清神益智针法联合感官刺激疗法治疗脑卒中后持续植物状态的临床疗效  

Clinical Efficacy of Qingshen Yizhi Acupuncture Combined with Sensory Stimulation Therapy in the Treatment of Persistent Vegetative State after Stroke

作　　者：龙威力 班志娟[1] 黄玉凤 何荷 麦琪 LONG Wei-li;BAN Zhi-juan;HUANG Yu-feng;HE He;MAI Qi(The First People′s Hospital of Qinzhou,Qinzhou Guangxi 535000;College of Health,Guangxi Talent International College,Qinzhou Guangxi 535000)

机构地区：[1]钦州市第一人民医院,广西钦州535000 [2]广西英华国际职业技术学院大健康学院,广西钦州535000

出　　处：《世界中西医结合杂志》2023年第6期1233-1237,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：广西壮族自治区中医药管理局科研课题(GXZYZ20210013);广西壮族自治区中医药管理局科研课题(GXZYZ20210096)。

摘　　要：目的 探讨清神益智针法联合感官刺激疗法在脑卒中后持续植物状态(Persistent vegetative state, PVS)治疗中的应用价值。方法 选取2020年1月—2021年12月期间钦州市第一人民医院收治的108例脑卒中后PVS患者作为研究对象,按随机数字表法分感官刺激组、针刺组、中西医结合组,每组各36例。3组患者均给予康复基础治疗,在此基础上,感官刺激组给予感官刺激疗法,针刺组给予清神益智针法,中西医结合组给予感官刺激疗法+清神益智针法治疗。治疗30 d后,观察比较3组患者临床疗效,治疗前后病情程度评分[格拉斯哥昏迷评分法(Glasgow coma scale, GCS)与全面无反应性量表(Full Outline of Unresponsiveness Scale, FOUR)]、脑血流量及脑电生理变化。结果 治疗后中西医结合组临床总有效率86.11%(31/36)与感官刺激组66.67%(24/36)、针刺组71.43%(25/35)比较,差异有统计学意义(P<0.05)。治疗后3组患者病情程度GCS、FOUR评分均较治疗前升高,差异有统计学意义(P<0.05);且中西医结合组高于感官刺激组、针刺组,差异有统计学意义(P<0.05)。治疗后3组患者额叶、丘脑血流量均较治疗前升高,差异有统计学意义(P<0.05);且中西医结合组高于感官刺激组、针刺组,差异有统计学意义(P<0.05)。治疗后3组患者脑电图分级、脑干听觉诱发电位、体感诱发电位评分均较治疗前升高,差异有统计学意义(P<0.05);且中西医结合组高于感官刺激组、针刺组,差异有统计学意义(P<0.05)。结论 清神益智针法联合感官刺激疗法治疗脑卒中后PVS效果显著,有利于促进疾病转归,增加患者脑血流量,改善脑电生理。Objective To explore the application value of the combined therapy of Qingshen Yizhi acupuncture and sensory stimulation in the treatment of persistent vegetative state(PVS)after stroke.Methods A total of 108 PVS patients after stroke admitted to the First People′s Hospital of Qinzhou between January 2020 and December 2021 were selected and randomly divided into three groups:a sensory stimulation group,an acupuncture group,and a combination group,with 36 patients in each group.All three groups received basic rehabilitation treatment.In addition,the sensory stimulation group received sensory stimulation therapy,the acupuncture group received Qingshen Yizhi acupuncture,and the combination group received sensory stimulation therapy combined with Qingshen Yizhi acupuncture.After 30 days of treatment,the clinical efficacy,pre-and post-treatment severity scores[Glasgow Coma Scale(GCS)and Full Outline of Unresponsiveness Scale(FOUR)],cerebral blood flow,and changes in electroencephalography(EEG)were observed and compared among the three groups.Results After treatment,the total effective rate was 86.11%(31/36)in the combination group,and the differences were significant as compared with 66.67%(24/36)in the sensory stimulation group and 71.43%(25/35)in the acupuncture group(P<0.05).After treatment,the GCS and FOUR scores of the three groups increased compared with those before treatment(P<0.05),and the combination group had higher scores than the sensory stimulation group and acupuncture group(P<0.05).After treatment,the cerebral blood flow in the frontal lobe and thalamus increased in all three groups compared with those before treatment(P<0.05),and the combination group had higher blood flow than the sensory stimulation group and acupuncture group(P<0.05).After treatment,the EEG classification,brainstem auditory evoked potentials,and somatosensory evoked potentials scores of the three groups increased compared with those before treatment(P<0.05),and the combination group had higher scores than the senso

关 键 词：脑卒中 持续植物状态 感官刺激疗法 清神益智针法 脑血流量 脑电生理 

分 类 号：R245.31[医药卫生—针灸推拿学] R743.3[医药卫生—中医临床基础]