针刺对严重脑损害昏迷患者疗效的量化研究

Quantitative study of acupuncture in treating unconsious patients with severe brain injuries.

目的 应用SPECT观察针刺治疗改善严重脑损害昏迷患者脑血流灌注和脑功能活动的可行性和价值 ,为针刺促醒及功能的康复治疗提供依据。方法 严重脑损害继发脑梗死 (DCI)昏迷患者 3 9例。随机分为观察组 (针刺组 ,17例 )和对照组 (2 2例 )。以韩氏穴位神经刺激仪电针患肢合谷、曲池穴、足三里和三阴交穴。使用SiemensECAM/ICONSPECT系统 ,同一患者同体位下 ,40min之内连续接受针刺前和电针状态下 2次SPECT脑灌注显像。用BFCR %数学模型定量分析 ,并在同样针刺 1周后比较对照组临床指标。结果 17例严重脑损害昏迷患者针刺治疗前SPECT皆显示脑内大片放射性分布稀疏区或缺损区。电针治疗时 ,诸患者脑血流灌注和脑功能活动增高 ,所有病灶都有不同程度的缩小。BFCR %增高差异有非常显著性 (P <0 0 1) ,较对照组有明显的促醒和防治DCI作用。结论 针刺治疗确实可以改善病灶区的脑血流灌注和脑细胞的功能 ,激发脑细胞活性 ,可以作为严重脑损害患者综合治疗的方法之一。

Objective To evaluate the effects of acupuncture therapy on cerebral function and blood perfusion in unconsious patients with severe brain injuries and brain infarction by SPECT and clinic analysis. Methods\ 39 unconsious patients with severe brain injuries were quantitatively studied. Electric acupuncture was performed with Han's acupoint & nerve stimulator. Brain perfusion was measured before and during electric acupuncture stimulation by using Siemens ECAM/ICON SPECT. Acupoints of LI 4 (Hegu), LI 11 (Quchi), ST 36 (Zusanli) and SP 6(Sanyinjiao)were selected. The brain imaging agent 99m Tc-ECD was injected and data was processed with BFCR% mathematical model for quantitative analysis. The clinic curative effect was compared with control-group(22 cases). Results SPECT showed impaired perfusion and hypofunction before acupuncture and unconsious improvement at different levels during electric acupuncture stimulation in 17 patients with severe brain injuries. And similar effects were found in terms of BFCR% ( P <0 01). Conclusion This result assurs the clinical value of electric acupuncture therapy in treating unconsious patients with severe brain injuries by increasing brain perfusion and improving brain cell function and repairing.