“滋水涵木”针刺法结合毫火针治疗中风后痉挛性偏瘫临床研究

Observation on effect of “Zishui Hanmu” acupuncture method combined with filiform-fire needle on spastic hemiplegia after stroke

目的:研究“滋水涵木”法针灸结合毫火针治疗中风后痉挛性偏瘫的临床效果。方法:将62例中风后痉挛性偏瘫患者随机均分为观察组和对照组,均常规给予对症支持治疗和康复锻炼,在此基础上对照组取患侧腧穴采用毫火针进行治疗,观察组采用“滋水涵木”法针灸合毫火针治疗,两组疗程均为28 d,评估两组临床疗效、神经功能缺损程度评分(NDS)、改良Barthel指数(MBI)和简化Fugl-Meyer功能量表评分,同时采用酶联免疫吸附法(ELISA)检测两组治疗前后血清碱性成纤维生长因子(bFGF)和血管内皮生长因子(VEGF)水平,采用CT灌注成像测量脑血容量(CBV)、脑血流量(CBF)和平均通过时间(MTT)等指标。结果:观察组和对照组有效率分别为87.10%和64.52%(P<0.05),观察组治疗28 d中医证候积分和NDS评分低于对照组,Fugl-Meyer、MBI评分和Lovett肌力分级高于对照组,差异有统计学意义(P<0.05)。治疗28 d,两组血清bFGF和VEGF水平及病灶部位CBV和CBF均明显升高(P<0.05),MTT明显降低(P<0.05),且观察组bFGF、VEGF、CBV和CBF高于对照组,MTT低于对照组,差异有统计学意义(P<0.05)。结论:“滋水涵木”法针灸结合毫火针治疗中风后痉挛性偏瘫有利于减轻神经功能损伤,改善脑微循环,对促进患者康复和改善日常生活能力具有积极作用。

Objective:To study the clinical effect of acupuncture and moxibustion of “Zishui Hanmu” method combined with filiform-fire needle in the treatment of spastic hemiplegia after stroke.Methods:A total of 62 patients with spastic hemiplegia after stroke were randomly and evenly divided into observation group and control group.The two group were given routine symptomatic supportive treatment and rehabilitation exercise,and on this basis,control group was given filiform-fire needle therapy on the acupoints of affected side,and observation group was treated with acupuncture and moxibustion of “Zishui Hanmu” method combined with filiform-fire needle,and the two groups were treated for 28 d.The clinical efficacy,neurological deficit score(NDS),modified Barthel index(MBI) and simplified Fugl-Meyer functional scale were evaluated in the two groups.ELISA was used to detect the levels of serum bFGF and VEGF in the two groups before and after treatment.Cerebral blood volume(CBV),cerebral blood flow(CBF) and mean transit time(MTT) were measured by CT perfusion imaging.Results:The effective rates of observation group and control group were 87.10% and 64.52%(P<0.05),and the scores of TCM symptoms and NDS of observation group at 28 d of treatment were lower while the Fugl-Meyer score,MBI score and Lovett muscle strength grading were higher compared with those of control group(P<0.05).At 28 d of treatment,the levels of serum +bFGF and VEGF and CBV and CBF at the lesions in the two groups were significantly enhanced(P<0.05) while MTT was significantly reduced(P<0.05),and the bFGF,VEGF,CBV and CBF of observation group were higher while MTT was lower compared to control group(P<0.05).Conclusion:Acupuncture and moxibustion of “Zishui Hanmu” method combined with filiform-fire needle for spastic hemiplegia after stroke is beneficial to reducing neurological damage and improving brain microcirculation,and it has a positive effect on promoting the rehabilitation and improving the ability of daily living of patients.