经皮穴位电刺激治疗后循环缺血疗效和脑血循环动力学研究

Therapeutic effect and cerebrovascular hemodynamics of transcutaneous acupoint electrioacupuncture on posterior circulation ischemia

目的观察经皮穴位电刺激治疗对后循环缺血(PCI)患者的临床疗效及对脑血循环动力学的影响。方法选择2007年9月至2008年3月在北京大学人民医院神经内科门诊就诊、以眩晕为主要表现的PCI患者70例,并随机分为电刺激组(35例)和假刺激组(35例);常规体检的健康人作为正常对照组(10名)。电刺激组应用经络开通治疗仪给予电刺激治疗20min;假刺激组操作步骤同上,但不给予电刺激治疗,仅暗示患者正在进行治疗,持续20min。2组治疗前后及正常对照组应用脑血循环动力学检测仪(CVA)监测双侧颈内动脉、椎动脉、基底动脉平均脑血流速度和脑血管阻力变化。结果电刺激组患者主观临床疗效明显高于假刺激组(P<0.01);电刺激组与假刺激组相比,其双侧颈内动脉、双侧椎动脉、基底动脉平均脑血流速度明显增快(P<0.01),脑血管阻力明显降低(P<0.01)。结论经皮穴位电刺激治疗可明显缓解以眩晕为主要表现的PCI患者症状,可明显增加患者的脑血流速度并降低脑血管阻力。

Objective To observe the influence of transcutaneous acupoint electrical stimulation on the clinical effect and cerebrovascular hemodynamics in patients with posterior circulation ischemia（PCI）. Methods Seventy patients with PCI characterized by vertigo were chosen and randomly divided into electrical stimulation group （ n = 35 ） and faked electrical stimulation group （n = 35 ）. Ten healthy individuals were included as the normal controls. The electrical stimulation group were treated with electrical stimulation by Dredging Meridian Instrument for 20 rain, while the faked electrical stimulation group were treated without electricity but with a hint of ongoing therapy for 20 min. Mean blood flow velocity （Vm） of bilateral internal carotid arteries （ ICA）, bilateral vertebral arteries （ VA）, basilar arteries （BA） and bilateral cerebrovascular resistance were monitored before and after electrical stimulation by CVA. Results Compared with the faked electrical stimulation group,the electrical stimulation group showed significant improvement in subjective therapeutic effects （P 〈 0. 01 ） increase in mean blood flow velocity of bilateral ICA, VA BA and decrease in bilateral cerebrovascular resistance （ P 〈 0.01 ）. Conclusion The transcutaneous acupoint electrical stimulation can attenuate the vertigo, increase the cerebral blood flow and decrease cerebrovascular resistance in patients with PCI.