针刺任督二脉联合皮内针治疗缺血性脑梗死睡眠-觉醒节律紊乱随机平行对照研究
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摘要
[目的]观察针刺任督二脉联合皮内针治疗缺血性脑梗死睡眠-觉醒节律紊乱疗效。[方法]使用随机平行对照方法,将106例住院患者按病志号抽签简单随机分两组。对照组53例取内关、神门、百会、四神聪,痰热内扰加足三里、丰隆、内庭;阴虚火旺加太溪、心俞;气虚血瘀加血海、脾俞、膈俞、足三里;于神庭、百会平刺帽状肌腱膜0.5寸,捻转泻法;直刺关元、气海1~1.5寸,提插捻转,补法为主;余穴均平补平泻;5次/周。治疗组53例任督二脉主穴:任脉取关元、气海,督脉取百会、印堂、神庭;随证取穴与治疗方法同对照组;皮内针:耳穴取皮质下、神门;取三阴交、神门、心俞;心胆气虚者配胆俞,心脾两虚配脾俞;穴位消毒,体穴用颗粒皮内针,左手按压穴位并撑开穴位皮肤,右手用镊子夹住皮内针,沿皮下入针至真皮内,针身平行埋入0.5~1cm,将针柄用箭头状胶布固定,用箭头标明针尖走向。耳穴用揿针型皮内针,针尖直刺穴位后用方形胶布固定;夏季埋针1~2d,其余季节为3~4d。连续治疗4周为1疗程。观测临床症状、AIS评分、夜间睡眠总时间、NIHSS、ADL、不良反应。治疗1疗程(4周),随访3个月,判定疗效。[结果]治疗组治愈13例,显效17例,有效19例,无效4例,总有效率92.45%;对照组治愈12例,显效19例,有效12例,无效10例,总有效率81.13%;治疗组疗效优于对照组(P<0.05)。AIS评分、夜间睡眠总时间、NIHSS、ADL治疗组优于对照组(P<0.01)。[结论]针刺任督二脉联合皮内针治疗缺血性脑梗死睡眠-觉醒节律紊乱,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of acupuncture at the treatment of acupuncture on the sleep-awakening rhythm disorder of ischemic cerebral infarction. [Methods] 106 random cases were randomly divided into two groups according to the random number method. The control group of 53 cases take Neiguan, Shenmen, Baihui,Sishencong, phlegm within the disturbance plus Sanli, Fenglong, inner court; Yin Huo-wang Taixi, Xinshu; Qi deficiency blood stasis plus blood, Pishu, Geshu, Zusanli; in the court, Baihui flat-shaped cap-shaped tendon veins 0.5 inch, twist diarrhea method; straight Guanyuan, air sea 1~1.5 inch, mention inserted twist, fill the main; Flat fill diarrhea; 5 times/week. Treatment group 53 cases of any governor of the second line of the main points: any pulse to take Guan Yuan, gas sea, Du line to take Baihui, Yintang, Shen Ting; with the card acupoints and treatment with the control group; intradermal needle: Shenmen; take Sanyinjiao, Shenmen, Xinshu; heart gall bladder with Danshu, heart and spleen deficiency with spleen; acupuncture points, the body with the particles within the needle, the left hand press the acupuncture points and support the skin, right hand with tweezers Pinch the needle, along the needle into the dermis, the needle body buried in parallel 0.5~1 cm, the needle handle with arrowshaped tape fixed, with arrows to indicate the tip to the direction. Ear with a needle-type intradermal needle, needle straight after the acupuncture points fixed with square tape; summer buried needle 1~2 d, the rest of the season for 3~4 d. Continuous treatment for 4 weeks for a course of treatment. Observation of clinical symptoms, AIS score, total nighttime sleep time, NIHSS, ADL, adverse reactions. Treatment 1 course of treatment(4 weeks), followed up for 3 months to determine the efficacy. [Results] The treatment group was cured in 13 cases, markedly effective in 17 cases, effective in 19 cases, ineffective in 4 cases, the total effective rate was 92.45%; the control group was cured in 12 cases, markedly effective in 19 cases, effective in 12 cases, 10 cases, the total effective rate was 81.13%; The treatment group was better than the controlgroup(P<0.05). AIS score, total nighttime sleep time, NIHSS, ADL treatment group was better than the control group(P<0.01). [Conclusion] The treatment of ischemic cerebral infarction with sleep-awakening rhythm disorder, curative effect and no serious adverse reaction is worthy of promotion.
[Objective] To observe the curative effect of acupuncture at the treatment of acupuncture on the sleep-awakening rhythm disorder of ischemic cerebral infarction. [Methods] 106 random cases were randomly divided into two groups according to the random number method. The control group of 53 cases take Neiguan, Shenmen, Baihui,Sishencong, phlegm within the disturbance plus Sanli, Fenglong, inner court; Yin Huo-wang Taixi, Xinshu; Qi deficiency blood stasis plus blood, Pishu, Geshu, Zusanli; in the court, Baihui flat-shaped cap-shaped tendon veins 0.5 inch, twist diarrhea method; straight Guanyuan, air sea 1~1.5 inch, mention inserted twist, fill the main; Flat fill diarrhea; 5 times/week. Treatment group 53 cases of any governor of the second line of the main points: any pulse to take Guan Yuan, gas sea, Du line to take Baihui, Yintang, Shen Ting; with the card acupoints and treatment with the control group; intradermal needle: Shenmen; take Sanyinjiao, Shenmen, Xinshu; heart gall bladder with Danshu, heart and spleen deficiency with spleen; acupuncture points, the body with the particles within the needle, the left hand press the acupuncture points and support the skin, right hand with tweezers Pinch the needle, along the needle into the dermis, the needle body buried in parallel 0.5~1 cm, the needle handle with arrowshaped tape fixed, with arrows to indicate the tip to the direction. Ear with a needle-type intradermal needle, needle straight after the acupuncture points fixed with square tape; summer buried needle 1~2 d, the rest of the season for 3~4 d. Continuous treatment for 4 weeks for a course of treatment. Observation of clinical symptoms, AIS score, total nighttime sleep time, NIHSS, ADL, adverse reactions. Treatment 1 course of treatment(4 weeks), followed up for 3 months to determine the efficacy. [Results] The treatment group was cured in 13 cases, markedly effective in 17 cases, effective in 19 cases, ineffective in 4 cases, the total effective rate was 92.45%; the control group was cured in 12 cases, markedly effective in 19 cases, effective in 12 cases, 10 cases, the total effective rate was 81.13%; The treatment group was better than the controlgroup(P<0.05). AIS score, total nighttime sleep time, NIHSS, ADL treatment group was better than the control group(P<0.01). [Conclusion] The treatment of ischemic cerebral infarction with sleep-awakening rhythm disorder, curative effect and no serious adverse reaction is worthy of promotion.
