醒脑开窍针刺法治疗脑梗死

Clinical study of wake up the brain acupuncture in treating cerebral infarction

目的观察醒脑开窍法对脑梗死患者的疗效及机理研究。方法将50例符合标准的脑梗死患者,分为常规针刺法组及醒脑开窍法组,治疗后对其进行中医证候疗效评价,神经功能缺损变化,残障指数组间评定,并于针刺前后观察患侧大脑中动脉(MCA)收缩期(Vs)、舒张期血流速度(Vd)、平均血流速度(Vm)、脉冲指数(PI)及阻力指数(RI)的变化。结果醒脑开窍法治疗脑梗死患者,治疗后在中医症状积分方面明显优于常规针刺组(P<0.05),在神经功能缺损和巴氏指数的改善方面明显优于常规针刺组(P<0.05)。针刺治疗后,大脑中动脉血流速度、脉冲指数和阻力指数均发生不同程度的变化,治疗后大脑中动脉舒张期的血流速度比治疗前加快(P<0.05)。结论醒脑开窍法通过改善大脑中动脉血流动力学,使病灶侧脑缺血得到改善,血管痉挛缓解,增加缺血区血供,从而改善神经功能缺损症状。

Objective Effect of wake up the brain on curative effect and mechanism study of cerebral infarction patients. Methods 50 cases of cerebral infarction patients meet the criteria, divided into regular acupuncture and wake up the brain groups after treatment, it is Chinese medicine symptom evaluation, neurologic changes, disability index assessment between groups, and acupuncture before and after, observe the ipsilateral Middle cerebral artery（MCA） systolic（Vs） and diastolic blood flow velocities（Vd）, Mean blood flow velocity（Vm）, the pulse index（PI） and resistance index（RI） change. Results Cerebral infarction patients treated by wake up the brain, after treatment in terms of TCM symptom score significantly better than conventional acupuncture group（P〈 0.05）, neurologic and Barthel Index improved significantly better than conventional acupuncture group（P〈 0.05）. After acupuncture treatment, blood flow velocity in the Middle cerebral artery, pulse index and resistance index of different degrees of change, diastolic blood flow in the cerebral artery after treatment than before treatment to accelerate（P〈 0.05）. Conclusion Wake up the brain by improving cerebral blood flow dynamics, improved the focal cerebral ischemia, Vasospasm mitigation, increased ischemia blood supply, so as to improve the neurologic symptoms.