三步针法对缺血性脑卒中二级预防的疗效

Clinical observation on therapeutic effect of three-step acupuncture for the secondary prevention of ischemic cerebral apoplexy

目的:观察三步针法对缺血性脑卒中二级预防的疗效及其安全性。方法:将120例首发的缺血性脑卒中患者按先后顺序随机分为观察组和对照组,各60例。两组在常规治疗的基础上,观察组予三步针法治疗6个月,同时给予口服阿司匹林,三步针法予头穴针刺、体穴针刺及康复训练;对照组给予口服阿司匹林,两组均随访6个月。比较两组患者缺血性脑卒中复发率、临床神经功能缺损、日常生活活动能力和中医症状评分的改善情况以及三步针法的安全性。结果:观察组和对照组的复发率分别为10.2%(5/49)和16.7%(9/54),两组差异无统计学意义(P>0.05)。观察组和对照组在改善临床神经功能缺损评分、日常生活活动能力评分、中医症状评分方面,观察组优于对照组(P<0.01,P<0.001)。两组均未出现严重不良反应,对照组有2例因服用阿司匹林出现胃肠道反应。结论:三步针法对于缺血性脑卒中的治疗和二级预防均有一定的疗效,是临床治疗和预防缺血性脑卒中安全有效的方法之一。

Objective To observe the therapeutic effect and safety of three-step acupuncture for the secondary prevention of ischemic cerebral apoplexy. Methods One hundred and twenty cases of first-episode ischemic cerebral apoplexy were randomly divided into an observation group and a control group according to the visiting sequence, 60 cases in each group. Both groups were treated on the basis of the routine treatment, the observation group was treated with three-step acupuncture combined with oral administration of Aspirin for six months. The three-step acupuncture ineluds scalp acupuncture, body point acupuncture and rehabilitation training. The control group was treated with oral administration of Aspirin alone. Six-month follow-up was clone in two groups. Then the recurrence rate of ischemic cerebral apoplexy, the improvement of neurologic impairment, activity of daily living and TCM symptom scores and the safety of three-step acupuncture between two groups were compared. Results The recurrence rate was 10.2%（5/49） in observation group, and 16.7% （9/54） in control group. There was no significant difference between two groups （P〈0.05）. The observation group was superior to the control group in improving the scores of the neurologic impairment, activity of daily living and TCM symptom （P〈0.01, P〈0. 001）. There was no severe adverse reaction in two groups except 2 cases of gastrointestinal reaction caused by oral administration of Aspirin in control group. Conclusion Three-step acupuncture has a certain therapeutic effect for both treatment and the secondary prevention of ischemic cerebral apoplexy, and it is one of the safe and effective methods for treating and preventing ischemic cerebral apoplexy in clinic.