引文
[1]王盼,张熙.阿尔茨海默病与睡眠-觉醒节律紊乱[J].中华保健医学杂志,2015,17(2):154-156.
[2]肖仁国.改良悬雍垂腭咽成形术后出血并急性脑梗死1例[J].西南军医,2016,18(3):294-295.
[3]王晓华,周震,王颖,等.调神利眠针法联合艾司唑仑对脑梗死后失眠的影响[J].河北中医,2016,27(1):102-104;105.
[4]中华人民共和国卫生部.涉及人的生物医学研究伦理审查办法(试行)[S].(2007-03-26)[2015-02-05].http://www.moh.gov.cn/qjjys/s3581/200804/b9f1bfee4ab344ec892e68097296e2a8.shtml.
[5]温权,卢家春,陆必波,等.针灸治疗卒中后睡眠障碍疗效分析[J].中医临床研究,2016,8(24):97-98.
[6]靳国民,郭静.中医辨证施护配合耳穴贴压对缺血性卒中后失眠的影响[J].河北中医,2015,21(4):600-601;602.
[7]谢宇锋,陈赟,吴云天,等.围剿推拿疗法治疗脑卒中后睡眠倒错的临床疗效分析[J].针灸临床杂志,2016,32(1):15-17;18.
[8]邢来丽.针灸结合放血治疗脑卒中后抑郁症疗效观察[J].现代中西医结合杂志,2014,21(22):2485-2487.
[9]阮班魁.针灸和药物治疗脑卒中后睡眠障碍的效果对比[J].中医临床研究,2015,7(19):31-32.
[10]温权,卢家春,陆必波,等.针灸治疗卒中后睡眠障碍疗效分析[J].中医临床研究,2016,8(24):97-98.
[11]梁妮,黄丽燕,黄树武,等.五行针灸治疗卒中后抑郁症的理论探讨[J].中西医结合心脑血管病杂志,2015,22(17):1958-1960.
[12]宋晶晶,曹铁民.针刺联合加味黄连温胆汤治疗卒中后睡眠障碍30例[J].针灸临床杂志,2016,32(3):29-31.
[13]洪秀瑜,张卫.卒中后睡眠障碍应用畅气通络针法治疗的效果观察[J].中外医学研究,2015(25):157-158.
[14]马晓明,杨卓欣,于海波,等.调任通督针法治疗卒中后失眠的临床效果[J].中国医药导报,2016,13(11):150-154.
[2]肖仁国.改良悬雍垂腭咽成形术后出血并急性脑梗死1例[J].西南军医,2016,18(3):294-295.
[3]王晓华,周震,王颖,等.调神利眠针法联合艾司唑仑对脑梗死后失眠的影响[J].河北中医,2016,27(1):102-104;105.
[4]中华人民共和国卫生部.涉及人的生物医学研究伦理审查办法(试行)[S].(2007-03-26)[2015-02-05].http://www.moh.gov.cn/qjjys/s3581/200804/b9f1bfee4ab344ec892e68097296e2a8.shtml.
[5]温权,卢家春,陆必波,等.针灸治疗卒中后睡眠障碍疗效分析[J].中医临床研究,2016,8(24):97-98.
[6]靳国民,郭静.中医辨证施护配合耳穴贴压对缺血性卒中后失眠的影响[J].河北中医,2015,21(4):600-601;602.
[7]谢宇锋,陈赟,吴云天,等.围剿推拿疗法治疗脑卒中后睡眠倒错的临床疗效分析[J].针灸临床杂志,2016,32(1):15-17;18.
[8]邢来丽.针灸结合放血治疗脑卒中后抑郁症疗效观察[J].现代中西医结合杂志,2014,21(22):2485-2487.
[9]阮班魁.针灸和药物治疗脑卒中后睡眠障碍的效果对比[J].中医临床研究,2015,7(19):31-32.
[10]温权,卢家春,陆必波,等.针灸治疗卒中后睡眠障碍疗效分析[J].中医临床研究,2016,8(24):97-98.
[11]梁妮,黄丽燕,黄树武,等.五行针灸治疗卒中后抑郁症的理论探讨[J].中西医结合心脑血管病杂志,2015,22(17):1958-1960.
[12]宋晶晶,曹铁民.针刺联合加味黄连温胆汤治疗卒中后睡眠障碍30例[J].针灸临床杂志,2016,32(3):29-31.
[13]洪秀瑜,张卫.卒中后睡眠障碍应用畅气通络针法治疗的效果观察[J].中外医学研究,2015(25):157-158.
[14]马晓明,杨卓欣,于海波,等.调任通督针法治疗卒中后失眠的临床效果[J].中国医药导报,2016,13(11):150-154.