全息穴电针不同留针时间对脑梗死患者血液流变学的影响

Temorheological Effects of Different Retention Times of Electroacupuncture at Holographic Points in Cerebral Infarction Patients

目的观察全息穴电针疗法不同留针时间对老年脑梗死患者血液流变学的影响,探讨全息穴电针疗法治疗脑梗死的时间效用关系。方法 126例老年脑梗死患者,按轻度、中度和重度分3层随机分为留针20 min、40 min和60 min三组。依据张颖清先生的四肢长骨穴位分布全息律,可以定位四肢全息穴位分布,在四肢各节肢系统的远心端是头穴。取双上肢第二掌骨侧远心端的头穴及桡尺骨段远心端桡侧的头穴,一侧为一组,用长40 mm毫针进针0.5～1寸,进针后提插或捻转行针以使得气,施平补平泻手法,加疏波电刺激,三组留针时间分别为20 min、40 min和60 min,每天针刺1次,10次为1个疗程。在针刺治疗前后分别进行血液流变学检测。结果三组患者总有效率分别为48.8%、68.3%和85.4%,显效率分别为19.5%、26.8%和36.6%,20 min组和40 min组与60 min组比较差异有统计学意义(P<0.05)。针刺后患者多项血液流变学指标基本都降低,组间差异也均有统计学意义,以60 min组作用最明显。结论改善血液流变学是全息穴电针治疗脑梗死的有效机制之一,具有显著的时效关系,值得进一步临床研究。

Objective To investigate the hemorheological effects of different retention times of electroacupuncture at holographic points in cerebral infarction patients and explore its time-effect relationship in the treatment of cerebral infarction.Methods One hundred and twenty-six senile patients with cerebral infarction were stratified into 3 groups according to slight,moderate and severe degrees.Each of them was randomly allocated to 3 groups receiving 20,40 and 60 min retention of needles respectively.Holographic points distributed on four limbs were located using the holographic law according to Mr Zhang Yingqing＇s distribution of limb long bone acupoints.Head point were at the distal ends of segmental limb systems.Selected were head points at the lateral distal ends of second metacarpi and at the radial distal ends of radio-ulnas of two upper limbs.The points on one side formed a group.A filiform needle of 40 mm in length was inserted 0.5-1 cun deep.After the insertion,the needle was manipulated by even reinforcing-reducing lifting and thrusting or twirling for the arrival of qi and electrified with sparse waves.The needle retention times in the three groups were 20,40 and 60 min,respectively.Acupuncture was given once daily,10 times as a course of treatment.A hemorheological test was performed before and after acupuncture treatment.Results The total efficacy rates in the three groups were 48.8%,68.3% and 85.4% respectively and the marked efficacy rates,19.5%,26.8% and 36.6% respectively.There was a statistically significant difference between the 20 or 40 min group and the 60 min group（P0.05）.Many hemorheological indices decreased in the patients after acupuncture.There were statistically significant between-group differences in all of them.The effect was most marked in the 60 min group.Conclusion The hemorheological improvement is one of effective mechanisms for treating cerebral infarction with electroacupuncture at holographic points.It has a clear time-effect relationship and deserves further studies clinically.