醒脑开窍针刺法对早期重度颅脑损伤患儿意识障碍促醒的影响  

Xingnao Kaiqiao acupuncture on promoting wake-up of consciousness disorder in children with early severe traumatic brain injury

作　　者：吴婧 吴浪龙[1] 王彦军[1] 汪杨 李清[1] WU Jing;WU Lang-long;WANG Yan-jun;WANG Yang;LI Qing(Pediatric Rehabilitation Center,Jiangxi Provicial Children's Hospital,Nanchang 330006,China)

机构地区：[1]江西省儿童医院小儿康复中心,南昌330006

出　　处：《中国针灸》2023年第3期277-281,共5页Chinese Acupuncture & Moxibustion

基　　金：江西省重点研发计划项目:KT2020119。

摘　　要：目的:观察在西医治疗基础上联用醒脑开窍针刺法对早期重度颅脑损伤(STBI)患儿意识障碍的促醒作用及安全性。方法:将62例STBI患儿随机法分为观察组(31例,脱落1例)和对照组(31例,脱落1例)。对照组予常规康复治疗(每周治疗6次,治疗30 d)及脑苷肌肽注射液静脉滴注(每天1次,治疗28 d);观察组在对照组治疗基础上加用醒脑开窍针刺法,穴取内关、水沟、印堂、百会、三阴交、足三里,并随症配穴,每天1次,每周治疗6次,治疗30 d。观察两组治疗前及治疗10、20、30 d后格拉斯哥昏迷量表(GCS)、改良国际昏迷恢复量表(CRS-R)、改良Barthel指数(MBI)评分;观察两组治疗前后脑电图(EEG)分级,并评价安全性。结果:治疗10、20、30 d后,两组患儿GCS、CRS-R、MBI评分均较治疗前升高(P<0.05),观察组高于对照组(P<0.05);治疗后,两组EEG分级较治疗前改善(P<0.05),观察组优于对照组(P<0.05)。治疗期间两组患儿均无不良安全事件及不良反应发生。结论:在西医治疗基础上,联用醒脑开窍针刺法对早期STBI患儿有促醒作用,可改善患儿意识障碍水平和日常生活能力,且安全有效。Objective To observe the awakening effect and safety of Xingnao Kaiqiao(regaining consciousness and opening orifices)acupuncture on consciousness disorder in children with early severe traumatic brain injury(STBI)based on western medicine treatment.Methods A total of 62 children with STBI were randomly divided into an observation group(31 cases,1 case dropped off)and a control group(31 cases,1 case dropped off).The control group was treated with routine rehabilitation therapy(6 times a week for 30 days),and intravenous drip of cattle encephalon glycoside and ignotin injection(once a day for 28 days).On the basis of the treatment in the control group,the observation group was treated with Xingnao Kaiqiao acupuncture at Neiguan(PC 6),Shuigou(GV 26),Yintang(GV 24+),Baihui(GV 20),Sanyinjiao(SP 6),Zusanli(ST 36),etc.,and supplementary acupoints according to clinical symptoms,once a day,6 times a week for 30 days.The scores of Glasgow coma scale(GCS),coma recovery scale-revised(CRS-R)and modified Barthel index(MBI)were observed before treatment and 10,20 and 30 d into treatment.Electroencephalogram(EEG)grading before and after treatment was observed in the two groups,and safety was evaluated.Results After 10,20 and 30 days of treatment,the scores of GCS,CRS-R and MBI in the two groups were increased compared before treatment(P<0.05),and those in the observation group were higher than the control group(P<0.05).After treatment,EEG grading of both groups was improved compared with that before treatment(P<0.05),and the observation group was better than the control group(P<0.05).There were no adverse events or adverse reactions in the two groups during treatment.Conclusion On the basis of western medicine treatment,Xingnao Kaiqiao acupuncture plays a remarkable role in wakening the early STBI children,can improve the level of consciousness disorder and daily living ability,and it is safe and effective.

关 键 词：早期重度颅脑损伤 醒脑开窍针刺法 针刺 促醒 意识障碍 随机对照试验 

分 类 号：R246.4[医药卫生—针灸推拿学]