利用磁共振PWI技术观察头皮针对脑梗死患者脑血流灌注影响研究
作者:
作者单位:

1. 安徽中医药大学第二附属医院,安徽 合肥 230061;2. 安徽中医药大学针灸骨伤临床学院,安徽 合肥 230038

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R246.6

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* 基金项目: 安徽中医药大学临床科研基金项目(2014lc01024) 收稿日期: 2016 - 09 - 23 作者简介: 胡进(1984-),男,安徽合肥人,主治医师,研究方向:针灸防治脑病。


Effect of Scalp Acupuncture on Cerebral Blood Flow in Patients with Cerebral InfarctionUsing Magnetic Resonance PWI Technique
Author:
Affiliation:

1. The Second Affiliated Hospital of Anhui University of CM, Hefei 230061, China;2. Acupuncture Clinical College, Anhui University of CM, Hefei 230038, China

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    摘要:

    目的 观察并探索头皮针结合体针治疗脑梗死的作用疗效及作用途径。方法 将180例脑梗死患者随机分为头针组、体针组、综合组(头皮针结合体针),每组均60例,头针组取顶中线、顶旁1线、顶旁2线、顶颞前斜线、顶颞后斜线、颞前线、颞后线;体针组主穴取患侧肩髃、曲池、外关、合谷、伏兔、双膝眼、双足三里。配穴取患侧极泉、尺泽、内关、气冲、委中、阴陵泉、三阴交、太冲;综合组穴位及操作同头针组和体针组,头皮针联合体针。每周治疗6d,休息1d之后继续治疗,4周为1疗程,1疗程之后观察临床疗效。结果 从神经功能缺损程度评分、日常生活活动能力、上肢简式Fugl-Meyer运动评分、肌张力痉挛程度的测定、残疾程度等多方面进行疗效评价,经过1个疗程的治疗,综合组疗效较为显著。在神经功能缺损程度评分(NIHSS)、日常生活活动能力(ADL BI)、上肢简式运动能评价方法(FMA)、下肢简式运动能评价方法(FMA)、肌张力痉挛程度的测定(A Shworth)、残疾程度(Rankin评分)的评价上,综合组优于头针组和体针组,差异具有统计学意义(P<0.05),在治疗前后进行PWI检查,观察灌血区域及时间的改善,结果表明综合治疗方法能显著改善患者脑灌血区域及时间,差异具有统计学意义(P<0.05)。结论 头皮针结合体针能发挥协同作用,更好地改善脑梗死患者后遗症。其作用机制可能与改善患者脑血流灌注区域及时间有关。

    Abstract:

    Objective To observe the combined scalp acupuncture effect features and advantages of acupuncture in the treatment of cerebral infarction. Methods 180 cases of cerebral infarction were randomly divided into acupuncture group, acupuncture group and integrated group(scalp acupuncture combined with body acupuncture), each group of 60 cases, scalp acupuncture group take the top line, top 1, top 2 side line side line, D, D, temporal front and posterior temporal line; Acupuncture the group took ipsilateral Jianyu, Quchi, Hegu, Waiguan, futu, double knee eye, double zusanli. With the ipsilateral Jiquan, chize, Neiguan, air, Weizhong, yinlingquan, Sanyinjiao, Taichong;comprehensive group the combination of scalp acupuncture combined with body acupuncture. Treatment 6 days a week, rest 1 days after the treatment, 4 weeks for 1 courses, 1 after the observation of clinical efficacy. Results To evaluate the curative effect score, from the degree of nervous function defect and activities of daily living, simple type Fugl-Meyer motor score, upper limb muscle spasticity was measured and the degree of disability and other aspects, after 1 courses of treatment, the curative effect is more significant in combination group. The score in the degree of neural function defect(NIHSS), activities of daily living(ADL BI), the upper limb movement simple evaluation method(FMA), lower limb movement simple evaluation method(FMA), the determination of muscle spasticity(A Shworth), the degree of disability evaluation(Rankin score), statistically significant differences(P<0.05), PWI was performed before and after treatment, improve blood irrigation area and the time of observation, the results showed that the method can significantly improve the treatment of patients with cerebral blood perfused area and time, the difference was statistically significant(P<0.05). Conclusion Scalp acupuncture has obvious advantages in the treatment of cerebral infarction, and has significant clinical curative effect.

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