针刺治疗中风后手指过屈疗效及对患者中医症候积分与关节功能相关指标的影响

目的:观察针刺治疗中风后手指过屈的疗效及对患者中医症候积分与关节功能相关指标的影响。方法:将60例中风后手指过屈患者随机分为针刺治疗组(30例)和巴氯芬治疗组(30例),治疗30d后,观察两组患者治疗效果,治疗前后中医证候积分、手指痉挛程度、神经功能缺损评分(NISS)、中医侯症积分和掌指关节活动度变化情况及检测两组患者治疗前后cAMP、cGMP、IP3、DAG水平。结果:针刺组患者治疗总有效率(86.67%)显著高于巴氯芬组(56.67%)(P<0.05),针刺组患者在治疗15d和30d后手指痉挛改善程度和掌指关节活动度显著优于巴氯芬组(P<0.05);治疗后针刺治疗组患者NISS评分和中医证候积分较巴氯芬药物组改善更明显,差异具有统计学意义(P<0.05)。与巴氯芬药物组比较,治疗后针刺组患者cAMP含量显著增加,而cGMP、IP3和DAG含量明显降低,差异具有统计学意义(P<0.05)。结论:针刺治疗中风后手指过屈有显著改善作用,能够提高cAMP水平和降低cGMP、IP_3、DAG水平,介导Ca^(2+)超载,降低肌肉张力,促进手指关节功能恢复。

针刺足少阳经穴治疗中风后足内翻60例

目的:观察针刺足少阳经穴治疗中风后足内翻的临床疗效。方法:对偏瘫患者整体采用醒脑开窍针刺法并配以足少阳经分布于小腿及足部的诸穴治疗足内翻。结果:观察组60例中痊愈21例,显效28例,有效6例,无效5例,总有效率90.17%。结论:针刺"足少阳经"分布于小腿及足部穴位对缓解偏瘫后痉挛性足内翻有显著疗效。

以颞穴为主针刺治疗中风偏瘫的临床疗效观察

以颞穴为主针刺治疗中风偏瘫的临床疗效观察５１０４０７广州中医药大学彭旭明，靳瑞、张家维、赖新生（指导）主题词中风偏瘫／针刺疗法，颞穴／临床应用中风偏瘫是指中风经救治，所遗留的半身不遂，一侧肢体活动不利，从而导致患者生活障碍，丧失工作能力，针刺颞穴治疗...

针刺配合电针治疗中风后遗症疗效观察

目的:观察中风后遗症采取针刺联合电针共同治疗的临床治疗效果。方法:抽取中风后遗症的病人70例,随机分为治疗组和对照组,每组各35例。对照组对病人单一针刺治疗模式,治疗组在针刺治疗的基础之上加入电针治疗。结果:治疗组总有效率总体有效率为88.5%;明显优于对照组(65.7%),两组间差异具有统计学意义(P<0.05)。结论:对中风后遗症采用针刺联合电针共同治疗,可以获得良好的临床治疗效果,不良反应极少,具有安全稳定性,使病人的健康生活质量得到保障。

针刺治疗中风假性延髓麻痹疗效分析

目的:研究针刺疗法应用于中风假性延髓麻痹临床治疗中的效果。方法:选取本院接诊的中风假性延髓麻痹患者76例,随机分为治疗组(西医联合针刺治疗)与对照组(常规西医治疗)各38例,比较两组疗效。结果:治疗组的治疗总有效率显著高于对照组,两组间疗效对比差异具统计学意义(P<0.05);治疗组的吞咽功能评级结果、各症状(饮水呛咳、构音障碍及声嘶)消失时间均低于对照组水平,各指标的组间对比差异显著(P均<0.05)。结论:针刺治疗中风假性延髓麻痹的临床效果显著,有利于症状改善,促进吞咽功能恢复,值得应用。

化瘀通脉针刺法治疗中风急性期后120例

目的:观察化瘀通脉针刺法治疗中风急性期后疗效。方法:将180例中风病患者随机分为治疗组120例和常规针刺法60例。2组患者住院期间均进行内科常规对症处理,治疗组加用头针、CT定位围针法和体针(通脉三针)结合治疗,对照组采用常规针刺法,选取肩髁、曲池、外关、环跳、阳陵泉等治疗,观察其疗效。结果:化瘀通脉针刺法疗效明显优于常规针刺疗法,2组临床疗效对比,差别有统计学意义(P<0.01);化瘀通脉针刺法对脑梗死与脑出血疗效对比,差别无统计学意义(P>0.05)。结论:化瘀通脉针刺法治疗中风是一种安全有效的治疗方法。

