针刺左侧曲泽穴对脑梗死恢复期患者颈内动脉、椎基底动脉血流动力学影响的研究
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摘要
目的应用经颅多普勒超声(TCD)技术,探究针刺左侧曲泽穴对脑梗死恢复期患者颈内动脉(ICA)和椎基底动脉(VA,BA)血流动力学的影响,为临床选用曲泽穴治疗脑血管疾病提供理论依据。方法随机选取脑梗死恢复期患者60例,针刺患者左侧曲泽穴,采用经颅多普勒超声仪经颞窗探测受试者双侧颈内动脉和椎基底动脉,分别在针刺前、进针后、行针时、出针时、出针后5个时间节点记录受试者ICA、VA、BA收缩末期最大血流速度Vs、舒张末期最大血流速度Vd、平均血流速度Vm、波动指数PI及阻抗指数RI的数据。结果针刺左侧曲泽穴,与针刺前相比,右侧ICA在行针时、出针时与出针后三个时间点Vs、Vd、Vm呈现上升趋势,具有统计学意义(P<0.05);左侧ICA各项血流动力学指标与进针前相比虽有改变,但差异无统计学意义(P>0.05)。针刺左侧曲泽穴,右侧VA在行针时、出针时与出针后三个时间点的Vs、Vd、Vm增加,在进针时Vs、Vm增加,差异具有统计学意义(P<0.05);左侧VA的各项指标改变无统计学意义(P>0.05)。针刺左侧曲泽穴,BA在进针时、行针时、出针时与出针后三个时间点的Vs,Vd,Vm增加,差异有统计学意义(P<0.05)。结论针刺左侧曲泽穴可以增加右侧ICA、右侧VA及BA的血流速度,对脑梗死恢复期患者脑血流动力学具有正性调节作用和累积效应。
Objective To explore the impacts on the hemodynamics of the internal carotid artery(ICA) and vertebrobasilar arteries(VBA) in the patients at the recovery stage of cerebral infarction treated with acupuncture at the left Quze(PC3) with the transcranial Doppler technique(TCD) so as to provide the theoretic evidences of Quze(PC3) for cerebral vascular diseases in clinical treatment. Methods A total of 60 patients at the recovery stage of cerebral infarction were randomly selected. Acupuncture was used at the left Quze(PC3). TCD was adopted to detect the bilateral ICA and VBA via the temperal window. Separately,before acupuncture,after needle insertion,during manipulation,at the time of needle withdrawal and after needle withdrawal,the Vs,Vd,Vm,PI and RI of ICA and VBA were recorded. Results After acupuncture at the left Quze(PC3),Vs,Vd and Vm were increased in tendency during manipulation,at the time of needle withdrawal and after needle withdrawal at ICA on the right side,indicating the significant differences as compared with that before acupuncture(P < 0. 05). The hemodynamic indexes changed as compared those before needle insertion at the left ICA,but the differences were not significant(P > 0. 05). Vs,Vd and Vm were increased at the right VA during manipulation,at the time of needle withdrawal and after needle withdrawal and Vs and Vm increased when needle inserted,the differences were significant(P < 0. 05). The changes in the indexes were not significant at the left VA(P > 0. 05). Vs,Vd and Vm were increased significantly at BA when needle inserted,withdrawn and manipulated and after withdrawal(P < 0. 05). Acupuncture at the left Quze(PC3) did not change PI and RI significantly at the bilateral ICA,VA and BA. Conclusion Acupuncture at the left Quze(PC3) increases the blood velocity at the right ICA and VBA and presents the positive regulatory and accumulative effects on the hemodynamics of the brain in the patients at the recovery stage of cerebral infarction.
Objective To explore the impacts on the hemodynamics of the internal carotid artery(ICA) and vertebrobasilar arteries(VBA) in the patients at the recovery stage of cerebral infarction treated with acupuncture at the left Quze(PC3) with the transcranial Doppler technique(TCD) so as to provide the theoretic evidences of Quze(PC3) for cerebral vascular diseases in clinical treatment. Methods A total of 60 patients at the recovery stage of cerebral infarction were randomly selected. Acupuncture was used at the left Quze(PC3). TCD was adopted to detect the bilateral ICA and VBA via the temperal window. Separately,before acupuncture,after needle insertion,during manipulation,at the time of needle withdrawal and after needle withdrawal,the Vs,Vd,Vm,PI and RI of ICA and VBA were recorded. Results After acupuncture at the left Quze(PC3),Vs,Vd and Vm were increased in tendency during manipulation,at the time of needle withdrawal and after needle withdrawal at ICA on the right side,indicating the significant differences as compared with that before acupuncture(P < 0. 05). The hemodynamic indexes changed as compared those before needle insertion at the left ICA,but the differences were not significant(P > 0. 05). Vs,Vd and Vm were increased at the right VA during manipulation,at the time of needle withdrawal and after needle withdrawal and Vs and Vm increased when needle inserted,the differences were significant(P < 0. 05). The changes in the indexes were not significant at the left VA(P > 0. 05). Vs,Vd and Vm were increased significantly at BA when needle inserted,withdrawn and manipulated and after withdrawal(P < 0. 05). Acupuncture at the left Quze(PC3) did not change PI and RI significantly at the bilateral ICA,VA and BA. Conclusion Acupuncture at the left Quze(PC3) increases the blood velocity at the right ICA and VBA and presents the positive regulatory and accumulative effects on the hemodynamics of the brain in the patients at the recovery stage of cerebral infarction.
引文
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[5]吴福梅.针刺少阳经腧穴治疗偏头痛即时效应和累积效应的大脑局部一致性研究[D].成都:成都中医药大学,2013.
[6]周恩华.针刺对腹泻型肠易激综合征患者结肠蠕动的即时效应观察[J].中华中医药学刊,2011,29(2):293-296.
[7]刘波,刘岘.观察针刺后效应对脑功能连接的影响[J].中国医学影像技术,2009,25(12):2186-2189.
[8]程为平,赵健.针刺左侧足三里对健康青年人大脑后动脉血液流动力学影响的研究[J].针灸临床杂志,2013,29(9):37-39.
[9]程为平,张安邦,何微,等.针刺左侧飞扬穴对健康青年大脑中动脉血流动力学的影响[J].针灸临床杂志,2012,28(5):33-35.
[10]易玮,许能贵.针刺对局灶性脑缺血大鼠脑血流量的影响[J].实验针灸,2001,10(33):75-76.
[2]中华神经科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[3]国家中医药管理局脑病协作组.中风病诊断与疗效评定标准[J].北京中医药大学学报,1996,19(1):55-56.
[4]石学敏.针灸学[M].2版.北京:中国中医药出版社,2007:81.
[5]吴福梅.针刺少阳经腧穴治疗偏头痛即时效应和累积效应的大脑局部一致性研究[D].成都:成都中医药大学,2013.
[6]周恩华.针刺对腹泻型肠易激综合征患者结肠蠕动的即时效应观察[J].中华中医药学刊,2011,29(2):293-296.
[7]刘波,刘岘.观察针刺后效应对脑功能连接的影响[J].中国医学影像技术,2009,25(12):2186-2189.
[8]程为平,赵健.针刺左侧足三里对健康青年人大脑后动脉血液流动力学影响的研究[J].针灸临床杂志,2013,29(9):37-39.
[9]程为平,张安邦,何微,等.针刺左侧飞扬穴对健康青年大脑中动脉血流动力学的影响[J].针灸临床杂志,2012,28(5):33-35.
[10]易玮,许能贵.针刺对局灶性脑缺血大鼠脑血流量的影响[J].实验针灸,2001,10(33):75-76.
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