维筋相交针刺法治疗卒中后动眼神经麻痹临床观察  

Clinical observation on post-stroke oculomotor nerve palsy treated with the interaction of twelve meridian muscle regions and contralateral needling therapy

作　　者：刘晓新[1] 吴江莹[2] 赵颖[1] LIU Xiao-xin;WU Jiang-ying;ZHAO Ying(Clinic Department of Acupuncture-Moxibustion,First Teaching Hospital of Tianjin University of TCM/National Clinical Medical Research Center of Acupuncture-Moxibustion in TCM,Tianjin 300000,China;Department of TCM,Tianjin Huanhu Hospital)

机构地区：[1]天津中医药大学第一附属医院针灸临床部/国家中医针灸临床医学研究中心,天津300000 [2]天津环湖医院中医科

出　　处：《中国针灸》2020年第8期805-809,共5页Chinese Acupuncture & Moxibustion

摘　　要：目的:观察维筋相交针刺法治疗卒中后动眼神经麻痹的临床疗效。方法:将46例卒中后动眼神经麻痹患者随机分为观察组和对照组,每组23例。对照组患者臀部肌内注射甲钴胺注射液,每次1 mL,隔日1次,每周3次;同时口服胞磷胆碱钠胶囊,每次0.2 g,每日3次。观察组在对照组治疗基础上加用维筋相交针刺法治疗,穴取健侧巨髎、颔厌,患侧睛明、四白、阳白、攒竹、上明、丝竹空、瞳子髎,风池、曲池、偏历、外关、合谷,每次30 min,每日1次,每周5次。两组均治疗4周。观察两组患者治疗前后颈椎活动度复视检查(CROM)评分、瞳孔大小、睑裂宽度、眼球活动度,并评定两组临床疗效。结果:治疗后两组患者CROM评分降低(P<0.05),瞳孔缩小(P<0.05),且观察组小于对照组(P<0.05);睑裂宽度和眼球活动度均增大(P<0.05),且观察组眼裂宽度及内直肌、下直肌和下斜肌活动度大于对照组(P<0.05)。观察组有效率为82.6%(19/23),高于对照组的65.2%(15/23,P<0.05)。结论:维筋相交针刺法可以有效改善卒中后动眼神经麻痹患者复视、瞳孔散大、睑裂变窄和眼球活动度减小的情况。Objective To observe the clinical effect on post-stroke oculomotor nerve palsy treated with the interaction of twelve meridian muscle regions and contralateral needling therapy.Methods A total of 46 patients with post-stroke oculomotor nerve palsy were randomized into an observation group and a control group,23 cases in each one.In the control group,the intramusclar injection of mecobalamine at the buttock region was given,1 mL each time,once every two days,3 times weekly.Besides,citicoline sodium capsules were prescribed for oral administration,0.2 g each time,3 times daily.In the observation group,on the base of the treatment as the control group,the interaction of twelve meridian muscle regions and contralateral needling therapy was supplemented.Acupoints on the health sides included Juliao(ST 3)and Hanyan(GB 4),acupoints on the affected side included Jingming(BL 1),Sibai(ST 2),Yangbai(GB 14),Cuanzhu(BL 2),Shangming(Extra),Sizhukong(TE 23),Tongziliao(GB 1)and bilateral Fengchi(GB 20),Quchi(LI 11),Pianli(LI 6),Waiguan(TE 5),Hegu(LI 4)were selected.The needles were retained for 30 min in each acupuncture treatment,once a day,5 times weekly.The treatment for 4 weeks was required in the two groups.Before and after treatment,the score of cervical range of motion(CROM),pupil size,eye fissure width and eyeball mobility were observed in the patients of the two groups.The clinical effect was evaluated in the two groups.Results After treatment,CROM scores and pupil size were reduced in the patients of the two groups(P<0.05),and the values in the observation group were lower than the control group(P<0.05).The eye fissure width and eyeball mobility were increased in the two groups(P<0.05),the eye fissure width and the mobility of the muscles of rectus internus,inferior rectus and inferior oblique in the observation group were larger than the control group(P<0.05).The effective rate was 82.6%(19/23)in the observation group,higher than 65.2%(15/23)in the control group(P<0.05).Conclusion The interaction of twelve meridian mu

关 键 词：卒中后动眼神经麻痹 维筋相交针刺法 复视 眼球活动度 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]