庄礼兴调神针法治疗中风后抑郁思路探讨

总结庄礼兴教授运用调神针法治疗中风后抑郁的诊治思路和临床经验。庄礼兴教授认为中风后抑郁病位在脑,往往因中风后,气机逆乱,痰瘀内生,留于脑窍心神,使脑神失所养、神失所藏而发病;治疗时突出"神"的主导地位,将调理神志的优选穴位组合为固定穴组,取四神针、智三针、印堂、神门、三阴交等穴,同时配合电针刺激及临证加减来调节患者的整体神志功能,从而达到从神导气、气行郁止之效。其临床经验对于中风后抑郁的针刺治疗具有较好的临床参考意义。

针刺配合天眩清治疗假性球麻痹142例

目的:观察针刺合天眩清治疗脑卒后患者假性球麻痹吞咽障碍的临床疗效。方法:将196例脑卒中患者随机分两组,对照组常规应用药物,治疗组在对照组基础上给予针刺合静滴天眩清。结果:镇刺合天眩清组明显优于对照组,两组比较,差异有统计学意义(P<0.001)。结论:针刺合天眩清治疗可显著提高脑卒中患者的吞咽功能,减少并发症的发生。

子午流注取穴与循经取穴治疗中风病对比观察

应用子午流注针法治疗中风病100例,与循经取穴治疗对照,子午流注组疗效优于循经取穴组。说明子午流注针法能够提高针灸治疗中风病的临床疗效。

DEVELOPMENT OF CLINICAL STUDIES ON ACUPUNCTURE TREATMENT OF SHOULDER PAIN IN PATIENTS WITH WIND STROKE

In the present paper, the authors review some new results of acupuncture treatment of shoulder pain in stroke patients from ① application of filiform needle with different needling manipulations, ② selection and combination of acupoints, and ③ some special needling methods including point-injection. Generally, if acupuncture therapy is used in combination with other rehabilitation methods, the therapeutic effect of shoulder-pain-relief will be much better. Regarding the acupoint selection, both local acupoints and those of the yang meridians are primarily used in clinical practice. Further studies on treating shoulder pain of hemiplegia based upon the basic theory of TCM are necessary.

OCULO-ACUPUNCTURE TREATMENT OF CEREBRAL INFARCTION INDUCED HEMIPLEGIA

Objective: To observe the therapeutic effect of oculo acupuncture therapy in the treatment of cerebral infarction induced hemiplegia. Methods: 58 cases of stroke patients were randomly divided into treatment group (n=30) and control group (n=28). In treatment group, on the basis of medication plus rehabilitation treatment, patients voluntarily accepted oculo acupuncture therapy (acupuncture of Upper Jiao Area and Lower Jiao Area). In control group, patients only accepted medication and rehabilitation treatment. The therapeutic effect was evaluated with Brunstrom’s 6 stages Assessing Method. Results: After 24 sessions of treatment, the ratios of the diseased limbs reaching stage VI and more in functional activity in the patients of treatment group increased from 16.7% (upper limb) and 20.0% (lower limb) before treatment to 70.0% and 90.0% respectively; while in control group, those ratios of the upper and lower limbs increased from 10.7% and 28.6% before treatment to 39.2% and 60.7% separately. There was a significant difference between two groups in the therapeutic effect (P<0.05). Conclusion: Oculo acupuncture plus medication is superior to simple medication treatment in improving functional activity of the hemiplegic limbs.

EFFECT OF ACUPUNCTURE ON BLOOD OXYGEN FREE RADICAL AND NO LEVELS IN TREATMENT OF APOPLECTIC SEQUELAE

Objective: To observe the effect of acupuncture on blood oxygen free radical (OFR) and nitric oxide (NO) levels in the treatment of apoplectic sequelae. Methods: A total of 61 cases of apoplectic patients were subjected into this study and randomly divided into "JIN San Zhen" group (n=30) and control group (n=31). Blood lipid peroxidase (LPO), superoxide dismutase (SOD), glutathione peroxidase(GSH Px) and nitric oxide (NO) contents before and after acupuncture treatment were determined with radioimmunoassay. In both groups, acupuncture was given once daily, six times a week, with 4 weeks being a therapeutic course and with the interval between two weeks being a week, 3 courses all together. In "JIN San Zhen" group, acupoints of "JIN San Zhen" were used predominately, while in control group, scalp point Motor Sensory Area (MS 8) was used as the main point. Results: Self comparison showed that after 3 courses of treatment, in both groups, LPO and NO levels decreased significantly (P<0.05-0.01), SOD and GST Px values increased considerably (P<0.05-0.01). Comparison between two groups indicated that the effects of "JIN San Zhen" group are significantly superior to those of control group in raising blood SOD and GST Px levels (P<0.05-0.01) and in lowering blood NO content (P<0.01). Analysis on the correlation between the restoration of neural function and the changes of LPO, SOD and GST Px levels suggested that the effect of acupuncture in improving neural function may be related to changes of the aforementioned indexes. Conclusion: Acupuncture therapy can significantly lower blood LPO and NO levels and evidently raise blood SOD and GST Px levels in stroke patients.

