基于PWI技术探讨通督调神针刺预处理对缺血性小卒中患者脑血流影响

Effect of Acupuncture Preconditioning on Cerebral Blood Flow in Minor Ischemic Stroke Patients with Perfusion-weighted Imaging Technique

目的:基于磁共振灌注成像(PWI)技术探讨通督调神针刺预处理对缺血性小卒中患者脑血流的影响。方法:将56例缺血性小卒中患者随机分成针刺组(28例)和药物组(28例)。针刺组采用通督调神针刺预处理,主穴腰阳关、命门、至阳、神道、大椎、风府、百会等,每天针刺1次,每周7次。药物组给予尼莫地平片,30 mg,每天晚上口服1次,两组均连续治疗4周(28 d)。观察两组患者治疗前后中医证候评分,并应用PWI技术观察各组患者治疗前后脑血流的变化。结果:治疗4周后,针刺组和药物组总有效率分别是89.3%和92.3%。两组中医证候评分分别与本组治疗前比较,分值显著降低(P<0.01);治疗后针刺组中医证候评分与药物组比较,分值变化无统计学意义(P>0.05)。同一组治疗前后PWI各参数(rCBV、rCBF、rMTT、rTTP)结果比较,差异有显著意义(P<0.01);治疗后针刺组PWI各参数(rCBV、rCBF、rMTT、rTTP)结果与药物组比较,数值变化无统计学意义(P>0.05)。结论:通督调神针刺预处理缺血性小卒中患者对改善其脑血流灌注情况与药物组疗效相当,均能有效降低严重缺血性脑卒中的发病率。

Objective：To study the effect of acupuncture preconditioning on cerebral blood flow in minor ischemic stroke patients by perfusion-weighted imaging technique. Methods：56 cases of patients with minor ischemic stroke were randomly divided into acupuncture group and drug group. Each group has 28 cases. In acupuncture group,dredging governor vessel for regulating mentality pretreatment was adopted,where main points were Yaoyangguan,Ming Men,Zhiyang,Shendao,Dazhui,Fengfu,Baihui,etc. and the frequency was 1 times per day and 7 times per week. In drug group,patients took in 30 mg nim plain radiographs per night. The treatment duration of two groups was 4 weeks. TCM syndrome scores of two groups were observed respectively before and after treatment. And cerebral blood flow changes were detected with the PWI technique. Results：After 4 weeks of treatment,the total effective rate of acupuncture group was 90.0%,that of drug group was 93.3%. The TCM syndrome scores of two groups,when compared with prior ones respectively,had statistically significant difference（P〈0.01）;After treatment,acupuncture group compared with drug group,there was no statistically significant difference（P〉0.05）. The PWI parameters（rCBV,rCBF,rMTT,rTTP）of two groups,when compared with prior ones,had statistically significant difference（P〈0.01）. After treatment,acupuncture group compared with drug group,there was no statistically significant difference（P〉0.05）. Conclusion：Dredging governor vessel for regulating mentality acupuncture pretreatment has similar effects on patients with minor ischemic stroke to improve the cerebral blood flow perfusion,when compared to drug group. It can effectively reduce the incidence of severe ischemic stroke.