缺血性脑卒中急性期电针干预防治便秘临床观察

Clinical observation of preventing and treating constipation by electroacupuncture intervention in ischemic stroke patients at acute stage

目的：观察急性期电针介入预防缺血性脑卒中患者发生便秘的临床疗效。方法：符合纳入标准的340例缺血性脑卒中患者随机分为电针组和常规治疗组,每组170例。电针组在常规西医治疗、康复训练及常规针刺治疗基础上,取穴天枢、足三里,分别连接SDZ-Ⅴ型华佗牌电针仪,予以电流强度为0.1~1.0mA的疏密波（10Hz/50Hz）刺激,前2周每日1次,每周5次,后2周每周2次;常规治疗组仅给予基础治疗。两组疗程均为4周,治疗结束后随访8周。观察比较治疗第1~4周和第4、8周随访时两组自主排便次数〈3次/周的实际病例数和12周期间服用具有通便作用的药物的情况。结果：治疗第1~4周便秘发生例数,电针组均少于常规治疗组[24.7%（42/170）vs 36.5%（62/170）,18.8%（32/170）vs 30.6%（52/170）,10.5%（17/162）vs 27.5%（44/160）,9.3%（15/162）vs 19.4%（31/160）,P〈0.05,P〈0.001）;在第4周和第8周随访时,电针组便秘发生例数仍少于常规治疗组[9.0%（14/156）vs 18.1%（28/155）,7.7%（12/155）vs16.9（26/154）,均P〈0.05）;在整个12周期间,电针组患者服用促进排便药物的例数少于常规治疗组[21.2%（36/170）vs 34.7%（59/170）,P〈0.05）]。结论：缺血性脑卒中患者急性期电针天枢、足三里穴配合基础综合治疗方案对防治便秘症状发生具有临床意义。

Objective To observe the efficacy of preventing constipation by electroacupuncture intervention in ischemic stroke patients at acute stage.Methods Three hundred and forty ischemic stroke patients who matched the inclusive criteria were randomly divided into an electroacupuncture（EA）group and a routine treatment group,170 cases in each one.In the EA group,based on routine western treatment,rehabilitation training and common acupuncture,Tianshu（ST 25）and Zusanli（ST 36）were selected and connected to SDZ-Ⅴ Hwato brand electric acupuncture apparatus respectively,given stimulation of dense-disperse wave（10Hz/50Hz）with electric current of 0.1to 1.0mA,once every day and 5times a week in the first 2weeks,2times a week in the latter 2weeks.In the routine treatment group,only basic treatment was applied.In the two groups,the course of treatment was4 weeks and 8weeks＇ follow-up was required after treatment.The actual numbers who independently defecated less than 3times a week after 1to 4weeks＇ treatment and in the 4th and the 8th weeks＇ follow-up and condition taking laxative medicines during the 12 weeks in the two groups were observed and compared.Results Compared on the numbers of constipation cases after 1to 4weeks＇ treatment,those in the EA group were all less than those in the routine treatment group[24.7%（42/170）vs 36.5%（62/170）,18.8%（32/170）vs 30.6%（52/170）,10.5%（17/162）vs 27.5%（44/160）,9.3%（15/162）vs 19.4%（31/160）,P〈0.05,P〈0.001].In the 4th and the 8th weeks＇ follow-up,numbers in the EA group were still less than those in the routine treatment group [9.0%（14/156）vs 18.1%（28/155）,7.7%（12/155）vs 16.9（26/154）,both P〈0.05）].During the 12 weeks,the number of cases who took laxative medicines in the EA group was less than that in the routine treatment group[21.2%（36/170）vs 34.7%（59/170）,P〈0.05].Conclusion There is clinical significance to electroacupuncture at Tianshu（ST 25）and Zusanli（ST 36）combined with basic comprehensive treatment for preventing and treating constipation symptom in ischemic stroke acute stage.