醒脑开窍针法结合脑电仿生电刺激对PVS患者诱发电位的影响  被引量:4

Effect of Xingnao Kaiqiao Acupuncture combined with EEG Biomimetic Electrical Stimulation on Evoked Potential of Patients with Persistent Vegetative State

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作  者:邓丽霞 刘吉权 章良翔 吕晓 陈星 冯毅刚 倪莹莹 DENG Lixia;LIU Jiquan;ZHANG Liangxiang;LV Xiao;CHEN Xing;FENG Yigang;NI Yingying(Guangdong 999 Brain Hospital,Guangzhou,Guangdong 510510,China)

机构地区:[1]广东三九脑科医院,广东广州510510

出  处:《康复学报》2020年第2期108-113,共6页Rehabilitation Medicine

基  金:广东省中医药局科研项目(20171045)。

摘  要:目的:观察醒脑开窍针法结合脑电仿生电刺激对持续植物状态(PVS)患者脑干听觉诱发电位(BEAP)及体感诱发电位(SEP)的影响。方法:选择广东三九脑科医院植物状态促醒中心收治的90例PVS患者,按照随机数字表法分为针刺组、仿生电组和联合组3组,每组30例。3组均给予常规治疗(包括用基础管理、高压氧治疗和药物治疗等)。此外,针刺组接受醒脑开窍针法治疗(主穴选水沟、双侧内关、双侧三阴交等穴位,辅穴选极泉、尺泽、委中等穴位),每日1次;仿生电组接受脑电仿生电刺激治疗,主电极放于完骨穴和天柱穴,每次治疗99 min后,休息30 min,再继续治疗99 min,每日1次;联合组接受醒脑开窍针法联合脑电仿生电刺激治疗,每日1次;3组均连续治疗30 d。治疗前1 d及结束治疗后1 d采用修订的昏迷恢复量表(CRS-R)评估3组患者意识状态,应用肌电诱发电位仪监测BAEP和SEP的分级及患侧各波潜伏期、间期的变化。结果:治疗前,3组CRS-R量表评分、BAEP和SEP分级、Ⅰ、Ⅴ波潜伏期及Ⅰ~Ⅴ波间期、P15、N20、P38波潜伏期比较无明显区别,差异无统计学意义(P>0.05)。与治疗前比较,3组治疗30 d后CRS-R评分明显升高,BAEP和SEP分级均明显降低,3组Ⅰ、Ⅴ波潜伏期及Ⅰ~Ⅴ波间期、P15、N20、P38波潜伏期均明显缩短,差异有统计学意义(P<0.05);治疗30 d后联合组CRS-R量表评分高于针刺组和仿生电组,BAEP和SEP分级均低于针刺组和仿生电组,差异均有统计学意义(P<0.05);治疗后联合组Ⅰ、Ⅴ波潜伏期及Ⅰ~Ⅴ波间期、P15、N20、P38波潜伏期较针刺组和仿生电组均明显缩短,差异有统计学意义(P<0.05)。结论:醒脑开窍针法结合脑电仿生电刺激有助于促进PVS患者意识恢复,能提高临床促醒疗效,一定程度上可改善PVS患者的SEP和BAEP。Objective: To observe the effect of Xingnao Kaiqiao acupuncture combined with EEG biomimetic electrical stimulation on brainstem auditory evoked potential(BEAP) and somatosensory evoked potential(SEP) in patients with persistent vegetative state(PVS). Methods: A total of ninety patients with PVS treated in the PVS awareness center of Guangdong 999 Brain hospital were randomly divided into Acupuncture group, Bionic electricity group and Combined group, with thirty cases in each group. All groups were given routine treatment, including basic management, hyperbaric oxygen therapy and drug treatment etc. In addition, the Acupuncture group received Xingnao Kaiqiao acupuncture, the refreshement treatment, at which the main acupoints were Shuigou, bilateral Neiguan, bilateral Sanyinjiao, and the auxiliary acupoints were Jiquan, Chize and Weizhong acupoints, once a day, the Bionic electricity group received the treatment of EEG bionic electrical stimulation, the main electrode were placed at GB 12 and BL 10, each treatment was for a continuous 99 min followed by a rest of 30 min, followed by another 99 min, once a day, the Combined group received Xingnao Kaiqiao acupuncture combined with EEG bionic electrical stimulation, once a day. Three groups were treated continuously for thirty days. On the day before treatment and the day after treatment, the consciousness state of the three groups was assessed by the revised coma recovery scale(CRS-R), and the grades of BAEP, SEP and the changes of latency and interval of each wave on the affected side were monitored by electromyographic evoked potential. Results: Before treatment, there was no significant difference of the CRS-R scores, the grades of SEP and BAEP, the latency of Ⅰ, Ⅴ, P15, N20, P38 wave and Ⅰ-Ⅴ wave interval in three groups(P>0.05). Compared with before treatment, the CRS-R scores after treatment were significantly higher, the grades of SEP and BAEP after treatment were significantly lower, the latency of Ⅰ, Ⅴ, P15, N20, P38 wave and Ⅰ-Ⅴ wave inte

关 键 词:持续植物状态 醒脑开窍 针法 脑电仿生电刺激 脑干听觉诱发电位 体感诱发电位 

分 类 号:R246.6[医药卫生—针灸推拿学]

 

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