头穴透刺法治疗急性脑梗死临床疗效动态观察

摘要

目的：动态观察头穴透刺法治疗急性脑梗死的临床疗效，以期规范针灸疗程，提高针灸疗效。方法：66例急性脑梗死患者随机分为针刺组、药物组，每组33例。药物组采用神经内科常规药物治疗；针刺组在常规药物治疗（同药物组）基础上采用百会透刺曲鬓穴针法治疗，连续治疗8周，期间通过动态观察神经功能缺损程度评分、Barthel指数，比较疗前、疗后1周、2周、4周、8周两组间疗效变化的差异。结果：排除脱落病例后，针刺组29例、药物组30例纳入统计。疗后1周针刺组的神经功能缺损程度评分、Barthel指数及总有效率与药物组比较均无显著性差异；疗后2周针刺组的神经功能缺损评分明显下降（P＜0．05），总有效率为69％，优于药物组的33．3％，但Barthel指数变化不显著；疗后4周针刺组总有效率为89．7％，优于药物组的63．3％（P＜0．05），Barthel指数显著高于药物组（P＜0．05）；疗后8周与疗后4周对比，针刺组神经功能缺损评分下降及Barthel 指数增加的幅度均显著大于药物组（ P＜0.05），针刺组总有效率96．6％优于药物组73．3％（P＜0．05）。结论：针刺起效需要一定时间，头穴透刺法治疗急性脑梗死应以2周作为1个疗程，延长疗程会进一步提高疗效。%Objective:To observe the clinical efficacy of scalp point -through -point acupuncture on acute cerebral infarction to standardize the treatment session , as to increase the therapeutic effect of acupuncture . Methods:Sixty-six patients with acute cerebral infarction were randomized into an acupuncture group and a medication group ,with 33 cases in each group .In the medication group , the conventional medicine treatment was applied .In the acupuncture group , based on the same treatment in the medication group , Baihui-Qubin acupuncture was supplemented .The treatment session was for 8 weeks and compare the difference of therapeutic efficacy between two groups before and after 1 week, 2 weeks, 4 weeks, 8 weeks of the treatment by using scores of nervous functions deficit and Barthel scale .Results:Twenty-nine cases in the acupuncture group and 30 cases in the medication group were included in the statistical analysis .There were no significant differences in the scores of nervous functions deficit , Barthel scale and total effective rate between two groups before and af-ter 1 week;after 2 weeks, in the acupuncture group the scores of nervous functions deficit were reduced signifi-cantly and the total effective rate was 69%,which was superior to that of 33.3%in the medication group(P<0.05), but there was no significant difference in Barthel scale;after 4 weeks, the total effective rate was 89.7%,which was better than that of 63 .3%in the medication group and the Barthel scale was higher than that in the medication group ( P<0 .05 );after 8 weeks and 4weeks , the decreasing degree of the scores of nervous functions deficit and increasing degree of the Barthel scale in the acupuncture group were more obvious than those in the medication group(P<0.05),and the total effective rate was 96.6%,which was superior to that of 733.%in the medication group(P<0.05).Conclusion:It needs some time to get the efficacy of acupuncture treatment.The treatment period should be 2 weeks for scalp point -through-point acupuncture on acute cere-bral infarction .Prolonging the acupuncture treatment can get a better efficacy .