针刺百会穴结合长留针治疗缺血性卒中的疗效观察及对凝血功能的影响  

Efficacy observation of acupuncture at point Baihui(GV20) plus long-time retention for ischemic stroke and its effect on coagulation function

作　　者：汪节[1] 朱婷婷[1] 朱晓凯 何其英 高婷[1] 王宇[1] WANG Jie;ZHU Tingting;ZHU Xiaokai;HE Qiying;GAO Ting;WANG Yu(Second Hospital Affiliated to Anhui University of Traditional Chinese Medicine,Hefei 230061,China)

机构地区：[1]安徽中医药大学第二附属医院,合肥230061

出　　处：《上海针灸杂志》2023年第8期802-807,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：安徽省自然科学基金项目(1808085MH278)。

摘　　要：目的 观察针刺百会穴结合长留针治疗缺血性卒中的临床疗效及对血浆D-二聚体(d-dimers,D-D)、纤维蛋白原降解物(fibrinogen degradation product,FDP)和抗凝血酶-Ⅲ(antithrombin-Ⅲ,AT-Ⅲ)水平的影响。方法 将60例急性缺血性卒中患者随机分为观察组(30例)和对照组(30例)。对照组予氯吡格雷及常规基础康复治疗;观察组在对照组治疗基础上联合针刺百会穴并长留针治疗。比较两组治疗前后美国国立卫生院卒中量表(National Institutes of Health stroke scale,NIHSS)评分、简易智力状态检查(mini-mental state examination,MMSE)评分、Barthel指数(Barthel index,BI)评分以及凝血功能指标(血浆D-D、FDP和AT-Ⅲ)水平的变化。比较两组临床疗效。结果 两组治疗前NIHSS及MMES评分比较,差异无统计学意义(P>0.05);观察组治疗后NIHSS评分低于对照组(P<0.05),且MMES评分高于对照组(P<0.05)。两组治疗前BI评分比较,差异无统计学意义(P> 0.05);观察组治疗后BI评分高于对照组(P <0.05)。观察组总有效率高于对照组(P<0.05)。两组治疗前血浆D-D、AT-Ⅲ和FDP水平比较,差异无统计学意义(P>0.05);观察组治疗后D-D、AT-Ⅲ和FDP水平均优于对照组(P<0.05)。结论 在氯吡格雷及常规基础康复治疗基础上,针刺百会穴结合长留针治疗缺血性卒中可改善神经功能和认知功能,提高日常生活能力,改善凝血功能,临床疗效优于单纯氯吡格雷及常规基础康复治疗。Objective To observe the clinical efficacy of acupuncture at point Baihui(GV20)plus long-time retention for ischemic stroke and its effect on serum D-dimer(D-D),fibrinogen degradation product(FDP)and antithrombin-Ⅲ(AT-Ⅲ)levels.Method Sixty patients with acute ischemic stroke were randomized to an observation group(30 cases)and a control group(30 cases).The control group was given Clopidogrel and routine basic rehabilitation therapy and the observation group received acupuncture at point Baihui plus long-time retention in addition.The National Institutes of Health stroke scale(NIHSS)score,the mini-mental state examination(MMSE)score,the Barthel index(BI)score and coagulation function indicators(D-D,FDP and AT-Ⅲ)levels were compared between the two groups before and after treatment.The clinical therapeutic effects were compared between the two groups.Result There were no statistically significant pre-treatment differences in the NIHSS and MMSE scores between the two groups(P>0.05).After treatment,the NIHSS score was lower and the MMSE score was higher in the observation group than in the control group(P<0.05).There was no statistically significant pre-treatment difference in the BI score between the two groups(P>0.05).After treatment,the BI score was higher in the observation group than in the control group(P<0.05).The total efficacy rate was higher in the observation group than in the control group(P<0.05).There were no statistically significant pre-treatment differences in D-D,FDP and AT-Ⅲlevels between the two groups(P>0.05).After treatment,D-D,FDP and AT-Ⅲlevels were better in the observation group than in the control group(P<0.05).Conclusion On the basis of Clopidogrel and routine basic rehabilitation therapy,acupuncture at point Baihui plus long-time retention can improve neurological and cognitive functions,the activities of daily living and coagulation function in treating ischemic stroke.Its clinical therapeutic effect is superior to that of Clopidogrel plus routine basic rehabilitation therapy a

关 键 词：针刺疗法 留针 穴 百会 针药并用 中风后遗症 脑梗死 康复训练 

分 类 号：R246.6[医药卫生—针灸推拿学]