针刺结合康复训练治疗脑卒中后单侧空间忽略:随机对照研究  

Post-stroke unilateral spatial neglect treated with acupuncture and rehabilitation: a randomized controlled trial

作　　者：李艳丽[1] 徐基民[1,2] 刘兰群[1] 李明玉[1] 卢虎英[1] 陈洪雷[1] 李惠兰[1,2] 陈之罡[1,2] LI Yanli XU Jimin LIU Lanqun LI Mingyu LU Huying CHEN Honglei LI Huilan CHEN Zhigang(I. Department of TCM, Beijing Charity Hospital, China Rehabilitation Research Center, Beijing 100068, China Rehabilitation Medicine School, Capital Medical University, Beijing 100068)

机构地区：[1]中国康复研究中心北京博爱医院中医科,北京100068 [2]首都医科大学康复医学院,北京100068

出　　处：《中国针灸》2017年第9期913-917,924,共6页Chinese Acupuncture & Moxibustion

基　　金：中央级公益性科研院所基本科研业务费专项资金项目:2014-CZ-34

摘　　要：目的:观察"醒神益髓开窍"针刺结合康复训练治疗对脑卒中后单侧空间忽略的影响。方法:将脑卒中后伴有单侧空间忽略的40例患者随机分为观察组与对照组,每组20例。观察组行头部百会、四神聪、本神、神庭及双侧心、心包、肾经原穴+络穴的"醒神益髓开窍"取穴与常规循经取穴针刺结合康复治疗,对照组仅行常规循经针刺结合康复治疗,每天1次,每周5次,治疗8周后观察疗效。采用直线二等分试验等单侧空间忽略的指标、简易精神状态量表(MMSE)评分、简式Fugl-Meyer运动功能评定评分、改良Barthel指数指标对两组患者的单侧空间忽略的程度、认知功能、运动功能、日常生活活动能力进行评定。结果:治疗后两组患者单侧空间忽略指标(直线二等分试验、线段划销试验、画钟试验、平面图形临摹试验)及MMSE评分、简式Fugl-Meyer运动功能评定、改良Barthel指数均较疗前明显改善(均P<0.01);且观察组均比对照组改善明显(P<0.05,P<0.01)。结论:"醒神益髓开窍"针刺结合康复训练治疗能更有效减轻脑卒中后单侧空间忽略程度,并提高患者运动功能及日常生活自理能力。Objective To observe the impacts on post-stroke unilateral spatial neglect treated with acupuncture for＂regaining consciousness, benefiting marrow and opening orifices＂ and rehabilitation.Methods Forty patients of post-stroke unilateral spatial neglect were randomized into an observation group and a control group, 20 cases in each one. In the observation group, acupuncture was applied to the acupoints for＂regaining consciousness, benefiting marrow and opening orifices＂, named Baihui （GV 20）, Sishencong （EX-HN 1）, Benshen （GB 13）, Shenting （GV 24）, and the bilateralyuan-primary points andluo-connecting points of the heart meridian, pericardium meridian and kidney meridian, as well as the acupoints along the affected meridians. Additionally, the rehabilitation was provided. In the control group, acupuncture at the acupoints along the affected meridians and rehabilitation were adopted. The treatment was given once a day, 5 times a week. After 8 weeks of treatment the evaluation was made. the indexes of unilateral spatial neglect such as line bisection test, the score of the mini-mental state examination （MMSE）, the score of simple Fugl-Meyer motor function assessment and the modified Barthel indexes were adopted for the assessment of the severity of unilateral spatial neglect, cognitive function, motor function, and the activities of daily living.Results After treatment, the indexes of unilateral spatial neglect （line bisection test, line cancellation test, clock-drawing test and copying drawing test）, MMSE score, the simple Fugl-Meyer motor function assessment and modified Barthel indexes were all improved as compared with those before treatment in the two groups （allP〈0.01）. The improvements in the observation group were more obvious than those in the control group （P〈0.05,P〈0.01）.Conclusion The combination of acupuncture treatment for＂regaining consciousness, benefiting marrow and opening orifices＂ and rehabilitation much more effectively alleviates the severity o

关 键 词：脑卒中 单侧空间忽略 针刺疗法 康复 随机对照试验 

分 类 号：R743.3[医药卫生—神经病学与精神病学]