针刺治疗短暂性脑缺血发作的临床疗效分析

Analysis on the Clinical Effect of Acupuncture in the Treatment of Transient Ischemic Attack

目的观察针刺治疗短暂性脑缺血发作的临床疗效。方法将患者分为2组,针刺组与对照组。对照组:静点疏血通,前列地尔。口服阿司匹林肠溶片、阿托伐他汀钙片。针刺组:在对照组基础上应用针刺治疗。观察临床疗效及3个月内复发率,治疗前、后双侧大脑中动脉、椎-基底动脉的平均血流速度。结果对照组24 h内、48 h内、3 d内、7 d内TIA发作停止例数分别为12(16.90%)、18(25.35%)、42(59.15%)、50(70.42%)。而针刺组分别为18(26.47%)、25(36.76%)、50(73.52%)、65(95.58%),病情恢复好于对照组,有显著性差异,P<0.05。出院后1个月内、2个月内(包括1个月内)、3个月内(包括2个月内)定期复查或者回访,追踪治疗后脑梗死的发生情况,对照组进展为脑梗死分别为8.45%,14.08%,16.90%。而针刺组进展为脑梗死分别为4.41%,7.35%,11.76%,低于对照组,有显著性差异,P<0.05。针刺组与对照组患者治疗前、治疗1周后双侧大脑中动脉、双侧椎动脉和基底动脉平均血流速度的数据统计分析,治疗前2组组间比较无明显差异(P>0.05)。但2组治疗1周后,针刺组较对照组患者脑血流速度明显增快,具有统计学差异(P<0.05)。结论针刺治疗短暂性脑缺血发作可缩短症状持续时间,降低进展为脑梗死风险,可能与针刺能够改善脑供血有关。

Objective To observe the clinical effect of acupuncture in the treatment of transient ischemic attack. Methods Patients were divided into acupuncture group and control group. The control group was given intravenous administration of Shuxuetong and Alprostadil and oral administration of aspirin tablets and atorvastatin calcium tablets. The acupuncture group applied acupuncture on the basis of the control group. The clinical effect and the recurrence rate within 3 months, the mean blood flow velocity of the bilateral middle cerebral artery and vertebrobasilar artery before and after the treatment were observed. Results In the control group, the numbers of TIA episodes within 24h, 48h, 3d and 7d were 12 （16.90%） , 18 （25.35%） , 42 （59.15%） and 50 （70.42%） , respectively. The numbers of patients were 18 （26.47%） , 25 （36.76%） , 50 （73.52%） and 65 （95.58%） , respectively, in the acupuncture group. The recovery rate of the acupuncture group was better than that of the control group （P 〈0.05） . During l-month, 2-month and 3-month following-up visits after treatment, the rate of progress to cerebral infarction were 8.45%, 14.08% and 16.90% in control group, and 4.41%, 7.35% and 11.76% in the acupuncture group, respectively. The rate of cerebral infarction of the acupuncture group was lower than that of the control group （P 〈0.05） . There was no significant difference between the two groups before and after treatment （P〉 0.05） in mean blood flow velocity in bilateral middle cerebral artery, bilateral vertebral artery and basilar artery. However, the cerebral blood flow velocity in acupuncture group was significantly faster than that in control group after one week of treatment （P 〈0.05） . Conclusion The acupuncture in the treatment of transient ischemic attack can shorten the duration of symptoms, and reduce the risk of cerebral infarction, which may be related to acupuncture improving cerebral blood supply.