行气散瘀针刺法对后循环脑梗死恢复期患者脑血流调控的作用研究

Effect of acupuncture method of promoting qi and dispersing blood stasis on cerebral blood flow regulation in patients with cerebral infarction of posterior circulation in convalescent stage

目的观察行气散瘀针刺法对后循环脑梗死恢复期患者脑血流调控的作用。方法将200例后循环脑梗死恢复期患者按照随机数字表法分为2组。对照组100例予西医常规治疗,观察组100例在对照组治疗基础上加用行气散瘀针刺法治疗。2组均7 d为1个疗程,2个疗程后统计临床疗效,并比较2组治疗前后椎动脉(VA)及基底动脉(BA)峰值血流速度(Vs)、平均血流速度(Vm)、舒张末期血流速度(Vd)、动脉搏动指数(PI)、阻力指数(RI)改变,血浆5-羟色胺(5-HT)、去甲肾上腺素(NE)含量,日常生活能力Barthel指数量表、美国国立卫生研究院卒中量表(NIHSS)评分变化。结果观察组总有效率84%(84/100),对照组总有效率71%(71/100),观察组临床疗效优于对照组(P<0.05)。治疗后2组VA及BA的Vs、Vm、Vd均较本组治疗前增快(P<0.05),且观察组快于对照组(P<0.05)。治疗后2组BA的RI均较本组治疗前降低(P<0.05),但2组组间比较差异无统计学意义(P>0.05)。治疗后观察组左侧、右侧VA的RI和对照组左侧VA的RI均较本组治疗前降低(P<0.05),且观察组左侧VA的RI低于对照组(P<0.05)。治疗后观察组左侧VA的PI低于本组治疗前及对照组治疗后(P<0.05)。治疗后2组NIHSS评分均较本组治疗前降低(P<0.05),Barthel指数量表评分均升高(P<0.05),且观察组改善优于对照组(P<0.05)。治疗后2组5-HT、NE水平均较本组治疗前降低(P<0.05),且观察组均低于对照组(P<0.05)。结论行气散瘀针刺法治疗后循环脑梗死恢复期疗效确切,可改善生活质量和临床症状,增加脑血流。

Objective To observe the effect of acupuncture method of promoting qi and dispersing blood stasis on cerebral blood flow regulation in patients with cerebral infarction of posterior circulation in convalescent stage.Methods 200 patients with cerebral infarction of posterior circulation were randomly divided into two groups according to the random number table method.100 cases in the control group were treated by routine western medicine.100 cases in the observation group were treated by acupuncture method of promoting qi and dispersing blood stasis on the basis of the control group.Both groups were treated for 7 days as a course of treatment,after two courses of treatment,the clinical efficacy was statistically counted.The changes of peak blood flow velocity(Vs),mean blood flow velocity(Vm),end diastolic velocity(Vd),arterial pulsatility index(PI),resistance index(RI)of vertebral artery(VA)and basilar artery(BA),plasma 5-hydroxytryptamine(5-HT),noradrenalin(NE),Barthel index of activities of daily living and NIHSS scores of the two groups before and after treatment were compared.Results The total effective rate of the observation group was 84%(84/100),and that of the control group was 71%(71/100).The clinical efficacy of the observation group was better than that of the control group(P<0.05).After treatment,the Vs,Vm and Vd of VA and BA in the two groups increased faster than those before treatment(P<0.05),and the observation group was faster than the control group(P<0.05).After treatment,the RI of BA in both groups was lower than that in the group before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).After treatment,the RI of left and right VA in the observation group and the RI of left VA in the control group were lower than those in the group before treatment(P<0.05),and the RI of left VA in the observation group was lower than that in the control group(P<0.05).After treatment,the PIof left VA in observation group was lower than that before treatment and after treatment in control group(P<0.05).After treatment,NIHSS scores of both groups were lower than those in the group before treatment(P<0.05),and Barthel Index scores were increased(P<0.05),and the improvement of the observation group was better than that of the control group(P<0.05).After treatment,the levels of 5-HT and NE in both groups were lower than those in the group before treatment(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).Conclusion The acupuncture method of promoting qi and dispersing blood stasis is effective in the treatment of cerebral infarction of posterior circulation in convalescent stage,which can improve the quality of life and clinical symptoms,and increase cerebral blood flow.