早期针刺对急性缺血性脑卒中患者脑血流即刻效应和累积效应影响
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摘要
目的探讨早期针刺对急性缺血性脑卒中患者脑血流动力学即刻效应和累积效应的影响。方法采用随机数字表法将60例急性缺血性脑卒中患者分为治疗组和对照组各30例。2组患者均予西医常规治疗。治疗组在常规西医治疗基础上予针刺(使用循环药物前行首次针刺),每次留针30 min,每10 min行针1次,每日1次。2组均连续治疗14 d。观察2组患者大脑中动脉收缩期峰速(Vs)、舒张期峰速(Vd)、搏动指数(PI)及阻力指数(RI)情况。结果与治疗前比较,治疗组首次针刺后大脑中动脉Vs、Vd升高,PI、RI降低(P<0.01)。与首次针刺后比较,治疗组治疗后大脑中动脉Vs、Vd升高,PI、RI降低(P<0.05)。与本组治疗前比较,治疗组治疗后Vs、Vd、PI、RI及对照组治疗后Vs、PI明显改善(P<0.05);2组治疗后比较,治疗组Vs、Vd、PI、RI改善优于对照组(P<0.05)。结论早期针刺对急性缺血性脑卒中患者脑血流可产生即刻效应和累积效应,多次针刺可增强效果。
Objective To investigate the immediate and cumulative effects of early acupuncture therapy on cerebral hemodynamics in patients with acute ischemic stroke. Methods Totally 60 patients with acute ischemic stroke were selected and randomly divided into treatment group and control group, with 30 patients in each group. The two groups were treated with routine Western treatment. On the basis of above, the treatment group was given acupuncture treatment(acupuncture for the first time before the use of circulating medication), 30 minutes for each needle, 1 needle every 10 minutes, once per day. The treatment for both groups lasted for 14 d. The changes of systolic peak velocity(Vs), diastolic peak velocity(Vd), pulsatility index(PI) and resistance index(RI) of middle cerebral artery(MCA) in the two groups were observed. Results Compared with before treatment, both Vs and Vd increased and both PI and RI decreased in the treament group(P<0.05); Compared with the treatment for 1 d, both Vs and Vd increased and both PI and RI decreased in the treament group after treatment(P<0.05). Compared with before treatment, Vs, Vd, PI, RI in the treatment group and Vs and PI in the control group were significantly improved after treatment(P<0.05). After treatment, the improvement of Vs, Vd, PI and RI in the treatment group was better than that in the control group(P<0.05). Conclusion Early acupuncture has immediate and cumulative effects on cerebral blood flow in patients with acute ischemic stroke. Many times of acupuncture may strengthen the effects of acupuncture.
Objective To investigate the immediate and cumulative effects of early acupuncture therapy on cerebral hemodynamics in patients with acute ischemic stroke. Methods Totally 60 patients with acute ischemic stroke were selected and randomly divided into treatment group and control group, with 30 patients in each group. The two groups were treated with routine Western treatment. On the basis of above, the treatment group was given acupuncture treatment(acupuncture for the first time before the use of circulating medication), 30 minutes for each needle, 1 needle every 10 minutes, once per day. The treatment for both groups lasted for 14 d. The changes of systolic peak velocity(Vs), diastolic peak velocity(Vd), pulsatility index(PI) and resistance index(RI) of middle cerebral artery(MCA) in the two groups were observed. Results Compared with before treatment, both Vs and Vd increased and both PI and RI decreased in the treament group(P<0.05); Compared with the treatment for 1 d, both Vs and Vd increased and both PI and RI decreased in the treament group after treatment(P<0.05). Compared with before treatment, Vs, Vd, PI, RI in the treatment group and Vs and PI in the control group were significantly improved after treatment(P<0.05). After treatment, the improvement of Vs, Vd, PI and RI in the treatment group was better than that in the control group(P<0.05). Conclusion Early acupuncture has immediate and cumulative effects on cerebral blood flow in patients with acute ischemic stroke. Many times of acupuncture may strengthen the effects of acupuncture.
引文
[1]ZHANG X,WU J,ZHANG B.Xuesaitong injection as one adjuvant treatment of acute cerebral infarction:a systematic review and meta-analysis[J].BMC Complement Altern Med,2015,15:36.
[2]LIU L.Stroke and stroke care in China:huge burden,significant workload,and a national priority[J].Stroke,2011,42(12):3651-3654.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[4]石学敏.针灸学[M].北京:中国中医药出版社,2004:116.
