早期针刺介入治疗脑卒中的研究进展  

A review on early acupuncture interventional treatment of stroke

作　　者：彭茂菡 王旭慧[1] 吴帮启[1] PENG Maohan;WANG Xuhui;WU Bangqi

机构地区：[1]天津中医药大学第一附属医院/国家中医针灸临床医学研究中心,天津300381

出　　处：《中医临床研究》2023年第9期56-60,共5页Clinical Journal Of Chinese Medicine

摘　　要：脑卒中是导致全世界人口死亡和长期残疾的主要原因之一,是世界范围内一个日益严重的公共卫生问题,中风的预防和治疗是一项巨大挑战。作为中医传统治疗方法的针刺疗法,目前已在全球范围展开运用,并作为长期治疗中风病的方法之一,取得不错的临床疗效。但对于针刺治疗而言,治疗时机是影响其疗效的重要因素之一,既往研究发现早期针刺介入是提高疗效的关键。尽管越来越多的证据支持针灸的有益作用,但对于针刺治疗中风的最佳干预时间点仍无明确的结论。通过搜集及整理相关文献,分析时间因素对针刺疗效影响的研究现状,发现早期针刺介入治疗能更好地改善脑卒中患者的临床症状,并且脑梗死急性发作时尽早施以针刺治疗甚至可以延长溶栓时间窗,其次根据动物实验及病理生理过程尚可以推测发病6~48 h是针刺介入治疗的最佳时期。针对缺血性卒中与出血性卒中治疗的最佳时机尚存在差别,仍需进一步通过全方位、综合的前瞻性研究进行针刺介入时间与疗效关系的探讨,优化治疗方案,提高临床疗效,改善患者临床预后。文章从中医理论、动物实验、病理生理过程及临床研究等方面就早期针刺治疗脑卒中进行综述,希望为今后针刺治疗脑卒中提供参考。Stroke is one of the main causes of death and long-term disability in the world.It is an increasingly serious public health problem worldwide.Stroke prevention and treatment is a huge challenge.Acupuncture,as a traditional treatment of traditional Chinese medicine,at present,has been used worldwide and has achieved good clinical results as one of the long-term treatment methods for stroke.However,for acupuncture treatment,the time of treatment is one of the important factors affecting its efficacy.Previous studies have found that early acupuncture intervention is the key to improving efficacy.Although more and more evidence supports the beneficial effect of acupuncture,there is still no clear conclusion on the best intervention time point of acupuncture in the treatment of stroke.By collecting and sorting out relevant literature,analyzes the current research status of the impact of time factors on the efficacy of acupuncture and finds that early acupuncture intervention can better ameliorate the clinical symptoms of stroke patients.It is also found that early acupuncture therapy during the acute onset of cerebral infarction can even prolong the thrombolysis time window,and according to animal experiments and pathophysiological processes,it can be speculated that the onset of 6-48 h is the best period for acupuncture interventional therapy.There is still a difference between the best time for the treatment of ischemic stroke and hemorrhagic stroke.And it is still necessary to further explore the relationship between acupuncture intervention time and efficacy through comprehensive and integrated prospective research,optimize the treatment plan,promote the clinical efficacy,and ameliorate the clinical prognosis of patients.This paper reviews the early acupuncture treatment of stroke from the aspects of traditional Chinese medicine theory,animal experiments,pathophysiological processes,and clinical research,hoping to provide a reference for acupuncture treatment of stroke in the future.

关 键 词：脑卒中 治疗 针刺 早期干预 综述 

分 类 号：R743.33[医药卫生—神经病学与精神病学]