针灸联合康复疗法对缺血性脑卒中偏瘫患者肢体运动功能及血清cAMP、cGMP的影响  

Influence of acupuncture combined with rehabilitation therapy on limb motor function and serum cAMP and cGMP in patients with hemiplegia of cerebral ischemic stroke

作　　者：景福权 秦虎[2] 刘欢[1] 王增亮[2] JING Fu-quan;QIN Hu;LIU Huan;WANG Zeng-liang(Department of Acupuncture-Moxibustion and Tuina,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China;Department of Neurosurgery,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院针灸推拿科,乌鲁木齐830011 [2]新疆医科大学第一附属医院神经外科,乌鲁木齐830011

出　　处：《中国针灸》2020年第6期581-585,共5页Chinese Acupuncture & Moxibustion

基　　金：新疆维吾尔自治区自然科学基金项目:2018D01C215;新疆医科大学第一附属医院院内项目:2015ZRQN25。

摘　　要：目的:评价平针法联合运动再学习康复疗法治疗缺血性脑卒中偏瘫的疗效及对血清环磷酸腺苷(cAMP)、环磷酸鸟苷(cGMP)水平的影响。方法:将90例缺血性脑卒中偏瘫患者随机分为观察组和对照组,每组45例。两组患者均予健康教育、饮食指导、常规对症治疗及运动再学习康复疗法。观察组予平针法,即于上午选择督脉、膀胱经等人体阳面腧穴,下午选择任脉、肾经等人体阴面腧穴进行针灸治疗;对照组予常规针刺。两组针灸及康复均每周治疗5 d,2周为一疗程,共治疗2个疗程。分别于治疗前后记录两组患者Fugl-Meyer运动功能(FMA)评分及临床神经功能缺损程度量表(CSS)评分,检测患者血清cAMP、cGMP水平,并评定两组临床疗效。结果:治疗后两组患者FMA评分均较治疗前升高(P<0.01),CSS评分均较治疗前降低(P<0.01);观察组治疗后FMA评分高于对照组(P<0.01),CSS评分低于对照组(P<0.01)。治疗后两组患者血清cAMP水平均较治疗前升高(P<0.01),c GMP水平均较治疗前降低(P<0.01);观察组治疗后血清cAMP水平高于对照组(P<0.01),c GMP水平低于对照组(P<0.01)。观察组总有效率为93.3%(42/45),优于对照组的73.3%(33/45,P<0.01)。结论:平针法联合运动再学习康复疗法可有效改善缺血性脑卒中偏瘫患者肢体运动功能和神经损伤,调节血清cAMP及cGMP水平。Objective To evaluate the therapeutic effect of the combined treatment with balance acupuncture therapy and exercise re-learning rehabilitation therapy and the impact on serum cAMP and cGMP in the patients with hemiplegia of cerebral ischemic stroke. Methods A total of 90 patients of hemiplegia of cerebral ischemic stroke were randomized into an observation group and a control group, 45 cases in each one. All of the patients in the two groups received health education, diet guidance, routine symptomatic treatment as well as exercise re-learning rehabilitation therapy. Additionally, in the observation group, balance acupuncture therapy was applied, in which, the acupoints on the yang aspect of the human body, on the governor vessel and bladder meridian were adopted in the morning and those on the yin aspect of the human body, on the conception vessel and kidney meridian were stimulated in the afternoon. In the control group, the regular acupuncture was given. In the two groups, both acupuncture and rehabilitation therapies were given 5 days a week, 2 week-treatment as one course and totally 2 courses were required. Separately, before and after treatment, the score of Fugl-Meyer assessment(FMA) and the score of Chinese stroke scale(CSS) were recorded, the levels of cyclic adenosine monophosphate(cAMP) and cyclic guanosine monophosphate(cGMP) detected in serum and the clinical therapeutic effect were evaluated in the two groups. Results After treatment, FMA score was increased in the patients of either of the groups as compared with that before treatment(P<0.01) and CSS score decreased as compared with that before treatment(P<0.01). After treatment, FMA score in the observation group was higher than that in the control group(P<0.01) and CSS score was lower than the control group(P<0.01). After treatment, the level of serum cAMP of the patients in either of the groups was increased as compared with that before treatment(P<0.01) and that of cGMP decreased as compared with that before treatment(P<0.01). After treatment

关 键 词：缺血性脑卒中 偏瘫 针刺 平针法 运动再学习康复疗法 环磷酸腺苷(cAMP) 环磷酸鸟苷(cGMP) 

分 类 号：R246.6[医药卫生—针灸推拿学]