针刺对缺血性卒中患者血液凝血功能与脑血流及神经功能缺损症状的影响  

Effect of Acupuncture on Coagulation Function, Cerebral Blood Flow and Neurologic Deficit Symptoms in Ischemic Stroke Patients

作　　者：查天柱[1] 陈思宇[1] 董怡君 ZHA Tian-zhu;CHEN Si-yu;DONG Yi-jun(The Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第二附属医院

出　　处：《上海针灸杂志》2019年第12期1330-1334,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：新疆医科大学科研创新基金项目(XYDCX201517)

摘　　要：目的观察针刺对缺血性卒中患者血液凝血功能与脑血流及神经功能缺损症状的影响。方法选取缺血性卒中患者158例,随机分为观察组和对照组,每组79例。对照组给予西药常规治疗及常规康复训练,观察组在对照组治疗基础上加用针刺治疗。观察两组治疗前后中医证候评分、凝血功能、美国国立卫生研究院卒中量表(NIHSS)评分;采用动脉自旋标记(ASL)技术观察两组患者治疗前后脑血流变化情况,并检测两组相对脑血流量(rCBF);比较两组临床疗效。结果两组治疗前中医证候评分、NIHSS评分、凝血功能等指标比较差异无统计学意义(P>0.05);两组治疗后中医证候评分、NIHSS评分较治疗前显著降低,差异有统计学意义(P<0.05);两组治疗后APTT、D-D、rCBF较治疗前显著改善(P<0.05);观察组治疗后ASL正常灌注例数65例,显著高于对照组正常灌注数52例(P<0.05);观察组治疗后中医证候评分、NIHSS评分、APTT、D-D及rCBF水平显著优于对照组(P<0.05);观察组总有效率为91.1%,显著高于对照组的73.4%(P<0.05)。结论针刺疗法对缺血性卒中患者具有一定疗效,能显著改善患者凝血功能,干预脑血流低灌注症状,增加脑血流量,促进神经细胞修复及干细胞增殖,加快神经损伤修复,提高治疗总有效率。Objective To observe the effect of acupuncture on coagulation function,cerebral blood flow and neurologic deficit symptoms in patients with ischemic stroke.Method A total of 158 patients with ischemic stroke were recruited and randomized into an observation group and a control group,with 79 cases in each group.The control group was given conventional Western medications and rehabilitation training,and the observation group was additionally intervened by acupuncture treatment.The traditional Chinese medicine(TCM)symptom score,coagulation function,National Institute of Health Stroke Scale(NIHSS)score were evaluated before and after treatment;arterial spin labeling(ASL)technique was adopted to observe the changes in cerebral blood flow and the relative cerebral blood flow(rCBF)was determined;the clinical efficacies of the two groups were compared.Result There were no significant differences in the TCM symptom score,NIHSS score and coagulation function between the two groups before treatment(P>0.05).After treatment,the TCM symptom score and NIHSS score dropped significantly in the two groups(P<0.05).The activated partial thromboplastin time(APTT),D-dimer(D-D)and rCBF all showed significant improvement after treatment in both groups(P<0.05).After treatment,65 cases in the observation group had normal ASL perfusion imaging,significantly higher than 52 cases in the control group(P<0.05).After treatment,the improvements in the TCM symptom score,NIHSS score,APTT,D-D and r-CBF were more significant in the observation group than in the control group(P<0.05).The total effective rate was 91.1%in the observation group,significantly higher than 73.42% in the control group(P<0.05).Conclusion Acupuncture therapy can produce certain efficacy in treating ischemic stroke patients.It can markedly improve the coagulation function and cerebral hypoperfusion,increase cerebral blood flow,encourage nerve cell repair and stem cell proliferation,boost nerve injury repair and enhance the total effective rate.

关 键 词：针刺疗法 卒中 脑缺血 凝血功能 相对脑血流量 神经功能缺损 美国国立卫生研究院卒中量表评分 

分 类 号：R246.6[医药卫生—针灸推拿学]