百会长留针治疗气虚血瘀型中风后认知功能障碍临床观察  

Clinical observation of long-time needle retaining at Baihui (GV 20) on post-stroke cognitive disorder of qi deficiency and blood stasis

作　　者：杨帆[1] 罗开涛[1] 杨喜兵[1] 任宏伟 高峰[1] 钱立锋[1] YANG Fan;LUO Katiao;YANG Xibing;REN Hongwei;GAO Feng;QIAN Lifeng(Department of Acupuncture and Moxibustion,Jiaxing TCM Hospital Affiliated to Zhejiang Chinese Medical University,Jiaxing 314001,China)

机构地区：[1]浙江中医药大学附属嘉兴市中医医院针灸推拿科,嘉兴314001

出　　处：《中国针灸》2018年第11期1151-1156,共6页Chinese Acupuncture & Moxibustion

基　　金：嘉兴市科技计划项目:2016 AY 23078

摘　　要：目的:观察百会穴长留针治疗气虚血瘀型中风后认知功能障碍的疗效。方法:将符合纳入标准的70例(3例脱失)气虚血瘀型中风后认知功能障碍患者随机分为观察组(34例)和对照组(33例)。对照组采用基础治疗,包括神经内科常规治疗及西医康复治疗;观察组在接受与对照组相同治疗的同时加用百会穴长留针(24 h),隔日1次,每周3次,共治疗4周。疗程结束后,观察两组患者治疗前后美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、简易精神状态检查量表(mini-mental state examination,MMSE)、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、气虚血瘀证候量表评分的变化,并比较两组的临床疗效。结果:治疗4周后,两组NIHSS评分均较治疗前降低(均P<0.01),MMSE、MoCA评分均较治疗前提高(P<0.05,P<0.01),且观察组评分优于对照组(均P<0.01)。两组治疗后气虚血瘀证候量表各项评分均较治疗前降低(均P<0.01);在气短乏力、面色白、舌苔脉象、头晕目眩方面,观察组优于对照组(均P<0.05),自汗方面组间比较差异无统计学意义(P>0.05)。观察组总有效率为94.1%(32/34),高于对照组的75.8%(25/33,P<0.05)。结论:在常规治疗基础上,百会穴长留针治疗气虚血瘀型中风后认知功能障碍安全有效。Objective To observe the clinical efficacy of long-time needle retaining at Baihui （GV 20） on post-stroke cognitive disorder of qi deficiency and blood stasis. Methods A total of 70 patients （3 cases dropping） with post-stroke cognitive disorder of qi deficiency and blood stasis were randomized into an observation group（34 cases） and a control group （33 cases）. Neurological routine treatment and western medicine rehabilitation therapy were given in the control group as the basic treatment, on the basis of the treatment as the control group, long-time needle retaining at Baihui （GV 20） was applied in the observation group. The treatment was given once every other day, 3 times a week for a total of 4 weeks. The National Institute of Health stroke scale （NIHSS）, mini-mental state examination （MMSE）, Montreal cognitive assessment （MoCA） and qi deficiency blood stasis syndrome scale score were observed before and after treatment, and the clinical efficacy was compared between the two groups. Results After 4 weeks of treatment, the NIHSS scores of the two groups were lower than those before treatment （both P0.01）, and the MMSE and MoCA scores were higher than those before treatment （P0.05, P0.01）, and the scores in the observation group were better than those in the control group （all P0.01）. After treatment, the scores of qi deficiency and blood stasis syndrome were lower than those before treatment （all P0.01）. The scores of the shortness of breath, facial color, tongue pulse and dizziness in the observation group were better than those in the control group （all P0.05）, there was no significant difference in the degree of spontaneous sweating between the two groups （P0.05）. The total effective rate was 94.1% （32/34） in the observation group, which was higher than 75.8% （25/33） in the control group （P0.05）. Conclusion Long-time needle retaining at Baihui （GV 20） is safe and effective in treating with post-stroke cognitive disorder of qi deficiency

关 键 词：中风后遗症 认知功能障碍 穴 百会 长留针法 督脉 

分 类 号：R246.6[医药卫生—针灸推拿学]