中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (31): 2914-2922.doi: 10.3969/j.issn.1673-5374.2013.31.004

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

“缪刺”法治疗急性缺血性脑卒中偏瘫

  

  • 收稿日期:2013-08-25 修回日期:2013-10-06 出版日期:2013-11-05 发布日期:2013-11-05

Contralateral needling at unblocked collaterals for hemiplegia following acute ischemic stroke

Huanmin Gao1, Xugang Li2, Xia Gao3, Benxu Ma3   

  1. 1 Department of Neurology, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, Ningxia Hui Autonomous Region, China
    2 Department of Intensive Care Unit, People's Hospital of Rizhao City, Rizhao 276826, Shandong Province, China
    3 Department of Rehabilitation, the Second Affiliated Hospital of Qingdao University Medical College, Qingdao 266042, Shandong Province, China
  • Received:2013-08-25 Revised:2013-10-06 Online:2013-11-05 Published:2013-11-05
  • Contact: Xugang Li, M.D., Department of Intensive Care Unit, People's Hospital of Rizhao City, Rizhao 276826, Shandong Province, China, rzyylixg@163.com.
  • About author:Huanmin Gao, M.D., Ph.D，Professor.

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摘要：

脑卒中造成的一侧肢体完全偏瘫表明患侧肢体无法正常实现大脑与肢体之间的信息传递，此时采用传统针刺法针刺患侧肢体穴位也无法将刺激信号传向大脑，而针刺健侧肢体穴位可将刺激信号传入大脑，然后通过大脑整合再调节患侧肢体功能，此方法即“缪刺”法，但其是否能有效治疗脑卒中后偏瘫目前尚缺乏明确的临床证据。鉴于此，实验对106例急性缺血性脑卒中后一侧肢体完全瘫痪的患者进行健侧肢体穴位针刺治疗，并与患侧肢体穴位针刺治疗的普通针刺组比较，主要穴位包括尺泽(LU 5)和肩髎(TE14)。连续治疗30 d后发现，与普通针刺组相比，健侧肢体针刺组治疗有效率、改良巴氏指数和Fugl-Meger评分均增高，神经功能缺损评分明显降低。结果证实，健侧肢体穴位针刺可明显促进急性缺血性脑卒中患者偏瘫肢体神经功能的恢复，效果优于普通针刺法。

关键词: 神经再生, 针灸, 脑卒中, 偏瘫, 健侧肢体, 神经功能, 脑缺血, 中医, 临床实践, 基金资助文章

Abstract:

Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs, namely collateral shock in the brain. Contralateral needling is the insertion of needles into acupoints on the relative healthy side of the body to treat diseases such as apoplexy. However, there is little well-designed and controlled clinical evidence for this practice. This study investigated whether contralateral needling could treat hemiplegia after acute ischemic stroke in 106 randomly selected patients with acute ischemic stroke. These patients were randomly assigned to three groups: 45 in the contralateral needling group, receiving acupuncture on the unaffected limbs; 45 in the conven-tional acupuncture group, receiving acupuncture on the hemiplegic limbs; and 16 in the control group, receiving routine treatments without acupuncture. Acupuncture at acupoints Chize (LU5) in the upper limb and Jianliao (TE14) in the lower limb was performed for 45 minutes daily for 30 consecutive days. The therapeutic effective rate, Neurological Deficit Score, Modified Barthel Index and Fugl-Meyer Assessment were evaluated. The therapeutic effective rate of contralateral nee-dling was higher than that of conventional acupuncture (46.67% vs. 31.11%, P < 0.05). The neuro-logical deficit score of contralateral needling was significantly decreased compared with conven-tional acupuncture (P < 0.01). The Modified Barthel Index and Fugl-Meyer Assessment score of contralateral needling increased more significantly than those of conventional acupuncture (both P < 0.01). The present findings suggest that contralateral needling unblocks collaterals and might be more effective than conventional acupuncture in the treatment of hemiplegia following acute is-chemic stroke.