例小量脑出血患者随机分为针刺组和常规治疗组,各27例。常规治疗组予监护、氧疗、营养神经及对症支持治疗,必要时予脱水剂、降压药控制血压或手术治疗;针刺组在常规治疗组基础上予针刺曲池、内关、足三里、三阴交、太冲穴,分别于入院时、发病4h、6h和12h时针刺。全程血压监测,发病6h、24h时复查头颅CT,比较两组各时间段收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、颅内血肿变化以及神经功能缺损程度评分。结果:(1)血压:在入院至发病12h时段,常规治疗组SBP、DBP、MAP升高明显,针刺组SBP、DBP、MAP升高较低,组间SBP[(164.3±21.6)mmHg vs(158.6±21.5)mmHg]、MAP[(113.4±4.9)mmHg vs(106.7±6.1)mmHg]比较,差异有统计学意义(均P<0.05);发病12h至24 h,针刺组SBP[(147.3±21.6)mmHg vs(158.4±23.5)mmHg]、MAP[(97.2±5.3)mmHg vs(106.6±5.1)mmHg]较常规治疗组回落明显,差异有统计学意义(均P<0.05)。(2)血肿体积:入院至发病6h,针刺组为(2.67±0.33)mL,常规治疗组增加量为(4.15±0.73)mL,差异有统计学意义(P<0.05);入院至发病24h,针刺组为(3.14±1.18)mL,常规治疗组增加量为(5.57±1.26)mL,差异亦有统计学意义(P<0.05)。(3)神经功能缺损程度评分:两组发病3天内均逐渐上升,针刺组第1天评分(38.39±6.84)与常规治疗组(42.37±7.46)比较,差异有统计学意义(P<0.05);10天后评分针刺组(24.68±5.42)与常规治疗组(29.74±7.36)比较,差异亦有统计学意义(P<0.05)。结论:针刺组未出现明显血压升高高峰,24h内继续出血量较少,可改善神经功能缺损程度评分,针刺治疗对早期脑出血有积极意义。Objective To explore the therapeutic effect of acupuncture for hypertensive cerebral hemorrhage at the early stage. Methods Fifty-four cases of small-amount cerebral hemorrhage were randomized into an acupunc- ture group and a conventional treatment group, 27 cases in each one. In the conventional treatment group, special care, oxygen therapy, nerve nutrition and symptomatic support were applied. In necessary, dehydrant and hypo- tensive drugs were prescribed for antihypertension, or surgery was given. In the acupuncture group, on the basis of the treatment as the control group, acupuncture was applied at Quchi （LI 11）, Neiguan （PC 6）, Zusanli （ST 36）, Sanyinjiao （SP 6） and Taichong （LR 3）. Acupuncture was given at the admission, 4 h, 6 h and 12 h after disease onset respectively. Blood pressure was monitored in the whole procedure. 6 h and 24 h after disease onset, the cranial CT was re-examined. Systolic blood pressure （SBP）, diastolic blood pressure （DBP）, mean ar- terial pressure （MAP）, hematoma volume and neurological deficit score were compared at different time points be- tween the two groups. Results （1） Blood pressure., from the admission to 12 h after disease onset, SBP, DBP and MAP were increased apparently in the conventional treatment group and increased slightly in the acupuncture group. The differences in SBP [（164.3±21.6） mmHg vs （158.6±21.5） mmHg] and MAP [（113.4±4.9） mmHgvs （106.7±6. 1） mmHg] were significant between the two groups （both P〈0. 05）. From 12 h to 24 h after disease onset, compared with the conventional treatment group, SBP and MAP were decreased apparently in the acupuncture group [（147.3±21.6） mmHg vs （158.4±23.5） mmHg, （97.2±5.3） mmHg vs （106.6±5.1） mmHg, both P〈0.05）]. （2） Hematoma volume： from the admission to 6 h after disease onset, the volume was increased by （4.15±0.73） mL in the convertional treatment group and （2.67 ± 0. 33） mL in the acupuncture group, indicating the sig

关 键 词：脑出血 高血压 针刺疗法 血压 血肿 神经功能缺损 

分 类 号：R246.1[医药卫生—针灸推拿学]