醒脑开窍针刺法辅助治疗缺血性脑卒中恢复期患者可行性研究  

Feasibility Study of Consciousness-Restoring and Orifice-Opening Acupuncture in Adjuvant Treatment of Patients with Ischemic Stroke in Convalescent Period

作　　者：郭萍 杨荣荣 GUO Ping;YANG Rongrong(Department of Rehabilitation,Linfen Central Hospital,Linfen 041000,Shanxi,China)

机构地区：[1]临汾市中心医院康复科,山西临汾041000

出　　处：《辽宁中医杂志》2024年第5期172-176,共5页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的 分析醒脑开窍针刺法辅助治疗缺血性脑卒中恢复期患者的可行性。方法 2021年2月—2022年2月临汾市中心医院康复科收治的缺血性脑卒中恢复期患者80例,按随机数字表法纳入对照组和观察组,各40例。对照组给予常规内科基础治疗和康复训练,观察组在此基础上给予醒脑开窍针刺法治疗,两组均治疗1个月,并随访2个月。比较两组治疗1个月后疗效,治疗前、治疗1个月后认知、神经功能缺损、运动功能及平衡,神经因子,脑血流动力学,治疗后2个月跌倒风险及预后情况。结果 治疗1个月后,观察组的总有效率(95.00%,38/40)高于对照组(77.50%,31/40),差异有统计学意义(P<0.05)。与治疗前比较,治疗1个月后,两组简易智力状态检查量表(mini-mental state examination, MMSE)、Fugl-Meyer量表(Fugl-meyer scale, FMA)、Berg平衡量表(Berg balance scale, BBS)评分,血清神经生长因子(serum levels of nerve growth factor, NGF)、脑源性神经营养因子(brain-derived neurotrophic factor, BDNF)水平,大脑中动脉收缩期峰值血流速度(peak systolic blood flow velocity, Vs)、舒张期末血流速度(end-diastolic blood flow velocity, Vd)、平均血流速度(mean blood flow velocity, Vm)均升高,且观察组更高(P<0.05);两组美国国立卫生研究院卒中量表(national institutes of health stroke scale, NIHSS)评分,血清神经元特异性醇化酶(serum levels of neuronal specific olase, NSE)、S100B蛋白(S100B)水平,大脑中动脉搏动指数(pulse index, PI)、阻力指数(resistance index, RI)均降低,且观察组更低(P<0.05)。治疗后2个月,观察组起立行走计时测验(timed up and go test, TUGT)≤12 s、站起测验(chair rising test, CRT)≤10 s、改良Rankin量表(modified Rankin scale, mRS)<2级比例更高(P<0.05)。结论 醒脑开窍针刺法辅助治疗缺血性脑卒中恢复期患者的可行性较高,可改善患者认知、神经功能缺损、运动功能及平衡能力,分析与其调节机体�Objective To analyze the feasibility of consciousness-restoring and orifice-opening acupuncture in the adjuvant treatment of patients with ischemic stroke during convalescence.Methods From February 2021 to February 2022,80 patients with ischemic stroke in recovery period admitted to Department of Rehabilitation of Linfen Central Hospital were divided into the control group and the observation group by random number table method,with 40 cases in each group.The control group was given conventional medical basic treatment and rehabilitation training,and the observation group was given consciousness-restoring and orifice-opening acupuncture treatment on this basis.Both groups were treated for 1 month and followed up for 2 months.The efficacy after 1 month of treatment,cognition,neurological deficits,motor function and balance,neurologic factors,cerebral hemodynamics before and after 1 month of treatment,fall risk and prognosis at 2 months after treatment of two groups were compared.Results After 1 month of treatment,the total effective rate of the observation group(95.00%,38/40)was higher than that of the control group[77.50%(31/40),P<0.05].After 1 month of treatment,the scores of mini-Mental State Examination(MMSE),Fugl-Meyer Scale(FMA),Berg balance scale(BBS),serum levels of nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF),end-diastolic blood flow velocity(Vd),peak systolic blood flow velocity(Vs)and mean blood flow velocity(Vm)of middle cerebral artery increased,and the indicators were higher in the observation group(P<0.05).The scores of national institutes of health stroke scale(NIHSS),serum levels of neuronal specific olase(NSE),S100B protein(S100B),pulse index(PI)and resistance index(RI)of middle cerebral artery decreased in the two groups,and those of the observation group were lower(P<0.05).At 2 months after treatment,the proportion of standing up and walking timing test(TUGT)≤12 s,chair rising test(CRT)≤10 s and modified Rankin scale(mRS)<2 were higher in the observation group(P<0.05).Co

关 键 词：缺血性脑卒中 恢复期 醒脑开窍针刺法 神经因子 脑血流动力学 认知 平衡能力 

分 类 号：R246.6[医药卫生—针灸推拿学]