手厥阴经电刺激对重症脑外伤昏迷患者促醒作用的初步研究

Revival effect of electrostimulation in Pericardium Channel of Hand Jueyin in coma patients induced by severe craniocerebral trauma

目的研究手厥阴经电刺激对重症脑外伤昏迷患者的促醒作用及其作用机制。方法18例重症脑外伤昏迷的患者随机分为对照组和治疗组,对照组给以常规治疗,治疗组在常规治疗的基础上进行手厥阴经电刺激。在第1次治疗前,对两组病人均行经颅多普勒检查椎-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 velocity,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30 min,刺激结束后在同一体位、同一条件下行第2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个月后再次进行相同指标的检测,比较检测结果。持续治疗3个月,对比治疗3个月时的格拉斯哥昏迷评分(GCS)、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重症脑外伤昏迷患者椎-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重症脑外伤昏迷患者椎-基底动脉的血流速度,对于促进重症脑外伤昏迷患者的苏醒有积极的治疗作用。

Objective To study the revival effect and mechanism of electrostimulation in the Pericardium Channel of Hand Jueyin in coma patients induced by severe craniocerebral trauma. Methods The patients （ n = 18） were randomly divided into the control group and treatment group. The control group was treated with the routine therapy and the treatment group was given the electrostimulation in the Pericardium Channel of Hand Jueyin besides the routine therapy. Before the initial treatment all patients were given the examination by transcranial Doppler （TCD） to detect their systolic velocity （Vs）, diastolic velocity （Vd）, mean velocity （Vm） and pulsitility index （PI）, and then the treatment group was given the electrostimulation in the Pericardium Channel of Hand Jueyin immediately for 30 minutes and detected by TCD for the second time in the same body position and condition. The instant changes of blood flow before and after the electrostimulation were compared. After that the treatment group was given the electrostimulation of 30 minutes every day for one month and the same indexes were detected and compared. The electrostimulation was continued for 3 months and Glasgow Coma Scale （GCS）, recovery of nervous function and lingual function were compared. Results The instant effectiveness was observed on the disorder of blood flow rate of basilar artery in the treatment group. After one month the blood flow rate in the treatment group was significantly increased compared with that of the control group. After 3 months the results of GCS, scales of lingual function and living quality in the treatment group were much better than those in the control group. Conclusion The electrostimulation in the Pericardium Channel of Hand Jueyin can promote the blood flow rate of basilar artery in coma patients induced by severe Craniocerebral trauma, and has a revival effect.