调任通督针法结合井穴刺血治疗脑卒中痉挛状态临床观察

Clinical Observation of Tiao Ren Tong Du Needling plus Bloodletting at Jing-well Points for Post-stroke Spastic State

目的观察调任通督针刺法结合井穴刺血治疗脑卒中痉挛状态的临床疗效。方法将符合标准的67例患者随机分为调任通督针法结合井穴刺血组(治疗组)和康复治疗组(对照组),两组均每日治疗1次,6次为1个疗程,共治疗4个疗程。采用改良Ashworth张力评分法所定标准对肌痉挛程度进行评定,以及中风痉挛性偏瘫基于报告结局指标(PRO)对患者主观症状、客观症状、心理状态、社会功能4个领域进行评分。结果两组患者治疗后机体痉挛、生理、心理、社会、环境等多方面评分均较治疗前改善(P<0.01,P<0.05)。调任通督针刺法结合井穴刺血治疗较康复治疗能够更大程度地缓解肌肉痉挛,降低PRO分值(P<0.01)。治疗组愈显率为70.6%,对照组为42.4%。结论调任通督针刺法结合井穴刺血治疗能有效地改善脑卒中痉挛状态,改善生存质量。

Objective To observe the clinical efficacy of Tiao Ren Tong Du（regulating the Conception Vessel and unblocking the Governor Vessel） needling method plus bloodletting at the Jing-well points in treating post-stroke spastic state. Method Sixty-seven eligible patients were randomized into a group to receive Tiao Ren Tong Du needling plus bloodletting at the Jing-well points（treatment group） and a rehabilitation group（control group）. For the two groups, the treatment was given once a day, 6 times as a treatment course, for 4 courses in total. The Modified Ashworth Scale was used to evaluate the spasticity intensity, and the Patient Reported Outcome（PRO） for post-stroke spastic hemiplegia was used to measure the patients from the following four aspects： subjective symptoms, objective symptoms, mental state, and social function. Result After intervention, the scores of spasticity, and physiological, mental, social, and environmental factors were significantly improved in both groups（P〈0.01,P〈0.05）. Compared to rehabilitation, Tiao Ren Tong Du needling plus bloodletting at Jing-well points can more significantly release the muscular spasticity and reduce the PRO score（P〈0.01）. The recovery plus markedly-effective rate was 70.6% in the treatment group versus 42.4% in the control group. Conclusion Tiao Ren Tong Du needling plus bloodletting at Jing-well points can effectively improve post-stroke spastic state and the quality of life.