不同手法针刺通里穴治疗缺血性脑卒中后运动性失语症的临床观察  

Clinical Observation of Different Acupuncture Manipulations at Tongli(HT5) Points for Treatment of Motor Aphasia after Ischemic Stroke

作　　者：王丽荣 吕艳丽 刘兢 姚爱荣 WANG Li-Rong;LYU Yan-Li;LIU Jing;YAO Ai-Rong(Tangshan Hongci Hospital,Tangshan 063000 Hebei,China;Zhaogezhuang Hospital of Kailuan General Hospital,Tangshan 063000 Hebei,China;Affiliated Hospital of North China University of Science and Technology,Tangshan 063000 Hebei,China;982 Hospital of Joint Service Support Force of Chinese People's Liberation Army,Tangshan 063000 Hebei,China)

机构地区：[1]唐山弘慈医院,河北唐山063000 [2]开滦总医院赵各庄医院,河北唐山063000 [3]华北理工大学附属医院,河北唐山063000 [4]中国人民解放军联勤保障部队第九八二医院,河北唐山063000

出　　处：《广州中医药大学学报》2021年第6期1162-1167,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：河北省中医药管理局中医药类科研资助项目(编号:2020214)。

摘　　要：【目的】观察不同手法针刺通里穴治疗缺血性脑卒中后运动性失语症的临床疗效。【方法】将105例缺血性脑卒中后运动性失语症患者随机分为阳中隐阴组、阴中隐阳组和烧山火组,每组各35例,3组患者均接受语言康复训练,阳中隐阴组给予阳中隐阴针刺手法治疗、阴中隐阳组给予阴中隐阳针刺手法治疗,烧山火组给予烧山火针刺手法治疗。3组患者均每周治疗6次,连续治疗6周。治疗6周后,评价3组患者的临床疗效,观察3组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、改良RANKIN量表(mRS)评分的变化情况,以评价神经功能,并采用功能性语言沟通能力检查法(CFCP)评价3组患者治疗前后语言功能的改善情况。【结果】(1)阳中隐阴组总有效率为94.29%(33/35),阴中隐阳组为71.43%(25/35),烧山火组为74.29%(26/35)。阳中隐阴组疗效明显优于阴中隐阳组与烧山火组,且差异均有统计学意义(P<0.05)。(2)治疗后,3组患者的NIHSS、mRS、CFCP评分均明显改善(P<0.05),且阳中隐阴组在改善NIHSS、mRS、CFCP评分方面明显优于阴中隐阳组与烧山火组,差异有统计学意义(P<0.05)。【结论】缺血性脑卒中后运动性失语症患者通里穴呈现虚损状态,阳中隐阴针刺手法刺激通里穴更能有效地改善患者的语言沟通能力,缓解患者的神经功能缺损,临床疗效显著。Objective To observe the clinical efficacy of different acupuncture manipulations at Tongli(HT5)points for treatment of motor aphasia after ischemic stroke. Methods One hundred and five ischemic stroke patients with motor aphasia were randomly divided into reinforcement before purging group,purging before reinforcement group and Shaoshanhuo group, 35 cases in each group. The three groups received language rehabilitation training,additionally,the reinforcement before purging group received acupuncture treatment with reinforcement before purging manipulation, and the purging before reinforcement group received acupuncture treatment with purging before reinforcement manipulation, and the Shaoshanhuo group received Shaoshanhuo acupuncture manipulation,6 times a week,the treatment lasting 6 continuous weeks. After 6 weeks of treatment,the clinical efficacy of the three groups was evaluated,the changes in National Institutes of Health Stroke Scale(NIHSS)and modified Rankin Scale(mRS)scores were observed in the three groups before and after treatment to evaluate the neurological function,and the improvement in language function of the three groups before and after treatment was evaluated by Chinese Functional Communication Profile(CFCP). Results(1)The total effective rate was 94.29%(33/35)in the reinforcement before purging group,71.43%(25/35)in the purging before reinforcement group,and 74.29%(26/35)in the Shaoshanhuo group. The curative effect of the reinforcement before purging group was superior to that of the purging before reinforcement group and Shaoshanhuo group,the difference being statistically significant(P < 0.05).(2)After treatment,the NIHSS,mRS and CFCP scores were significantly improved in the three groups(P < 0.05),and the improvement in NIHSS,mRS and CFCP scores of the reinforcement before purging group was significantly superior to that of the purging before reinforcement group and Shaoshanhuo group,the difference being statistically significant(P < 0.05). Conclusion Tongli(HT5)points of the ischemic s

关 键 词：通里穴 阳中隐阴 阴中隐阳 烧山火法 针刺手法 缺血性脑卒中 运动性失语症 

分 类 号：R246.9[医药卫生—针灸推拿学]