头针治疗卒中后神经功能缺损和失眠疗效观察

Effect of Scalp Acupuncture on Neurological Deficits and Insomnia in Patients with Stroke

目的:观察头针治疗卒中后神经功能缺损和失眠的临床疗效。方法:选取2021年11月至2022年11月山东省日照市人民医院神经内科住院治疗的卒中后神经功能缺损和失眠患者40例作为研究对象。根据是否行头针(SA)治疗,分为观察组(n=23)和对照组(n=17)。观察组在内科常规药物治疗的基础上,加用头针疗法,对照组不接受任何针刺治疗,只接受内科常规药物治疗。2组治疗前后进行美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)、匹兹堡睡眠质量指数量表(PSQI)、失眠严重程度指数量表(ISI)调查,3个月后再次评估并追踪随访6个月。安全性评估在基线和治疗的第4周进行。结果:随访3、6个月后,观察组与对照组比较差异有统计学意义(P<0.05)。治疗后及随访3个月,2组NIHSS差异无统计学意义(均P>0.05),随访6个月,2组NIHSS差异有统计学意义(P<0.05)。治疗后2组失眠症状均得到改善(P<0.05)。随访3~6个月,观察组PSQI和ISI评分均低于对照组(P<0.05)。结论:头针对卒中后神经功能重塑和改善失眠症状具有临床治疗价值,且安全性高。

Objective:To observe the effect of scalp acupuncture on neurological deficits and insomnia in patients with stroke.Methods:A total of 40 patients with neurological deficits and insomnia disorders after stroke who were hospitalized in the Department of Neurology of People′s Hospital of Rizhao were enrolled prospectively from November 2021 to November 2022.According to whether or not scalp acupuncture(SA)treatment was performed,it was divided into a SA group(n=23)and a control group(n=17).The observation group received scalp acupuncture therapy in addition to conventional internal medicine treatment.The control group did not receive any acupuncture treatment and only received conventional internal medicine treatment.The NIH Stroke Scale(NIHSS),Modified Rankin Scale(mRS),Pittsburgh Sleep Quality Index(PSQI),and Insomnia Severity Index(ISI)were performed before and after treatment,and reassessed after 3 months and followed up for 6 months.Safety assessment was performed at begining and at 4 weeks after the treatment.Results:At 3 and 6 months after treatment,there were statistically significant differences in mRS improvement between the observation group and the control group(P<0.05).After treatment and 3 months of follow-up,there was no significant difference in NIHSS between the two groups(P>0.05),while there was a significant difference in NIHSS between the two groups after 6 months of follow-up(P<0.05).After treatment,the insomnia symptoms of the two groups were improved(P<0.05).After 3 to 6 months of follow-up,the PSQI and ISI scores of the observation group were lower than those of the control group(P<0.05).Conclusion:Scalp acupuncture has clinical therapeutic value and high safety in reshaping neurological function and improving insomnia symptoms after stroke.