手厥阴经电刺激对脑性昏迷患者促醒作用的初步研究

Primary study on pericardium meridian of Hand-Jueyin Stimulation therapy in improving the level of consciousness of patients in brain coma

目的研究手厥阴经电刺激对脑性昏迷患者的促醒作用及机制。方法20例脑性昏迷的患者随机分为对照组(n=10)和治疗组(n=10),对照组给以常规治疗,治疗组即在常规治疗的基础上进行手厥阴经电刺激。在第一次治疗前,对两组病人均行经颅多普勒检查患者椎基底动脉的收缩期峰值血流速度(systolic velocity,Vs)、舒张期血流速度(diastolic velocity,Vd)、平均血流速度(mean ve-locity,Vm)、搏动指数(pulsitility index,PI)。检测结束后立即给以治疗组病人手厥阴经电刺激30min,刺激结束后在同一体位,同一条件下行第二次检测。对比刺激前后即时的血流变化情况。每天给予手厥阴经电刺激30 min,持续电刺激1个月后再次对对照组及刺激组进行相同TCD指标的检测,比较检测结果。1个月后两组治疗相同。对比治疗3(个月时的GCS评分、神经功能恢复情况和语言功能情况。结果刺激组患者手厥阴经电刺激对脑性昏迷患者椎-基底动脉血流速度异常状态有明显的即刻效应。持续刺激1个月后,治疗组血流速度较对照组有显著提高。伤后3个月时,刺激组患者GCS评分明显优于对照组,刺激组患者语言功能评分和生活质量评分也明显优于非刺激组。结论手厥阴经电刺激能提高脑性昏迷患者椎-基底动脉的血流速度,对于促进脑性昏迷患者的苏醒有积极的治疗作用。

Objective To investigate therapeutic effect of Pericardium Meridian of Hand-Jueyin stimulation therapy in improving the level of consciousness of patients in brain coma and the mechanism of its hastening awakening from coma. Methods 20 unconscious patients with brain coma were randomly assigned to the treated group （ n = 10） and control group （ n = 10） . The patients in the control group were treated routinely. Besides routine therapy the patients in the treated group were treated with Pericardium Meridian of Hand- Jueyin electrical stimulation . Before the initial treatment, transcranial Doppler（TCD）was performed to determinate the systolic velocity, diastolic velocity, mean velocity and pulsitility index of basilar artery （BA）. As the treated group were treated with initial stimulation, TCD was performed after 30 minutes＇ stimulation under the same condition. The changes of the cerebral blood flow rates of basilar artery （BA） were compared and analysed. After 30 minutes＇stimulation for a month, two groups had the same treatments . Three months after the injury, Glasgow Outcome Scale, motor function and verbal function were the indexes of assessment for patients＇prognosis. Results In the treated group, the blood flow rate of the basilar artery （BA） increased significantly after stimulation. Three months after the injury, GlasgowOutcome Sale, verbal and motor functions in the stimulation group were also statistically better than those in the control group. Conclusions The Pericardium Meridian of Hand-Jueyin stimulation can improve the level of consciousness of patients in coma caused by severe headtraumas. In addition, the treatment of stimulation can reduce mortality and morbidity.