针刺通督醒神穴联合rTMS治疗中风后意识障碍的交互作用探究  

Study on Interaction of Acupuncture at Acupoints for Dredging Du Meridians and Inducing Resuscitation Combined with rTMS in Treatment of Consciousness Disorders

作　　者：程剑利 李雨源 吴菁菁[2] 韩润霞[2] 韦玲[2] CHENG Jianli;LI Yuyuan;WU Jinjin;HAN Runxia;WEI Ling(Shanxi University of Traditional Chinese Medicine,Taiyuan 030024,Shanxi,China;The Third Hospital of Traditional Chinese Medicine,Shanxi College of Traditional Chinese Medicine,Taiyuan 030024,Shanxi,China)

机构地区：[1]山西中医药大学,山西太原030024 [2]山西中医学院第三中医院,山西太原030024

出　　处：《实用中医内科杂志》2022年第1期122-126,共5页Journal of Practical Traditional Chinese Internal Medicine

基　　金：山西省中医药管理局科研项目(2018ZYY011)。

摘　　要：目的通过观察针刺通督醒神穴联合rTMS治疗中风后意识障碍的临床疗效,探讨两者结合的交互作用,为两者结合更好的治疗意识障碍提供思路。方法纳入中风后意识障碍的患者90例,按入院顺序采用单盲、随机的方法,将90例中风后意识障碍的患者随机分为治疗组、对照组1、对照组2各30例。治疗组予以针刺通督醒神穴结合rTMS治疗,对照组1予以rTMS治疗,对照组2予以西医常规治疗,1次/d,10d1个疗程,治疗2个疗程。在治疗前、治疗后使用格拉斯哥昏迷量表(GCS)、全面无反应性量表(FOUR)、神经功能缺损评分量表(NIHSS)进行评定,并检测三组患者治疗前后脑电图(EEG)的变化,并对其进行疗效评价。结果治疗前三组患者的GCS评分、FOUR评分、CSS评分经统计学处理差异不明显(P>0.05),具有可比性;治疗结束后三组患者的GCS评分、FOUR评分较治疗前提高,NIHSS评分较治疗前下降,经统计学处理有显著性差异(P<0.05),且治疗组优于对照组1、对照组2,对照组1优于对照组2;治疗前三组患者的EEG比较差异无统计学意义,治疗2个疗程后三组患者EEG的α、β节律、波幅均有所增加,θ、δ波均有所减少,差异有统计学意义(P<0.05),且治疗组改善优于对照组1、对照组2,而对照组1优于对照组2,差异有统计学意义(P<0.05)。结论针刺通督醒神穴联合rTMS可更好的促进中风后意识障碍的恢复。Objective To observe the clinical efficacy of acupuncture at acupoints for dredging Du meridians and inducing resuscitation combined with rTMS in the treatment of post-stroke disorder of consciousness,explore the interaction of the combination of the two,andprovide ideas for the combination of the two to better treat disorders of consciousness.Methods Ninety patients with post-stroke consciousness disorder were enrolled.According to the admission order,a single-blind,random method was used to randomly divide 90 patients with post-stroke consciousness disorder into treatment group,control group 1 and control group 2 with 30 cases each.The treatment group was treated with acupuncture at acupoints for dredging Du meridians and inducing resuscitation combined with rTMS,the control group 1 was treated with rTMS,and the control group 2 was treated with conventional western medicine,once a day.Ten days was one course,and there were totally two courses.Before and after treatment,the Glasgow Coma Scale(GCS),the Global Unresponsiveness Scale(FOUR)and the Neurological Impairment Score Scale(NIHSS) for assessment were measured,and the electro encephalogram(EEG) of the three groups was tested before and after treatment.And its curative effect was evaluated.Results The GCS scores,FOUR scoresand CSS scores of the three groupsbefore treatment were not significantly different(P>0.05),and they were comparable.Aftertreatment,the GCS scores and FOUR scores of the three groups were higher than those before treatment.The NIHSS score was lower than that before treatment,and there was a significant difference after statistical processing(P<0.05),and the score of the treatment group was better than that of the control group 1 and the control group 2,and the score of the control group 1 was better than that of the control group 2.EEG comparison of the three groups before treatmentwas not statistically significant.After 2 courses of treatment,the alpha rhythm and amplitude of the EEG of the three groups were increased,and theta and delta w

关 键 词：通督醒神 重复经颅磁刺激 中风 意识障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]