电针前顶透囟会对脑梗死恢复期患者血流动力学的影响

Effect of electro-acupuncture Qianding through Xinhui on hemodynamics in convalescent patients with cerebral infarction

目的应用经颅多普勒超声(TCD)观察电针前顶透囟会对脑梗死恢复期患者血流动力学及NIHSS评分的影响。方法选取符合纳入标准的60例脑梗死恢复期受试者,随机分为针刺组、电针组,每组30例,针刺组针刺前顶透囟会,电针组在此基础上配合电针治疗,疗程2周。观察治疗前后MCA的收缩期锋速(Vs)、舒张期锋速(Vd)、平均流速(Vm)、搏动指数(PI)、阻力指数(RI)、血液流变学及NIHSS评分变化。结果MCA血流比较:与治疗前比较,治疗后2组大脑中动脉Vs、Vd、Vm均增加(P<0.01,P<0.05),电针组大脑中动脉PI、RI降低(P<0.05),针刺组大脑中动脉PI、RI降低(P>0.05)。与针刺组治疗后比较,电针组治疗后大脑中动脉Vs、Vd、Vm增加(P<0.05),PI、RI降低(P<0.05)。血液流变学比较:与治疗前比较,治疗后2组高切黏度、低切黏度、血浆比黏度、红细胞压积、纤维蛋白原均下降(P<0.01);与针刺组治疗后比较,电针组血液高切黏度、低切黏度、血浆比黏度、红细胞压积、纤维蛋白原均降低(P<0.05)。NIHSS评分比较:与治疗前比较,治疗后2组NIHSS评分均降低(P<0.01),与针刺组治疗后比较,电针组NIHSS评分降低(P<0.05)。结论电针前顶透囟会和针刺前顶透囟会对脑梗死恢复期患者血流动力学和神经功能恢复均有良性调节作用,且电针组优于针刺组。

Objective To observe the effect of electro-acupuncture on hemodynamics and NIHSS score of patients with cerebral infarction in convalescent stage by TCD.Methods A total of 60 cases of convalescent cerebral infarction were randomly divided into acupuncture group and electro-acupuncture group,30 cases in each group.The acupuncture group was treated with acupuncture at Qianding(GV 21)through Xinhui(GV 22).The electro-acupuncture group was treated with electro-acupuncture on this basis for 2 weeks.The Vs,Vm,PI,RI,hemorheology and NIHSS scores before and after treatment were observed.Results Compared with before treatment,Vs,Vd and Vm of MCA in the electro-acupuncture group and acupuncture group increased after treatment(P<0.01,P<0.05),PI and RI of MCA in electro-acupuncture group decreased(P<0.05),PI and RI of MCA in acupuncture group decreased(P>0.05).Compared with the acupuncture group,Vs,Vd and Vm of MCA increased(P<0.05)and PI and RI decreased(P<0.05)in the electro-acupuncture group.Hemorheological comparison:after treatment,the high shear viscosity,low shear viscosity,plasma specific viscosity,hematocrit and fibrinogen decreased in both groups(P<0.01),and after treatment,the high shear viscosity,low shear viscosity,plasma specific viscosity,hematocrit and fibrinogen decreased in the electro-acupuncture group(P<0.05).NIHSS score:after treatment,NIHSS score in the electro-acupuncture group and acupuncture group decreased(P<0.01)compared with before treatment,and NIHSS score in the electro-acupuncture group decreased(P<0.05).Conclusion Electro-acupuncture at Qianding through Xinhui has a benign regulating effect on hemodynamics and neurological function recovery of patients with cerebral infarction in convalescent stage,and the electro-acupuncture group is better than the acupuncture group.