刃针搜法治疗脑梗死后感觉障碍的临床研究

Clincal Study on Sensory Impairment after Cerebral Infarction Treated with Blade Needle Search

目的:探究刃针搜法治疗脑梗死后感觉障碍的临床作用机制。方法:将90例脑梗死后感觉障碍患者随机分为刃针治疗组、针刺对照组、药物对照组,每组30例。3组患者分别治疗14 d,评价治疗效果,并进行治疗前后的血液流变学、神经元功能、血流动力学、体感诱发电位等相关指标检测。结果:治疗后刃针治疗组疗效明显高于其他两组,差异有统计学意义(P<0.05)。与治疗前比较,3组患者治疗后Fugl-Meyer评分显著提高(P<0.05);患侧体感诱发电位(SEP)N20潜伏期明显缩短(P<0.05)、波幅明显增高(P<0.05);血浆粘度、血小板聚集率、纤维蛋白原等血液流变学指标明显改善(P<0.05);血清S100B、基质金属蛋白酶-9(MMP-9)显著下降(P<0.05),金属蛋白酶组织抑制剂-1(TIMP-1)显著升高(P<0.05);病侧大脑中动脉舒张末期血流速度(Vd)、收缩期最大血流速度(Vs)、平均血流速度(Vm)显著升高;刃针治疗组上述指标变化较药物对照组和针刺对照组显著(P<0.05)。结论:刃针搜法通过改善脑梗死后感觉障碍患者脑部组织血液循环和供血情况、改善神经元功能、促进感觉神经传导通路修复等作用机制达到治疗效果。

Objective:To explore the mechanism of sensory impairment after cerebral infarction treated with blade needle search.Methods:90 patients with sensory impairment after cerebral infarction were randomly divided into3 groups:blade needle treatment,acupuncture control,and drug control groups,30 patients in each group.Patients in the 3 groups were treated for 14 days to evaluate the therapeutic effects,and relevant indexes including hemorheology characteristics,neurons function,hemodynamics,somatosensory evoked potentials were detected before and after treatment.Results:The curative effect of blade needle treatment group was better than that of the other two groups(P<0.05).To compare with before treatment,Fugl-Meyer score was significantly raised in the three groups after treatment(P<0.05),somatosensory evoked potentials(SEP)N20 latency was shorten(P<0.05)and amplitude was heightened(P<0.05);hemorheology indexes such as plasma viscosity,platelet aggregation rate,and fibrinogen concentration were significantly decreased(P<0.05);serum S100B and MMP-9 levels were decreased and TIMP-1 was increased significantly(P<0.05);peak velocity of diastolic(VD),peak velocity of systolic(VS),velocity of mean(VM)in the affected side of the middle cerebral artery(MCA)were significantly increased(P<0.05).Changes of all above indexes in the blade needle treatment group were more significant than those in the other two groups(P<0.05).Conclusion:Needle search therapy can effectively treat sensory impairment after cerebral infarction by improving blood circulation and blood supply to brain tissue,improving neuronal function,and promoting repair of sensory nerve conduction pathways.