针刺对不同分型脑卒中患者神经功能的影响

Effects of acupuncture on rehabilitation of nervous functions in the stroke patient of different OCSP types

目的:探讨针刺疗法对不同分型的脑卒中偏瘫患者神经功能康复的效应差异。方法:采用随机和多中心的临床试验原则,根据牛津地区卒中计划(OCSP)分型将患者分为腔系梗死组(LA-CI)、完全前循环梗死组(TACI)、部分前循环梗死组(PACI)和后循环梗死组(POCI)4种类型,再将患者随机分成观察组和对照组。2组均行常规西医治疗,观察组在此基础上针刺百会、三阴交、太溪、血海等穴,行补泻手法;对照组采用不完整针刺,只留针,不行针。分别于入选时、第1月、第3月、第6月、第12月应用日常生活能力量表(BI)进行评定。结果:LACI亚型观察组与对照组差异无显著性意义(P>0.05),PACI、POCI亚型在第3月-第12月观察组与对照组差异均有显著性意义(P<0.05)。TACI第3月、第6月观察组与对照组差异有显著性意义(P<0.05),第12月组间差异无显著性意义(P>0.05)。结论:针刺对不同OCSP分型的脑卒中患者日常生活能力的康复效果不同,对PACI、POCI亚型有明显促进作用,针刺手法与疗效密切相关。

Objective To probe into effects of acupuncture on rehabilitation of nervous functions in the stroke pa- tient of different OCSP types. Methods The stroke patients were randomly divided into 4 subtypes （LACI, TACI, PACI, POCI） based on the OCSP clinical classification. The patients of every subtype were randomly sub-divided into an observation group and a control group. The patients in the 2 groups were treated with routine western medi- cine, and acupuncture at Baihui （GV 20）, Sanyinjiao （SP 6）, Taixi （KI 3）, Xuehai （SP 10）, etc. were added with reinforcing and reducing manipulation in the observation group and without manipulation of the needle in the control group. They were assessed with daily living ability scale （BI） at the time of enrollment, the end of 1, 3, 6, 12 months after the stroke, respectively. Results There was no significant difference between the two groups for BI in LACI （P〉0. 05） ; there were significant differences 3, 6 and 12 months after the stroke between the two groups in PACI, POCI （P〈0.05）; in the TACI, there was a significant difference between the two groups for BI 3 and 6 months after stroke （P〈0.05）, with no significant difference 12 months after stroke （P〉0.05）. Conclusion Acupuncture has different effects on rehabilitation of daily living function in the stroke oatient of different OCSP tvoes.