阴阳对刺呼吸补泻法对缺血性脑中风患者步态时间周期的影响

Impact on the gait time cycle of ischemic stroke in the treatment with yin-yang respiratory reinforcing and reducing needling technique

目的:比较阴阳对刺呼吸补泻法与常规针刺对缺血性脑中风患者步态时间周期的疗效差异。方法:将60例缺血性脑中风患者随机分为阴阳对刺组与常规针刺组,各30例。两组均给予基础治疗(控制血压、血糖、血脂,给予银杏达莫注射液和长春西汀注射液静脉滴注),常规针刺组取足阳明胃经穴位(髀关、梁丘、足三里、上巨虚、下巨虚等),行平补平泻法;阴阳对刺组采用阴阳对刺呼吸补泻法治疗,阴经取足五里、血海、阴陵泉、三阴交等,阳经取髀关、梁丘、阳陵泉等,阴经腧穴运用呼吸补泻法的泻法,阳经腧穴运用呼吸补泻法的补法。于治疗前、治疗4周后对患者进行运动学时间参数测定比较。结果:两组患者治疗后步行周期、患(健)侧支撑相时间(%)、患(健)侧单支撑相时间(%)、患(健)侧摆动相时间(%)、双支撑相时间(%),与治疗前比较差异均有统计学意义(均P<0.05),其中步行周期(1.75±0.21vs 2.02±0.37)、患(健)侧支撑相时间[(65.41±5.20)%vs(68.37±6.24)%,(70.99±6.47)%vs(74.51±5.19)%]、患(健)侧摆动相时间[(36.08±4.86)%vs(33.65±2.94)%,(31.04±3.41)%vs(26.77±2.67)%]、双支撑相时间[(36.91±5.10)%vs(41.22±5.39)%],阴阳对刺组较常规针刺组治疗后改善更明显(均P<0.05);两组支撑相时间(%)、单支撑相时间(%)、摆动相时间(%),治疗后患、健侧比较差异均有统计学意义(均P<0.05)。结论:阴阳对刺呼吸补泻法可有效改善缺血性脑中风偏瘫患者步态运动周期,提高步行功能,优于常规针刺治疗。

Objective To compare the difference in the efficacy on gait time cycle of ischemic stroke between yin-yang respiratory reinforcing and reducing needling technique （yin-yang needling） and the conventional acu- puncture. Methods Sixty cases of ischemic stroke were randomized into a conventional acupuncture group and a yin-yang needling group,30 cases in each one. The basic treatment （the control of blood pressure, blood sugar and blood lipid, the intravenous drops of ginkgo leaf extract and dipyridamole rejection and vinpocetine injection） were applied in the two groups. Additionally, in the conventional acupuncture group, the acupoints of the Stomach Meridian of Foot-Yangming [Biguan （ST 31）, Liangqiu （ST 34）, Zusanli （ST 36）, Shangjuxu （ST 37）, Xiajuxu （ST 39）, etc. ] were selected and stimulated with the even needling technique. In the yin-yang needling group, the acupoints of yin meridians such as Zuwuli （LR 10）, Xuehai （SP 10）, Yinlingquan （SP 9） and Sanyinjiao （SP 6）, etc. and the acupoints of yang meridians such as Biguan （ST 31）, Liangqiu （ST 34） and Yanglingquan （GB 34）, etc. were selected. The reducing manipulation of respiratory reinforcing and reducing technique was applied to the acupoints of yin meridians and the reinforcing manipulation was applied to the acupoints of yang me- ridians. The kinematics time parameters were determined and compared before and 4 weeks after treatment. Results After treatment, the differences in the gait cycle, the phase time of standing （%）, the phase time of sin- gle support （%）, the phase time of unilateral sway （%） on the affected （healthy） foot and phase time of double support （%） were significant as compared with those before treatment in the patients of the two groups （all P〈0.05）, in which, the gait cycle （1.75 ±0.21 vs 2.02±0. 37）, the phase time of standing （%） on the affected （healthy） foot[（65.41±5.20） % vs （68.37±6.24）% ,（70.99±6.47） % vs （74.51±5.19） %], the phase time of unilateral sway （%） on the affected （healthy） foot 1-（36.08±4.86）% vs （33.65±2.94）%, （31.04±3.41）% vs （26.77±2.67）%] and the phase time of double support （%） E（36.91±5.10）% vs （41.22±5.39）%] in the yirryang needling group were improved much obviously after treatment as compared with those in the conventional acupuncture group. The differences in support phase time （%）, single support phase time （%） and sway phase time （%） were significant between the affected limb and healthy limb of the two groups after treatment （all P〈 0.05）. Conclusion Yin-yang respiratory reinforcing and reducing needling technique effectively improves hemiple- gic gait movement cycle and walking function in patients of ischemic stroke, which is superior to the conventional acupuncture treatment.