人中（GV26）及内关（PC6）特效穴对颅脑外伤术后昏迷患者促醒疗效观察

Effect of Renzhong (GV26) and Neiguan (PC6) combination on consciousness in patients undergoing operation after traumatic brain injury

关键词:  人中穴  内关穴  颅脑外伤术后  昏迷

Key words:  Renzhong(GV26)  Neiguan(PC6)  operation after traumatic brain injury  coma

摘要:

[目的] 探讨人中（GV26）及内关（PC6）特效穴组合对颅脑外伤（TBI）术后患者的促醒疗效及操作安全性。[方法] 将重症监护病房（ICU）100例符合研究纳入标准的TBI术后昏迷患者随机分为特效穴治疗组与常规基础治疗对照组，每组50例。两组患者术后均采取常规西医治疗方案；特效穴治疗组在基础治疗方案基础上于术后第3天加用特效穴刺激治疗，治疗方案：取人中及内关穴，人中穴重手法雀啄刺激至患者眼球湿润或流泪，双侧内关穴电针疏密波刺激，频率10/50 Hz，电流强度以患者穴位局部肌肉抽动为度，每日治疗1次，留针90 min，共治疗14 d；对照组按常规基础方案治疗。疗效评价指标包括14 d苏醒率、失匹配负波（MMN）、总住院时间与ICU住院时间、死亡事件发生数等。[结果] 特效穴治疗组患者在治疗14 d后苏醒患者19例，苏醒率38%，优于对照组（10例，20%），MMN波形振幅增加高于对照组，差异具有统计学意义（P<0.05）；特效穴治疗组患者总住院时间及ICU住院时间均少于对照组，差异具有统计学意义（P<0.05）。[结论] 新发颅脑外伤术后第3天，开展针刺特效穴人中及内关治疗有助于改善患者意识障碍状态，并对缩短总住院时间及ICU住院时间具有帮助意义，同时重手法长时间结合双侧电针刺激的针刺操作方案是安全的，且操作简便易标准化统一，值得临床推广运用与进一步研究。

Abstract:

[Objective] To observe the efficacy and safety of acupuncture GV26+PC6 in patients with traumatic brain injury after operation to improve the consciousness.[Methods] A total of 100 intensive care unit (ICU) patients of standard depression were recruited in the trial and randomized into acupuncture or control groups,with 50 cases in each group. Patients in both groups were treated with conventional western medicine 3 days after surgery. For patients in acupuncture group,electro-acupuncture "GV26+PC6" were given based on western medicine. GV26 were punctured with heavy pecking until patients' eyes became moist or watery. And for the PC6,the disperse-dense wave electro-acupuncture(10 Hz/50 Hz) were given daily for 14 days,and retain needle for 90 min. The current intensity was depended on the degree of local muscle twitch at the acupoint. For patients in control group,treatment of western medicine was given simply. 14-day arousal rate,mismatch negativity,length of total hospital stays and ICU stay,and dead cases were used to assessing the therapeutic effect.[Results] The arousal rate of the patients in the acupuncture group (19 cases and 38%) was higher than that of the control group (10 cases and 20%) after 14-day treatment. The amplitude of mismatch negativity in the acupuncture increased more than that of the control group,and the length of total hospital stay and ICU stay of the patients were all shorter than those in the control group (P<0.05).[Conclusion] Three days after the operation of new traumatic brain injury,acupuncture "GV26+PC6" can improve the patients' consciousness,and shorten the total hospitalization days and the hospitalization days in the ICU. In addition,heavy pecking and bilateral electro-acupuncture stimulation for a long timeis safe,simple and easy to operate and standardized,which is worthy of clinical promotion and further study.