通督调神针法对脑梗死恢复期患者ROI-CBF、脑血流及神经功能的影响

Clinical effects of the Tongdu Tiaoshen acupuncture treatment on the ROI-CBF,cerebral blood flow and neurological function of convalescent patients with cerebral infarction

目的分析通督调神针法对脑梗死恢复期患者感兴趣区脑血流量(ROI-CBF)、脑血流及神经功能的影响。方法选择脑梗死恢复期患者127例,采用随机数表法分为常规组(n=63)和通督调神针组(n=64)。常规组采用常规治疗,通督调神针组在常规组的基础上采用通督调神针法进行治疗,2组均治疗3个月。比较治疗后2组临床疗效;比较2组治疗前后大脑动脉平均血流速度、搏动指数、血液流变学指标、ROI-CBF、生活质量及神经功能。结果治疗3个月后,通督调神针组总有效率(96.9%,62/64)显著高于常规组(79.4%,50/63 P<0.05)。治疗3个月后,2组收缩峰值血流速度(Vs)、舒张末期血流速度(Vd)、平均血流速度(Vm)、梗死灶区脑血流量(CBF)、梗死灶旁区CBF、镜像区CBF、Barthel指数(BI)量表评分较治疗前均显著升高,通督调神针组高于常规组(P<0.05)。治疗3个月后,通督调神针组血流阻力指数(RI)较治疗前显著降低,且显著低于常规组(P<0.05)。治疗3个月后,2组搏动指数(PI)、红细胞压积、血小板黏附率、血沉、神经功能缺损评分量表(NIHSS)评分较治疗前均显著降低,通督调神针组低于常规组(P<0.05)。结论通督调神针法可改善脑梗死恢复期患者血液流动,改善患者搏动指数、血液流变学指标和ROI-CBF,有利于患者神经功能的恢复,促进患者康复。

Objective To analyze the effects of the Tongdu Tiaoshen acupuncture treatment on the region of interest cerebral blood flow(ROI-CBF),cerebral blood flow and neurological function of convalescent patients with cerebral infarction.Methods A total of 127 patients with cerebral infarction in their convalescent stage were selected and randomly divided into a routine group(n=63)and a Tongdu Tiaoshen acupuncture group(n=64).The routine group was treated with a conventional therapy,while the Tongdu Tiaoshen acupuncture group was treated with the Tongdu Tiaoshen acupuncture treatment on the basis of the routine group,both for 3 months.The clinical efficacy of the two groups was compared after treatment,and the mean cerebral artery blood flow velocity,pulsatility index,hemorheology index,ROI-CBF,quality of life and neurological function were compared between the two groups before and after treatment.Results After 3 months of treatment,the total effective rate(96.9%,62/64)of the Tongdu Tiaoshen acupuncture group was significantly higher than that of the routine group(79.4%,50/63,P<0.05).After 3 months of treatment,the peak systolic blood flow velocity(Vs),end-diastolic blood flow velocity(Vd),mean blood flow velocity(Vm),cerebral blood flow(CBF)in the infarction area,CBF in the para-infarction area,CBF in the mirror area and Barthel index(BI)in the two groups were significantly higher than those before treatment,and the scores in the Tongdu Tiaoshen acupuncture group were higher than those in the routine group(P<0.05).After 3 months of treatment,the blood flow resistance index(RI)of the Tongdu Tiaoshen acupuncture group was significantly lower than that before the treatment,and significantly lower than that of the routine group(P<0.05).After 3 months of treatment,the pulsatility index(PI),hematocrit,platelet adhesion rate,erythrocyte sedimentation rate and National Institutes of Health Neurological Deficit Scale scores(NIHSS)of the two groups were significantly lower than before treatment,and the Tongdu Tiaoshen acupuncture group was lower than the routine group(P<0.05).Conclusion The Tongdu Tiaoshen acupuncture treatment can improve the blood flow,pulsatility index,hemorheology indexes and ROI-CBF of patients with cerebral infarction in their convalescent stage,which is beneficial to the recovery of the patients’neurological function and promotes their recovery.