头穴透刺治疗急性中风病针刺部位特异性观察

Observation on specificity of acupuncture location in treatment of acute apoplexy by scalp penetration needling

目的:观察头穴透刺与常规头针治疗急性中风病的临床疗效差异,探寻头针治疗急性中风病的有效部位及机制。方法:将60例急性中风病患者随机分为观察组和对照组,每组30例。两组在神经内科治疗基础上,观察组采用病灶侧百会透刺太阳穴,连续接力式针刺4针;对照组采用病灶侧顶颞前斜线,连续接力式针刺4针。治疗14天后,比较两组患者治疗前后神经功能缺损程度(NDS)评分变化和总体疗效,分别检测患者第2天、第14天血浆内皮素(ET)和降钙素基因相关肽(CGRP)的含量。结果:观察组有效率为86.7%(26/30),优于对照组的80.0%(24/30);两组治疗后NDS评分均有明显降低(均P<0.01),且观察组的改善程度优于对照组(P<0.01);两组治疗后ET水平均明显降低,CGRP水平均明显升高(均P<0.01),且观察组较对照组变化幅度更明显(均P<0.01)。结论:百会透刺太阳为治疗急性中风病的有效方法,优于常规头针治疗。

Objective To observe the clinical effects of scalp penetration acupuncture and conventional scalp acupuncture for treatment of acute apoplexy, to seek the effective location and mechanism of scalp acupuncture treatment for acute apoplexy. Methods Sixty cases of the apoplexy were randomly divided into an observation group and a control group, 30 cases in each group. Basis on the neurological treatment, the observation group was treated with penetration needling through Baihui （GV 20） to Taiyang （EX-HN 5） on the affected side, with four needles relay; the control group was treated with penetration needling at anterior oblique line of parietotemporal region, with four needles relay. After 14 days of treatment, the neurological deficit scores （NDS） and the therapeutic effects were compared before and after treatment, and the contents of plasma endothelins （ET） and the calcitonin gene-related peptide （CGRP） were tested respectively on the 2nd and 14th day after treatment. Results The effective rate of 86.7% （26/30） in the observation group was superior to that of 80.0% （24/30） in the control group; the NDS of both groups were obviously decreased after treatment（both P〈0.01）, the improvement degree in the observation group was better than that of the control group （P〈0.01）; the ET level was obviously decreased and the CGRP level was obviously increased in both groups after treatment （all P〈0.01）, and the range of change was more significant in the observation group （P〈0.01）. Conclusion Penetration needling through Baihui （GV 20） to Taiyang （EX-HN 5） is an effective treatment for acute apoplexy, which is better than conventional scalp acupuncture.