早期针刺对急性缺血性脑卒中患者脑血流即刻效应和累积效应影响

Immediate and Cumulative Effects of Early Acupuncture Therapy on Cerebral Blood Flow in Patients with Acute Ischemic Stroke

目的探讨早期针刺对急性缺血性脑卒中患者脑血流动力学即刻效应和累积效应的影响。方法采用随机数字表法将60例急性缺血性脑卒中患者分为治疗组和对照组各30例。2组患者均予西医常规治疗。治疗组在常规西医治疗基础上予针刺(使用循环药物前行首次针刺),每次留针30 min,每10 min行针1次,每日1次。2组均连续治疗14 d。观察2组患者大脑中动脉收缩期峰速(Vs)、舒张期峰速(Vd)、搏动指数(PI)及阻力指数(RI)情况。结果与治疗前比较,治疗组首次针刺后大脑中动脉Vs、Vd升高,PI、RI降低(P<0.01)。与首次针刺后比较,治疗组治疗后大脑中动脉Vs、Vd升高,PI、RI降低(P<0.05)。与本组治疗前比较,治疗组治疗后Vs、Vd、PI、RI及对照组治疗后Vs、PI明显改善(P<0.05);2组治疗后比较,治疗组Vs、Vd、PI、RI改善优于对照组(P<0.05)。结论早期针刺对急性缺血性脑卒中患者脑血流可产生即刻效应和累积效应,多次针刺可增强效果。

Objective To investigate the immediate and cumulative effects of early acupuncture therapy on cerebral hemodynamics in patients with acute ischemic stroke. Methods Totally 60 patients with acute ischemic stroke were selected and randomly divided into treatment group and control group, with 30 patients in each group. The two groups were treated with routine Western treatment. On the basis of above, the treatment group was given acupuncture treatment（acupuncture for the first time before the use of circulating medication）, 30 minutes for each needle, 1 needle every 10 minutes, once per day. The treatment for both groups lasted for 14 d. The changes of systolic peak velocity（Vs）, diastolic peak velocity（Vd）, pulsatility index（PI） and resistance index（RI） of middle cerebral artery（MCA） in the two groups were observed. Results Compared with before treatment, both Vs and Vd increased and both PI and RI decreased in the treament group（P〈0.05）; Compared with the treatment for 1 d, both Vs and Vd increased and both PI and RI decreased in the treament group after treatment（P〈0.05）. Compared with before treatment, Vs, Vd, PI, RI in the treatment group and Vs and PI in the control group were significantly improved after treatment（P〈0.05）. After treatment, the improvement of Vs, Vd, PI and RI in the treatment group was better than that in the control group（P〈0.05）. Conclusion Early acupuncture has immediate and cumulative effects on cerebral blood flow in patients with acute ischemic stroke. Many times of acupuncture may strengthen the effects of acupuncture.