“醒脑开窍”针刺法治疗早期缺血性脑卒中对远期致残率影响的临床研究  

Clinical Study on Effect of"Consciousness-Restoring and Orifice-Opening"Acupuncture on Long-Term Disability Rate of Early Ischemic Stroke

作　　者：田涛涛 王媛 马凤翘 赵佳如 楼敏[2] TIAN Taotao;WANG Yuan;MA Fengqiao;ZHAO Jiaru;LOU Min(Dongyang Peoples Hospital,Dongyang 322103,Zhejiang,China;The Second Affiliated Hospital of Zhejiang University Medical College,Hangzhou 310003,Zhejiang,China)

机构地区：[1]东阳市人民医院,浙江东阳322103 [2]浙江大学医学院附属第二医院,浙江杭州310003

出　　处：《中华中医药学刊》2023年第8期93-96,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81622017);金华市中医药科学技术研究计划项目(2022KY41)。

摘　　要：目的 观察“醒脑开窍”针刺疗法对早期缺血性脑卒中患者远期致残率的影响。方法 选取2022年1月-2022年9月东阳市人民医院神经内科、康复科收治的80例缺血性脑卒中住院患者,按照不同治疗方案和自愿原则均分为两组,其中常规治疗组40例,予以西医常规治疗,醒脑开窍组40例,在常规治疗组基础上给予“醒脑开窍”法针刺治疗。通过比较两组干预前后改良Rankin评分量表(Modified rankin scale, mRS)、Fugl-Meyer运动评估表(Fugl-meyer assessment scale, FMA)、功能性步行量表(Functional ambulation category scale, FAC)以及美国国立卫生研究院卒中量表(National institutes of health stroke scale, NIHSS)评分变化,评估患者神经功能、肢体运动功能以及生活质量情况。结果 与干预前比较,两组患者在干预完成后、3个月以及6个月的mRS评分均明显降低;与常规治疗组比较,醒脑开窍组患者在干预后不同时间节点的mRS评分均明显降低(P<0.01)。与常规治疗组比较,醒脑开窍组病人在干预完成后的mRS结局良好(0~2分)人数比例无显著差异,在发病后3个月时的mRS结局良好(0~2分)人数比例明显升高(P<0.05)。与干预前比较,两组患者在干预完成后、3个月以及6个月的FMA评分均明显上升;与常规治疗组比较,醒脑开窍组患者在干预后不同时间节点的FMA评分均明显上升(P<0.01)。与干预前比较,两组患者在干预完成后、3个月以及6个月的FAC评分均明显升高;与常规治疗组比较,醒脑开窍组患者在干预后不同时间节点的FAC评分均明显升高(P<0.01)。与干预前比较,两组患者在干预完成后、3个月以及6个月的NIHSS评分均明显降低(P<0.01);但与常规治疗组比较,醒脑开窍组患者在干预后各个时间节点的NIHSS评分均无明显差异(P>0.05)。治疗过程中,两组患者生命体征平稳,患者未发生晕针、断针、局部血肿等不良反应发生,针灸后均主诉良好。结论 Objective To observe the effect of"consciousness-restoring and orifice-opening"acupuncture therapy on the long-term disability rate of patients with early ischemic stroke.Methods According to the inclusion and exclusion criteria from January 2022 and September 2022 in Neurology and Rehabilitation Department of Dongyang People's Hospital,80 cases of hospitalized patients with ischemic stroke,according to the different treatment and voluntary principles were divided into the routine treatment group(40 cases,conventional western medicine treatment)and"consciousness-restoring and orifice-opening"acupuncture group(40 cases,on the basis of conventional treatment group,"consciousness-restoring and orifice-opening"acupuncture was given).The changes of modified Rankin scale(mRS),Fugl-Meyer assessment scale(FMA),functional ambulation category scale(FAC)and National Institutes of Health Stroke Scale(NIHSS)scores before and after intervention were compared between the two groups to evaluate the neurological function,limb motor function and quality of life of the patients.Results Compared with those before the intervention,the mRS scores of the two groups were significantly reduced after the completion of the intervention,3 and 6 months after the intervention.Compared with those of the conventional treatment group,the mRS scores of"consciousness-restoring and orifice-opening"acupuncture group at different time nodes after intervention were significantly decreased(P<0.01).Compared with the conventional treatment group,there was no significant difference in the proportion of patients with good mRS outcome(0-2 points)after the completion of the intervention,but the proportion of patients with good mRS outcome(0-2 points)was significantly higher in the"consciousness-restoring and orifice-opening"acupuncture group at 3 months after onset(P<0.05).Compared with those before intervention,the FMA scores of the two groups were significantly increased after the completion of intervention,3 and 6 months after intervention.Compared with t

关 键 词：“醒脑开窍”法 缺血性脑卒中 功能障碍 致残率 临床疗效 

分 类 号：R255.2[医药卫生—中医内科学]