目的 观察并分析早期针刺与康复运动双因素治疗重型颅脑损伤患者意识障碍的交互作用和临床意义.方法 120例重型颅脑损伤后急性期昏迷患者在常规治疗基础上随机分为综合组、针刺组、康复组和对照组.综合组予针刺和康复运动治疗;针刺组予针刺治疗;康复组行康复运动;对照组不针刺、不做康复运动.在治疗前后均对其进行Glasgow昏迷量表(GCS)评定.结果 治疗1个月后,4组GCS评分均有明显提高.综合组促醒时间优于对照组(P＜0.05);3个治疗组GCS评分明显优于对照组(P＜0.01);综合组、针刺组促醒时间明显优于康复组、对照组(P＜0.01).结论 重型颅脑损伤昏迷患者早期开展针刺及康复运动能明显缩短其昏迷时间,减轻意识障碍程度,改善预后.针刺腧穴、康复训练对颅脑损伤患者的意识障碍均有促醒作用.针刺促醒作用强,起效快捷,疗效显著,康复运动促醒作用较弱,起效缓慢.%Objective To observe the effect of early acupuncture and rehabilitation exercise for treatment of acute coma following severe cerebral trauma. Methods One hundred and twenty patients with acute coma following severe cerebral trauma were treated with routine surgical treatment and all patients were divided into the combination group (acupuncture with rehabilitation exercise group), the acupuncture group, the rehabilitation exercise group and the control group. The curative effect was evaluated by the Glasgow coma scale (GCS). Results After the treatment for 1 month, the index of GCS in all four groups were improved significantly. The clinical observation result showed: Wake up time of coma was better in combination group than that in control group (P<0. 05). GCS index in three treatment groups was better than that in control group (P<0. 01). Wake up time of coma in combination group and acupuncture group was better than that in rehabilitation group, control group (P<0. 01). Conclusion Early acupuncture and rehabilitation exercise could obviously reduce the coma time, reduce disorder of consciousness, and improve the prognosis. Acupuncture and rehabilitation exercise could promote wake up in patients with coma following severe cerebral trauma.
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