头针结合康复治疗急性脑梗死的最佳时间窗研究

The best time window for acute cerebral infarction treated with scalp acupuncture combined with rehabilitation

目的探讨头针配合康复介入急性脑梗死的最佳时间。方法将186例急性脑梗死患者按入院顺序随机分为针康组及对照组,各组再按发病时间分为6 h、12 h、24 h、48h、72 h亚组,所有病例接受常规药物治疗,治疗组同时接受头穴丛刺及康复治疗,经治疗14 d及30 d后,进行Fugl-meyer运动功能评分及日常生活能力的评分(采用改良的巴氏指数评分),观察急性脑梗死患者运动功能和日常生活活动能力的改善情况。结果治疗后相同时间窗内针康组Fugl-meyer运动功能评分及日常生活活动能力评分较对照组明显升高(P均<0.01)。针康组48 h及72 h亚组较6 h、12 h及24 h亚组评分明显降低(P均<0.01)。结论超早期介入针灸及康复能有效改善急性脑梗死患者的运动功能障碍,提高急性脑梗死患者的日常生活活动能力,且最佳介入时间为12 h以内。

Objective It is to investigate the best time for intervene in acute cerebral infarction with Scalp combined with rehabilitation. Methods 186 cases of acute cerebral infarction patients were randomly divided into acupuncture-rehabilitation group（ AR group） and control groups according to admission order, both groups were divided into 6 h, 12 h, 24 h, 48 h, 72 h subgroup according to onset time, all the patients were given normal medication, the treatment group were treated with scalp clustery acupuncture and rehabilitation at the same time. After 14 days＇and 30 days＇treatment, Fugl-meyer sports scores and daily living activity scores （using a modified Barthel Index score） were tested to observe the improvements of motor function and activities of daily living of patients with acute cerebral infarction. Results The motor function score of the Fugl-meyer and daily living activity scores in AR group were obviously higher than that in control group （P 〈 0.01 ） in the same time window. The scores in 48h sub group and 72 subgroup were significantly lower than that in 6h subgroup, 12h subgroup and 24h subgroup in AR group（P 〈 0. 01 ）. Conclusion Acupuncture and rehabilitation of ultra-early intervention can effectively improve motor dysfunction and activities of daily living in patients with acute cerebral infarction, and the best intervention was within 12 h.