病灶头皮反射区埋线治疗脑卒中后感觉障碍临床研究

Clinical research of catgut implantation at scalp reflecting foci for post-stroke sensory disturbance

目的:比较病灶头皮反射区埋线与常规针刺治疗脑卒中后感觉障碍的临床疗效差异及对患者血液流变学的影响。方法:将59例脑卒中后合并感觉障碍的患者随机分为埋线组(30例)和针刺组(29例),两组均予以内科常规治疗、肢体功能康复训练及感觉功能训练。埋线组在此基础上采用病灶头皮反射区埋线治疗,1周1次,4次为一疗程;针刺组予以针刺治疗,穴取百会、风池、肩髃、曲池、外关、合谷、四强、阳陵泉、足三里、丰隆、丘墟、太冲,每日1次,1周5次,4周为一疗程。疗程间均休息1周,共治疗2个疗程。观察两组治疗前后感觉和运动功能评分、改良Barthel指数(MBI)及血液流变学变化情况,并评定两组患者临床疗效。结果:经8周治疗后,埋线组总有效率为90.0%(27/30),优于针刺组的65.5%(19/29)(P<0.05);两组FugI-Meyer运动功能、感觉功能评分及MBI评分均较治疗前提高(均P<0.05),埋线组改善更明显,且与针刺组比较,差异有统计学意义(均P<0.05);两组患者全血黏度、红细胞比容、血小板聚集及纤维蛋白原检验均较治疗前改善(均P<0.05),且埋线组优于针刺组(均P<0.05)。结论:病灶头皮反射区埋线治疗对脑卒中后感觉障碍有较好的临床疗效,并能改善其血液流变学指标。

Objective To compare the difference in clinical efficacy on post-stroke sensory disturbance between catgut implantation at scalp reflecting foci and conventional acupuncture as well as the impacts on blood rheology.Methods Fifty-nine cases of post-stroke sensory disturbance were randomized into a catgut implantation group（30cases）and an acupuncture group（29cases）.The conventional internal medicine treatment,limb motor function rehabilitation training and sensory function training were applied in the two groups.Additionally,the catgut implantation was used at scalp reflecting foci in the catgut implantation group,once a week,4treatment made one session.In the acupuncture group,acupuncture was applied at Baihui（GV 20）,Fengchi（GB 20）,Jianyu（LI 15）,Quchi（LI 11）,Waiguan（TE 5）,Hegu（LI 4）,Siqiang（EX-LE 24）,Yanglingquan（GB 34）,Zusanli（ST 36）,Fenglong（ST 40）,Qiuxu（GB 40）and Taichong（LR 3）,once every day,5times a week,the 4weeks of treatment made one session.There was an interval of 1week between the two sessions in the two groups.Totally,2sessions of treatment were required.Before and after treatment,the sensory and motor scores,modified barthel index（MBI）and blood rheological indices were observed,and the clinical efficacy was evaluated in the patients of the two groups.Results After 8weeks of treatment,the total effective rate was 90.0%（27/30）in the catgut implantation group,which was better than 65.5%（19/29）in the acupuncture group（P〈0.05）.FugIMeyer motor function,sensory function scores and MBI were all improved as compared with those before treatment in the two groups（all P〈0.05）,and the results in the catgut implantation group was superior to the acupuncture group（all P〈0.05）.The levels of whole blood viscosity,erythrocyte hematocrit,platelet aggregation and fibrinogen were improved as compared with those before treatment（all P〈0.05）,and the results in the catgut implantation group was better than those in the acupuncture group（all P〈0.05）.Conclusion The catgut implantation at scalp reflecting foci achieves a satisfactory clinical efficacy on post-stroke sensory disturbance and improves the blood rheological indices.