眼针治疗缺血性卒中急性期患者肌力重建的时效关系及相关因素分析  

Time-Effect Relationship and Related Factors Analysis of Eye Acupuncture Treatment of Muscle Strength Rreconstruction in Patients with Acute Ischemic Stroke

作　　者：王宇 包烨华[1] 黄金秀[1] 袁健辉 王哲[2] 路漫漫[2] 周鸿飞[3] 林小林 WANG Yu;BAO Yehua;HUANG Jinxiu;YUAN Jianhui;WANG Zhe;LU Manman;ZHOU Hongfei;LIN Xiaolin(Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310000,Zhejiang,China;Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]杭州市中医院,浙江杭州310000 [2]辽宁中医药大学,辽宁沈阳110847 [3]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医杂志》2022年第11期183-187,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81673925);杭州市医学重点学科资助项目(2020SJZDXK05)。

摘　　要：目的 通过自身前后对照研究进一步明确眼针治疗缺血性卒中急性期(ACI)的即刻效应、持续效应及影响眼针时效性的相关因素,初步建立眼针时-效关系。方法 本研究共纳入ACI患者62例。在常规西医治疗基础上加入眼针治疗。眼针取双侧肝区、肾区、上焦区、下焦区,1次/d,每周5 d休息2 d。总疗程均2周。眼针组患者在治疗第1天、治疗第7天、治疗第14天采用MMT评定法观察即刻针刺效应及针刺持续作用,并对影响即刻效应的相关因素进行分析。结果 (1)经眼针治疗后,ACI患者即刻四肢肌力均照治疗前有明显提高(P<0.01),其中即刻近端肌力疗效明显优于即刻远端肌力(P<0.01)。(2)在眼针治疗前、即刻、针刺后30 min、针刺后1 h、针刺后2 h及针刺后4 h肌力不同时间点比较差异存在具有统计学意义(P<0.05)。ACI患者第7天的各时间点肌力与第1天各时间点肌力比较差异存在具有统计学意义(P<0.05)。ACI患者第14天各时间点肌力与第7天各时间点肌力比较差异存在具有统计学意义(P<0.05)。(3)不同病位对眼针的即刻效应影响差异具有统计学意义(P<0.05),其中病位在基底节、脑皮质及多发性梗死疗程优于脑干;不同病程对眼针的即刻效应影响差异具有统计学意义(P<0.05),其中早期接受眼针治疗优于中晚期接受治疗;病情轻重程度对对眼针的即刻效应影响差异不具备统计学意义(P>0.05)。结论 眼针对上肢近端、上肢远端、下肢近端、下肢远端即刻肌力均有显著疗效,且肢体近端肌力提高程度优于远端肌力提高程度。患者梗死部位及针刺介入时机影响眼针的即刻效应,其中病灶位于基底节及脑干的即刻效应反应不佳,眼针介入ACI越早即刻效应越好。眼针持续效应存在起效、发展、达峰、衰退的时效性规律,并随着针刺次数的累积,眼针进入衰退期的时间逐渐延后。Objective To further clarify the immediate and sustained effects of eye acupuncture in the treatment of acute ischemic stroke(ACI)and the related factors that affect the time-effect of eye acupuncture through its own before and after comparative study and initially establish the time-effect relationship of eye acupuncture.Methods A total of 62 patients with ACI were included in this study.Eye acupuncture treatment was added on the basis of conventional western medicine treatment.Eye acupuncture was taken from the bilateral liver area, kidney area, upper focal area, and lower focal area, once a day, with 2 days off 5 days a week.The total course of treatment was 2 weeks.In the eye acupuncture group, the Manual Muscle Test(MMT)evaluation method was used to observe the immediate acupuncture effect and the sustained effect of acupuncture on the first day, the seventh day and the fourteenth day of treatment, and the relevant factors affecting the immediate effect were analyzed.Results(1)After eye acupuncture treatment, the immediate muscle strength of the limbs of ACI patients was significantly improved before treatment(P<0.01),and the immediate proximal muscle strength was significantly better than the immediate distal muscle strength(P<0.01).(2)There were statistical differences in muscle strength at different time points including before eye acupuncture, immediately after eye acupuncture, 30 min, 1 h, 2 h and 4 h after eye acupuncture treatment(P<0.05).The muscle strength of ACI patients at various time points on day 7 was statistically different from that of ACI patients at various time points on day 1(P<0.05).The muscle strength of ACI patients at all time points on day 14 was statistically different from that of ACI patients at all time points on day 7(P<0.05).(3)The effect of different disease locations on the immediate effect of eye acupuncture was statistically different(P<0.05),and the treatment course of disease locations in basal ganglia, cerebral cortex and multiple infarctions was better than that of bra

关 键 词：眼针 中风病 缺血性卒中急性期 时效关系 徒手肌力测定 

分 类 号：R245.32[医药卫生—针灸推拿学]