脑出血急性期头穴透刺的安全性研究

Clinical safety research of penetrating acupuncture at the head points for cerebral hemorrhage at the acute stage

目的:通过对脑出血急性期患者头穴透刺的临床研究,以期证实脑出血急性期头穴透刺的安全性。方法:选择脑出血急性期患者60例,随机分为西药组与头穴组,每组30例。西药组行常规静脉点注甘露醇、硝普钠等降颅压、降血压治疗;头穴组在西药组治疗基础上加用头穴透刺治疗,其中意识障碍取太阳、本神、神庭透上星,头痛采用上星透印堂、风池透风池,尿便障碍采用百会透四神聪,失语采用风府透哑门穴等,面瘫采用地仓透颊车、下关,瘫痪采用百会透太阳穴等。观察治疗前后脑出血量的变化,检测血、尿、便常规,心、肝、肾功能及血压、呼吸、心率等生命指征变化情况以及对心电图的影响。结果:头颅CT显示头穴组血肿基本及显著吸收率为80.0%(24/30),优于西药组的56.7%(17/30,P<0.05);头穴组患者治疗前后血、尿、便常规及血压、呼吸、心率等生命指征均属于正常范围(均P>0.05),肝、肾功能无异常变化,且头穴组心电图异常率明显低于西药组[16.7%(5/30)vs 43.3%(13/30),P<0.05]。结论:在常规西医治疗基础上,脑出血急性期采用头穴透刺治疗是安全的。

Objective To verify the safety of penetrating acupuncture at the head points for cerebral hemorrhage at the acute stage. Methods Sixty cases of cerebral hemorrhage at the acute stage were selected and randomized into a western medication group and a head-point group, 30 cases in each one. In the western medication group, tt^e anti cranial pressure and anti-blood pressure program was administered with the conventional intravenous infusion of Sodium Nitroprusside, Mannite, etc. In the head-point group, on the basis of the treatment as the western medication group, the penetra^ing acupuncture at the head points was supplemented. For consciousness disturb ance, Taiyang （EX-HN .5）, Benshen （GB13） and penetrating needling from Shenting （GV 24） to Shangxing （GV 23） were selected. For headache, the penetrating needling was adopted from Shangxing （GV 23） to Yintang （EXHN 3） and from Fengchi （GB 20） to Fengchi （GB 20）. For disturbance of urination and defecation, the penetrating needling was adopted from Baihui （GV 20） to Sishencong （EX-HN 1 ）. For aphasia, the penetrating needling was adopted from Fengfu （GV 16） to Yamen （GV 15）, etc. For facial paralysis, the penetrating needling from Di- cang （ST 4） to Jiache （ST 6） and Xiaguan （ST 7） were selected. For paralysis, the penetrating needling was adopted from Baihui （GV 20） to Taiyang （EX HN 5）, etc. Before and after treatment, the changes in cerebral hemorrhagic volume, the resuhs of blood, urine and stool routine examination, the situations of the life indices such as heart, liver and kidney functions, blood pressure, respiration and heart rate were observed, as well as the impacts on ECG. Results The cranial CT scan indicated that the rate of the basic and significant absorption of hematoma was 80.0%（24/30） in thehea＆point group, which was superior to 56.7% （17/30） in the westernmedication group （P〈0.05）. Before and after treatment, the results of blood, urine and stool routine examination and the life indices such as blood pressure, respiration and heart rate were all in the normal scope for the patients in the head point group （all P〉0.05）. There were no any abnormal changes in liver and kidney functions. In the head-point group, the abnormality rate of ECG was lower obviously than that in the western medication group [16.7 （5/30） vs 43.3（13/30）, P=0.05]. Conclusion The penetrating acupuncture at the head points is safe in the treatment of cerebral hemorrhage at the acute stage. WORDS