[5]SANCHEZ E C.Mechanisms of action of hyperbaric oxygenation in stroke:a review[J].Crit Care Nurs Q,2013,36(3):290-298.
[6]ZHU X M,HOU J Y.Clinical observation on electroacupuncture for post stroke flaccid paralysis[J].J Acupunct Tuina Sci,2013,11(4):240-243.
[7]NI H H.Effect of combining acupuncture and functional training on post-stroke functional impairment of hand[J].J Acupunct Tuina Sci,2013,11(6):349-352.
[8]刘慧影,王鹏琴,边颖,等.眼针干预脑缺血再灌注模型大鼠神经功能及相关神经营养因子的表达[J].中国组织工程研究,2016,20(18):2634-2641.
[9]文怡川.针刺百会穴对急性缺血性卒中患者大脑中动脉血流即时效应的影响[J].现代医药卫生,2013,29(23):3528-3532.
[10]陈新勇.头针针刺病灶侧和非病灶侧对中风患者脑血流的影响[J].上海针灸杂志,2011,30(9):586-588.
[11]陈利芳.针刺治疗脑卒中亚急性期运动障碍多中心随机对照研究[J].中国针灸,2014,34(4):313-315.
[12]吴斐,曹文杰,董强,等.经颅多普勒超声在急性脑卒中静脉溶栓患者中的应用[J].中国临床神经科学,2014,22(2):228-233.
[13]KHAN M A,COMBS C S,BRUNT E M,et al.Positron emission tomography scanning in the evaluation of hepatocellular carcinoma[J].Hepatol,2000,32(5):792-797.
[14]BISHOP C C,POWEL S,RUUNT D,et al.Transcranial Doppler Measurement of middle cerebral artery blood fow velocity:a validation study[J].Stroke,1986,17(5):913-915.
[15]SUGIMORI H,LBAYSAHI S,FUJII K,et al.Can Transcranial Doppler really detect reduced cerebral perfusion states[J].Stroke,1995,26(11):2053-2055.
[16]佟旭.经颅多普勒超声评价脑血管反应性和脑血流自动调节[J].中国卒中杂志,2014,9(7):613-617.
[2]LIU L.Stroke and stroke care in China:huge burden,significant workload,and a national priority[J].Stroke,2011,42(12):3651-3654.
[3]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[4]石学敏.针灸学[M].北京:中国中医药出版社,2004:116.
[5]SANCHEZ E C.Mechanisms of action of hyperbaric oxygenation in stroke:a review[J].Crit Care Nurs Q,2013,36(3):290-298.
[6]ZHU X M,HOU J Y.Clinical observation on electroacupuncture for post stroke flaccid paralysis[J].J Acupunct Tuina Sci,2013,11(4):240-243.
[7]NI H H.Effect of combining acupuncture and functional training on post-stroke functional impairment of hand[J].J Acupunct Tuina Sci,2013,11(6):349-352.
[8]刘慧影,王鹏琴,边颖,等.眼针干预脑缺血再灌注模型大鼠神经功能及相关神经营养因子的表达[J].中国组织工程研究,2016,20(18):2634-2641.
[9]文怡川.针刺百会穴对急性缺血性卒中患者大脑中动脉血流即时效应的影响[J].现代医药卫生,2013,29(23):3528-3532.
[10]陈新勇.头针针刺病灶侧和非病灶侧对中风患者脑血流的影响[J].上海针灸杂志,2011,30(9):586-588.
[11]陈利芳.针刺治疗脑卒中亚急性期运动障碍多中心随机对照研究[J].中国针灸,2014,34(4):313-315.
[12]吴斐,曹文杰,董强,等.经颅多普勒超声在急性脑卒中静脉溶栓患者中的应用[J].中国临床神经科学,2014,22(2):228-233.
[13]KHAN M A,COMBS C S,BRUNT E M,et al.Positron emission tomography scanning in the evaluation of hepatocellular carcinoma[J].Hepatol,2000,32(5):792-797.
[14]BISHOP C C,POWEL S,RUUNT D,et al.Transcranial Doppler Measurement of middle cerebral artery blood fow velocity:a validation study[J].Stroke,1986,17(5):913-915.
[15]SUGIMORI H,LBAYSAHI S,FUJII K,et al.Can Transcranial Doppler really detect reduced cerebral perfusion states[J].Stroke,1995,26(11):2053-2055.
[16]佟旭.经颅多普勒超声评价脑血管反应性和脑血流自动调节[J].中国卒中杂志,2014,9(7):613-617.
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