脑梗死针灸治疗方案的优选及对IR的影响

Optimum selection of acupuncture treatment programs of cerebral infarction and its effects on insulin resistance

目的:研究针灸治疗脑梗死的优选方案及其机理。方法:将63例脑梗死病人按正交设计方案随机分组,分别采用行针次数(A)、留针时间(B)、针具(C)、穴位(D)4因素及相应的3水平进行治疗。观察治疗前后的神经功能缺损积分和胰岛素抵抗(IR)的改变。结果:D、A对两者都有非常明显的影响(P<0.01);B有明显的影响(P<0.05);而C对神经功能缺损程度改善影响不大(P>0.05),对IR改善则有非常明显的影响(P<0.01);D是针灸治疗脑梗死的最主要影响因素。结论:调督为主针法、行针2次、留针60分钟是这个实验中的最佳方案;对IR的良性调整作用是其获效的机理之一。

Objective To study the optimum acupuncture treatment program and the mechanism for treatment of cerebral infarction. Methods Sixty-three cases were randomly divided into 9 groups. The four factors, times of manipulation, the retaining time of the needle, acupuncture instrument and acupoints, and their corresponding three levels were adopted respectively in treatment of each group. Then nerve function defect score and insulin resistance were observed before and after treatment. Results The acupoints, the times of manipulation and the retaining time of the needle have significant effects on nerve function defect and insulin resistance (P<0. 01 or P<0. 05), and the acupuncture instrument has a significant effect on insulin resistance (P<0. 01). The choice of acupoints was the most important factor for acupuncture treatment of cerebral infarction. Conclusion Acupuncture for regulating The Governor Vessel with twice manipulations and retaining the needle for 60 min is optimum treatment program for cerebral infarction. The good regulating effect of acupuncture on insulin resistance is one of the mechanisms of achieving the therapeutic results.