头穴围刺结合针刀治疗脑梗死后痉挛性瘫痪临床研究  

Clinical Study on Spastic Hemiplegia after Cerebral Infarction Treated with Scalp Surrounding Needling and Acupotomy

作　　者：马乐 郑义 张倩[1] 谭锦郎 龚睿 陈思雨 康兴宇 师帅[2] MA Le;ZHENG Yi;ZHANG Qian;TAN Jinlang;GONG Rui;CHEN Siyu;KANG Xingyu;SHI Shuai(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001

出　　处：《针灸临床杂志》2025年第2期19-25,共7页Journal of Clinical Acupuncture and Moxibustion

基　　金：黑龙江省自然科学基金,编号:LH2022H080;黑龙江省中医药科研项目,编号:GY2022-15。

摘　　要：目的:阐明头穴围刺(百会,四神聪)联合针刀对脑梗死后痉挛性瘫痪的临床疗效。方法:在随机单盲(结果评估者)对照试验中将60例脑梗死后痉挛性瘫痪的患者随机分为治疗组和对照组,每组30例。治疗组为头穴围刺联合针刀治疗,对照组为针刀治疗。同一部位针刀治疗1次/周,非同一部位针刀连续治疗6 d休息1 d。头穴围刺治疗针刺6 d休息1 d。两组疗程均为4周。观察并比较两组患者治疗前与治疗第2、4周时的脑卒中专用生活质量量表(SS-QOL)、Barthel指数评定量表、改良Ashworth量表(MAS)和改良Rankin量表(mRS)改善程度变化以及血清γ-氨基丁酸(GABA)及甘氨酸(Gly)水平变化,并评估临床疗效。结果:两组患者治疗后Barthel指数、SS-QOL值指数、GABA和Gly含量均明显高于治疗前,差异具有统计学意义(P<0.05),治疗组在治疗2周、4周时上述指标明显高于对照组,差异具有统计学意义(P<0.05)。两组治疗后mRS值指数均明显低于治疗前,差异具有统计学意义(P<0.05),治疗组在治疗2周、4周时上述指标明显低于对照组,差异具有统计学意义(P<0.05)。治疗组和对照组在治疗后MAS评级比较明显优于治疗前。结论:在针刀治疗基础上配合头穴围刺治疗可以改善患者脑梗死后痉挛性偏瘫和临床症状,提高患者生活质量。Objective:To explore the clinical therapeutic effect of scalp surrounding needling Baihui(DU20)and Sishencong(EX-HN1)combined with acupotomy in treatment of spastic hemiplegia after cerebral infarction.Methods:In this randomized single-blinded(outcome evaluator)controlled trial,and 60 patients with spastic hemiplegia after cerebral infarction were randomly assigned to the treatment group and the control group,with 30 patients in each group.The treatment group was treated with scalp surrounding needling and acupotomy,and the control group was only treated with acupotomy.The same location was treated with acupotomy once a week,and the non-same location was treated with acupotomy for 6 consecutive days with 1 day off.Scalp surrounding needling was also 6 consecutive days with 1 day off.The treatment course of both groups was 4 weeks.The scores of stroke Specific Quality of Life Scale(SS-QOL),Barthel Index Rating Scale,Modified Ashworth Scale(MAS)and Modified Rankin Scale(mRS)were observed and compared between the two groups before the treatment and on the 2nd and 4th week of the treatment.The serum levels of gamma-aminobutyric acid(GABA)and glycine(Gly)were observed in the two groups.The clinical efficacy was compared between the two groups.Results:The indexes of Barthel and SS-QOL,as well as the contents of GABA and Gly were significantly higher after the treatment than those before the treatment in the two groups(P<0.05),and the above indexes in the treatment group were significantly higher than those in the control group on the 2nd and 4th week of the treatment(P<0.05).The mRS value was significantly lower after the treatment than that before the treatment in the two groups(P<0.05),which was lower in the treatment group than that in the control group on the 2nd and 4th week of the treatment(P<0.05).The MAS rating was significantly better after the treatment than that before the treatment in the two groups(P<0.05).Conclusion:The combination of scalp surrounding needling and acupotomy can improve spastic hemiplegia

关 键 词：痉挛性偏瘫 脑梗死 头穴围刺 百会穴 针刀 

分 类 号：R246.6[医药卫生—针灸推拿学]