治神调髓法治疗脑卒中后单侧空间忽略临床研究

Therapeutic effect of "Zhishen-Tiaosui" acupuncture for the stroke patients with unilateral spatial neglect

目的探讨治神调髓法治疗脑卒中单侧空间忽略(unilateral spatial neglect, USN)的临床疗效。方法将符合入选标准的66例患者采用随机数字表法分为2组,每组33例。对照组采用常规体针治疗,治疗组采用治神调髓法针刺治疗。2组均治疗20 d,随访8周。采用Fugl-Meyer肢体功能评分量表(Fugl-Meyer Assessment, FMA)评估肢体运动功能,采用凯瑟林波哥量表(Catherine Bergego Scale, CBS)评估USN的病变程度,采用改良Barthel指数评定量表(Modified Barthel Index, MBI)评估日常生活能力,评价临床疗效。结果治疗后,治疗组FMA[(39.21±8.96)分比(26.34±8.06)分,t=6.135]、MBI[(49.62±10.19)分比(40.18±9.52)分,t=5.919]评分高于对照组(P<0.01),CBS[(9.55±4.68)分比(18.20±6.97)分,t=3.889]评分低于对照组(P<0.01);治疗组脑区左侧额中回、左侧额下回、左侧枕中回、左侧颞前回及颞中回、左右侧前扣带回、右侧额中回、左侧后扣带回、左侧楔前叶激活强度均明显高于对照组(t值分别为4.615、3.052、3.644、3.575、3.152、2.816、2.579、3.511,P<0.01)。治疗组总有效率为78.8%(26/33)、对照组为54.5%(18/33),2组比较差异有统计学意义(χ2=5.657,P=0.017)。结论治神调髓法可改善脑卒中USN患者脑部血液循环,增强患者认知功能及运动能力,提高日常生活能力。

Objective To explore the clinical efficacy of "Zhishen-Tiaosui" acupuncture treatment for the stroke patients with unilateral spatial neglect. Methods A total of 66 patients who met the inclusion criteria were randomized into two groups, 33 in each group. The control group was treated with conventional body acupuncture, and the treatment group was treated with Zhishen-Tiaosui acupuncture treatment. Both groups were treated for 20 days and followed up for 8 weeks. The Fugl-Meyer Assessment (FMA) was used to assess limb motor function, and the Catherine Bergego Scale (CBS) was used to assess the daily living ability and the extent of unilateral spatial neglect. The Modified Barthel Index (MBI) assesses the ability of daily living and evaluates clinical outcomes. Results After treatment, FMA (39.21 ± 8.96 vs. 26.34 ± 8.06, t=6.135), MBI (49.62 ± 10.19 vs. 40.18 ± 9.52, t=5.919) in the treatment group were significantly higher than those in the control group (P<0.01), CBS (9.55 ± 4.68 vs. 18.20 ± 6.97, t=3.889) were significantly lower than those in the control group (P<0.01). Treatment group brain regions in the left frontal back, the left inferior frontal gyrus, left occipital in back to back to back to before the left temporal and temporal, left and right side of the anterior cingulate, back in the right frontal, cingulate gyrus of the left side, left precuneus activation intensity were significantly higher than the control group (t=4.615, 3.052, 3.644, 3.575, 3.152, 2.816, 2.579, 3.511, P<0.01). The total effective rate was 78.8% (26/33) in the treatment group and 54.5% (18/33) in the control group. The difference between the two groups was statistically significant (χ2=5.657, P=0.017). Conclusions The Zhishen-Tiaosui can improve the blood circulation of the brain in the unilateral space of the stroke, enhance the cognitive function and exercise capacity, and improve the daily living ability.