调神益气针法治疗中风后疲劳的临床研究

A clinical study on efficacy of Tiaoshen Yiqi acupuncture therapy in treating patients with post stroke fatigue

目的 观察调神益气针法治疗中风后疲劳（PSF）的临床疗效.方法 选择2017年1月至2018年5月山西中医学院第三中医院和山西医科大学第二医院神经内科收治的80例PSF患者,按治疗方法不同分为调神益气针刺组和常规针刺组,每组40例.两组均进行脑卒中基础治疗及康复锻炼,在此基础上,常规针刺组采用常规针刺治疗,选穴为内关、水沟、三阴交、极泉、尺泽、委中;调神益气针刺组采用调神益气针刺治疗,选穴为百会、四神聪、神庭、本神、曲池、内关、合谷、阳陵泉、足三里、三阴交、太冲.两组均每次留针30 min,每日1次,每周6次,连续治疗4周.观察两组干预前后疲劳严重程度量表（FSS）、脑卒中专用生活质量量表（SS-QOL）精力评分以及日常生活活动能力（ADL）评分的变化情况.结果 两组治疗后FSS评分均显著降低,SS-QOL精力评分及ADL评分均显著提高,与治疗前比较差异均有统计学意义〔FSS评分（分）：常规针刺组为42.53±8.35比45.35±9.56,调神益气针刺组为36.45±8.87比46.17±8.39;SS-QOL精力评分（分）：常规针刺组为9.65±1.52比4.56±1.24,调神益气针刺组为11.41±1.87比4.47±1.32;ADL评分（分）：常规针刺组为34.07±9.73比32.67±11.21,调神益气针刺组为37.21±9.26比33.73±12.02,均P〈0.05〕;且调神益气针刺组治疗后各评分的改善作用均优于常规针刺组〔FSS评分（分）：36.45±8.87比42.53±8.35,SS-QOL精力评分（分）：11.41±1.87比9.65±1.52,ADL评分（分）：37.21±9.26比34.07±9.73,均P〈0.05〕.结论 调神益气针法可以有效缓解PSF患者的疲劳症状,改善心境,提高患者主动参与康复训练和日常生活的积极性以及ADL,促进患者肢体功能恢复,增强其自我认同及社会价值感,从而改善患者生存质量.

Objective To-observe the clinical effect of Tiaoshen Yiqi acupuncture therapy on patients with post stroke fatigue （PSF）. Methods Eighty patients with PSF admitted to Department of Internal Medicine- Neurology of the Third Hospital of Shanxi University of Traditional Chinese Medicine and The Second Hospital of Shanxi Medical University from January 2017 to May 2018 were divided into a Tiaoshen Yiqi acupuncture group and a routine acupuncture group according to different treatment methods, 40 cases in each group. The basic treatment and rehabilitation exercise for cerebral apoplexy were carried out in both groups. On this basis, the routine acupuncture group was given conventional acupuncture treatment, and the acupoints were selected as Neiguan, Shuigou, Sanyinjiao, Jiquan, Chize and Weizhong; while the Tiaoshen Yiqi acupuncture group was given acupuncture therapy for Tiaoshen Yiqi, and the acupoints were used as Baihui, Sishencong, Shenting, Benshen, Quchi, Neiguan, Hegu, Yanglingquan, Zusanli, Sanyinjiao and Taichong. In two groups, all the needles were retaining for 30 minutes each time, once a day, 6 times a week for 4 weeks. Fatigue severity scale （FSS）, the energy part of the apoplexy specific quality of life scale （SS-QOL）, and the activities of daily living （ADL） scores were observed before and after the intervention of the two groups. Results After treatment, the FSS scores were significantly reduced, and the energy scores in SS-QOL and ADL scores were significantly increased in the two groups, the differences being statistically significant compared with those before treatment （FSS score： the routine acupuncture group was 42.53± 8.35 vs. 45.35± 9.56, the Tiaoshen Yiqi acupuncture group was 36.45 ±8.87 vs. 46.17±8.39; the energy part of SS-QOL： the routine acupuncture group was 9.65± 1.52 vs. 4.56± 1.24, the Tiaoshen Yiqi acupuncture group was 11.41 ± 1.87 vs. 4.47±1.32; ADL score： the routine acupuncture group was 34.07 ±9.73 vs. 32.67± 11.21, the Tiaoshen Yiqi acupuncture group was 37.21 ± 9.26 vs. 33.73 ±12.02, all P 〈 0.05）, and after treatment, the improvement of each score in the Tiaoshen Yiqi acupuncture group was better than that in the routine acupuncture group （FSS score： 36.45 ±8.87 vs. 42.53 ± 8.35, the energy part of SS-QOL： 11.41±1.87 vs. 9.65± 1.52, ADL score： 37.21 ±9.26 vs. 34.07 ± 9.73, all P 〈 0.05）. Conclusion The Tiaoshen Yiqi acupuncture therapy can effectively alleviate the fatigue symptoms of patients with PSF, improve theirmood and participation in rehabilitation training and daily activity, promote their recovery of limb functions, enhance their self-identification and social value, and elevate their quality of life.