头针不同留针时间对脑卒中后运动功能障碍和血清C反应蛋白、血糖、血脂的影响  

Effects of Needle Retention Time for Scalp Acupuncture on Motor Dysfunction and Serum C-Reactive Protein,Blood Glucose and Blood Lipid of Post-Stroke Patients

作　　者：钟琪 蔡海燕 金炳旭 霍湛新 罗慧艺 钟秋霞 郭浩讯 陈嘉雯 邹舒惠 ZHONG Qi;CAl Hai-Yan;JIN Bing-Xu;HUO Zhan-Xin;LUO Hui-Yi;ZHONG Qiu-Xia;GUO Hao-Xun;CHEN Jia-Wen;ZOU Shu-Hui(Dept.of Rehabilitation,Panyu Traditional Chinese Medicine Hospital,Guangzhou 511401 Guangdong,China)

机构地区：[1]广州市番禺区中医院康复科,广东广州511401

出　　处：《广州中医药大学学报》2024年第6期1510-1516,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20201145);广州市番禺区科技计划项目(编号:2020-Z04-056)。

摘　　要：【目的】观察头针不同留针时间对脑卒中患者运动功能障碍和血清C反应蛋白(CRP)、血糖、血脂的改善情况。【方法】将120例脑卒中后运动功能障碍患者随机分为对照组、观察1组、观察2组,每组各40例。3组患者均采取头针、体针及常规运动康复训练治疗,对照组头针留针30 min,观察1组头针留针1 h,观察2组头针留针2 h,每日1次,每周6次,连续治疗2周。比较3组患者的美国国立卫生研究院卒中量表(NIHSS)、Fugl-Meyer运动评定量表(FMA)、Berg平衡量表(BBS)、改良Barthel指数(MBI)评分以及外周血CRP、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的改善程度,并评价3组治疗方案的安全性。【结果】(1)量表评分方面,治疗后,3组患者的NIHSS评分均较治疗前降低(P<0.01),FMA、BBS、MBI评分均较治疗前升高(P<0.05或P<0.01);治疗后3组间比较,差异均有统计学意义(P<0.01),其中,观察2组对NIHSS评分的降低幅度及对FMA、BBS、MBI评分的升高幅度均明显优于对照组和观察1组(P<0.01),观察1组对FMA评分的改善幅度又明显优于对照组(P<0.01),对NIHSS、BBS、MBI评分的改善幅度均有优于对照组趋势,但差异均无统计学意义(P>0.05),表明头针运动治疗方案的疗效与头针留针时长呈正向时效关系。(2)实验室指标方面,治疗后,3组患者的外周血CRP、FPG水平和两观察组的TG、LDL-C水平以及观察2组的HDL-C水平均较治疗前改善(P<0.05或P<0.01);且治疗后3组间的外周血CRP、TG水平比较,差异均有统计学意义(P<0.05或P<0.01),其中,观察2组对CRP、TG水平的改善幅度明显优于对照组,对CRP水平的改善幅度又明显优于观察1组,差异均有统计学意义(P<0.05或P<0.01);而3组患者的TC水平治疗前后及组间比较,差异均无统计学意义(P>0.05)。(3)安全性方面,3组患者治疗期间均未发生晕针、断针、血肿等不良�Objective To observe the improvement of motor dysfunction and serum levels of C-reactive protein(CRP),blood glucose and blood lipid in post-stroke patients treated with scalp acupuncture at different needle retention time.Methods A total of 120 patients with motor dysfunction after stroke were randomly divided into control group,observation group 1 and observation group 2,with 40 cases in each group.The patients in the 3 groups were treated with scalp acupuncture,body acupuncture and routine rehabilitation exercise,once a day and 6 times a week,lasting for 2 weeks.The control group was given scalp acupuncture with retaining of needles for 30 minutes,the observation group 1 was given scalp acupuncture with retaining of needles for one hour,and the observation group 2 was given scalp acupuncture with retaining of needles for 2 hours.Before and after treatment,the 3 groups were observed in the changes of the scale scores of National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS)and modified Barthel Index(MBI),and the levels of laboratory indicators of peripheral blood CRP,fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).After treatment,the clinical safety of the three groups was evaluated.Results(1)After treatment,the scale scores of NIHSS in the three groups were lower(P<0.01)and the scale scores FMA,BBS and MBI were higher than those before treatment(P<0.05 or P<0.01).The comparison of post-treatment scale scores showed that the differences among the three groups were statistically significant(P<0.01).The intergroup comparison showed that the decrease of NIHSS score and the increase of FMA,BBS and MBI scores in the observation group 2 were significantly superior to those in the control group and the observation group 1(P<0.01);the improvement of FMA score in the observation group 1 was significantly superior to that in the control group(P<0.01),while the improveme

关 键 词：脑卒中 运动功能障碍 头针疗法 留针时间 C反应蛋白(CRP) 血糖 血脂 

分 类 号：R246.6[医药卫生—针灸推拿学]