醒脑开窍针法联合经皮耳迷走神经刺激治疗脑出血术后昏迷的临床观察

Clinical observation of Xing Nao Kai Qiao needling method plus transcutaneous auricular vagus nerve stimulation for coma after surgery for cerebral hemorrhage

目的观察醒脑开窍针法联合经皮耳迷走神经刺激治疗脑出血术后昏迷的临床疗效。方法将60例脑出血术后昏迷患者随机分为观察组和对照组,每组30例。两组患者均给予常规临床治疗及康复护理,对照组予以醒脑开窍针法治疗,观察组在醒脑开窍针法治疗的基础上加用经皮耳迷走神经刺激治疗。比较两组的苏醒时间和苏醒率,同时在治疗前后分别采用修订版昏迷恢复量表(coma recovery scale-revised,CRS-R)、格拉斯哥昏迷量表(Glasgow coma scale,GCS)评估其苏醒效果,美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评估其神经功能状况。结果观察组苏醒率高于对照组(P<0.05)。两组治疗后CRS-R评分、GCS评分均较治疗前增加,NIHSS评分较治疗前降低;观察组CRS-R评分、GCS评分和NIHSS评分优于对照组,差异均有统计学意义(P<0.05)。结论在常规临床治疗及康复护理的基础上,醒脑开窍针法联合经皮耳迷走神经刺激疗法对于脑出血术后昏迷患者促醒效应及改善神经功能方面优于醒脑开窍针法。

Objective To observe the clinical efficacy of Xing Nao Kai Qiao(brain-activating and mind-tranquilizing)needling method plus transcutaneous auricular vagus nerve stimulation(taVNS)in treating coma after cerebral hemorrhage surgery.Method Sixty patients with coma after cerebral hemorrhage surgery were randomized into an observation group and a control group,with 30 cases in each group.Both groups were given conventional clinical treatments and rehabilitation care.In addition,the control group received Xing Nao Kai Qiao needling therapy,and the observation group received Xing Nao Kai Qiao needling therapy and taVNS.The time of waking up and resuscitation rate were compared between the two groups.Before and after treatment,the coma recovery scale-revised(CRS-R)and Glasgow coma scale(GCS)were used to assess the resuscitation effect,and the National Institutes of Health stroke scale(NIHSS)was taken to evaluate the neurological function.Result The observation group had a higher resuscitation rate than the control group(P<0.05).After the treatment,the CRS-R and GCS scores increased in both groups,and the NIHSS score dropped;the observation group showed advantages in comparing the CRS-R,GCS,and NIHSS scores than the control group,and the between-group differences were statistically significant(P<0.05).Conclusion Based on conventional clinical treatments and rehabilitation care,Xing Nao Kai Qiao needling method plus taVNS can more significantly promote resuscitation and improve neurological function than Xing Nao Kai Qiao Needling alone in patients with coma after surgery for cerebral hemorrhage.