针刺联合动脉取栓术治疗急性脑梗死的临床观察

Clinical observation of acupuncture combined with arterial thrombectomy in the treatment of acute cerebral infarction

关键词:  针刺  动脉取栓术  急性脑梗死  临床观察

Key words:  acupuncture  arterial thrombectomy  acute cerebral infarction  clinical observation

摘要:

[目的] 比较针刺联合动脉取栓术与动脉取栓术治疗急性脑梗死的疗效差异。[方法] 将80例急性脑梗死患者随机分为试验组和对照组，每组40例。对照组给予动脉取栓术治疗，试验组在动脉取栓术治疗基础上针刺百会（GV20）、风池（GB20）、内关（PC6）、曲池（PC6）、三阴交（SP6）、足三里（ST36）、太冲（LR3），每日1次，连续治疗14 d。观察两组患者治疗后的发病90 d改良Rankin评分量表（mRS）评分、发病90 d时mRS评分为0~2、0~3分的分布比例、发病14 d美国国立卫生研究院卒中量表（NIHSS）评分、日常生活能力[Barthel指数（BI）评分]、Fugl-Meyer运动功能评分量表（FMA）评分。[结果] 发病第90天时试验组患者mRS评分低于对照组，两组比较差异有统计学意义（P＜0.05）。发病第90天时试验组患者mRS评分为0~2分的比例高于对照组，两组比较差异有统计学意义（P＜0.05）。发病第14天时，试验组患者NIHSS评分较治疗前降低，差异有统计学意义（P＜0.01）；对照组患者NIHSS评分较治疗前降低，但差异无统计学意义（P＞0.05）；发病第14天时，试验组患者NIHSS评分低于对照组，但差异无统计学意义（P＞0.05）。发病第14天时两组患者BI评定量表评分与治疗前比较，差异均无统计学意义（P＞0.05）；发病第14天时试验组患者与对照组患者BI评定量表评分比较，差异无统计学意义（P＞0.05）。发病第14天时，试验组患者FMA评分较治疗前升高，差异有统计学意义（P＜0.01）；发病第14天时，试验组患者FMA评分高于对照组，但差异无统计学意义（P＞0.05）。[结论] 针刺联合动脉取栓术能够改善急性脑梗死患者近期及远期预后，疗效优于单纯动脉取栓术治疗。

Abstract:

[Objective] To compare the efficacy of acupuncture combined with arterial thrombectomy and arterial thrombectomy in the treatment of acute cerebral infarction. [Methods] Total 80 patients with acute cerebral infarction were randomly divided into experimental group（40 cases） and control group（40 cases）. The control group was given arterial thrombectomy，and the experimental group was treated with Baihui（GV20），Fengchi（PC6），Neiguan（PC6），Quchi（PC6），Sanyinjiao（SP6），Zusanli（ST36） and Taichong（LR3） once a day for 14 days. The 90-day modified Rankin score（mRS），90-day mRS Score 0-2，0-3 distribution ratio，and 14-day National Institute of Health stoke scale were observed in the two groups. Barthel index rating scale for daily living ability（Barthel index rating scale for daily living ability，NIHSS），BI rating scale and Fugl-Meyer Motor Function Rating Scale（FMA）. [Results] The mRS Score of test group was lower than that of control group on the 90th day of disease onset，and there was a statistical difference between the two groups（P<0.05）. The proportion of mRS 0-2 in test group was higher than that in control group on the 90th day of onset，the difference was statistically significant（P<0.05）；the NIHSS score of test group on the 14th day of onset was lower than that in baseline period，the difference was statistically significant（P<0.01）；the NIHSS score of control group on the 14th day was lower than that in baseline period，the difference was not statistically significant（P>0.05）；the 14-day NIHSS score of experimental group was lower than that of control group，but the difference was not statistically significant（P>0.05）. There was no significant difference in BI index between the two groups on the 14th day of onset compared with the baseline period（P>0.05）. There was no significant difference in BI index between the experimental group and the control group on the 14th day of disease onset（P>0.05）. FMA scores of test groups on the 14th day of onset were higher than those of baseline period，with significant statistical difference（P<0.01），and FMA scores of test groups on the 14th day of onset were higher than those of control group，but the difference was not statistically significant（P>0.05）. [Conclusion] Acupuncture combined with arterial thrombectomy can improve the short-term and long-term prognosis of patients with acute cerebral infarction，and the efficacy is better than that of arterial thrombectomy alone.