CLINICAL OBSERVATION ON APOPLEXY TREATED BY TRANSVERSE ACUPUNCTURE OF ANTERIOR OBLIQUE LINE OF VERTEX-TEMPORAL

cases of apoplexy were randomly divided into two groups: group A (40 cases)and group B (32 cases). In group A, we used transverse acupuncture of anteriorobligue line of vertextemporal plus acupuncture of commonlyused body acupoints for apoplexy. After 30 times of treatments, the results were as follows: In group A, basic recovery rate was 20%, marked improvement rate was 50%. In growp B, basic recovery rate was 9.4%, marked improvement rate was 25%. The total therapeutic effect in group A was better than that in group B.This indicated: Transverse acupuncture of anterioroblique line of vertextemporal has definite therapeutic effect for apoplexy and has better therapeutic effect than acupuncture along the line.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ENCLOSING NEEDLING UNDER CT ORIENTATION FOR TREATMENT OF ISCHEMIC CEREBRAL STROKE AND ITS INFLUENCE ON PLASMA NO

In the present paper, 61 cases of ischemic cerebral apoplexy were randomly divided into enclosing needling group (n=31) and scalpacupuncture group (n=30). After 30 sessions of treatment, there was a significant difference between the two groups in the therapeutic effect (P<0.05), indicating enclosing needling being superior to scalpacupuncture. Both enclosing needling and scalpacupuncture could lower plasma NO content while the former was more apparent in lowering plasma NO level.

CLINICAL OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE OF JIAJI (EX-B2) IN THE TREATMENT OF APOPLECTIC SPASTIC HEMIPLEGIA

Objective: To compare the therape utic effects of acupuncture of different acupoints in the treatment of spast ic hemiplegia of apoplexy. Methods: Eighty stro ke patients with spastic hemiplegia were evenly randomized into control grou p and treatment group. Forty cases of treatment group were given with acupun cture of Jiaji (夹脊 EX-B2) from T1 to L5, while forty cases of control gro up were treated with conventional acupoints as Jianyu (肩NFDA1 LI 15), Quchi (曲池 LI 11), Huantiao (环跳 GB 30), Zusanli (足三里 ST 36), Kunlun (昆仑 BL 60), etc. o n the diseased side, once daily, with 10 sessions being one therapeutic course, and 3 courses all together. The modified Ashworth Scale (MAS) and neurological d eficit grading scale (NDS) were used as the indexes to assess the therapeutic ef fects. Results: After treatment, the scores of NDS of both treat ment and control groups reduced and the difference value between post- and pre-treatment of tr ea tment group was significantly bigger than that of control group. MAS showed a si milar tendency in both groups. Of the 40 cases in treatment and control groups, 6 and 1 were cured, 20 and 15 had marked improvement, 9 and 11 had improvement, 4 and 8 failed, 1 and 5 got worse, with the total effective rates being 87.5% an d 67.5% respectively. The therapeutic effect of treatment group was significantl y superior to that of control group (P<0.01). Conc lusion: Acupuncture of Jiaji ( EX-B2) is superior to acupuncture of conventional acupoints in alleviating the state of spastic hemiplegia of apoplexy.

EXPLORING THE MECHANISM OF ACUPUNCTURE IN THE TREATMENT OF STROKE FROM CHANGES OF GLUCOSE METABOLISM IN THE CEREBRAL MOTOR CENTER

Objective: To observe the effect of acupuncture on cerebral glucose metabolism in stroke patients. Methods:Changes of cerebral glucose metabolism before and after acupuncture stimulation were observed in six cases of stroke patients by using positron emission tomography (PET) scanner. Elecrocacupuncture (EA,4 Hz, continuous waves and duration of 20 min) was applied to Baihui (百会 GV 20) and right Qubin (曲鬓 GB 7). 18 Fluorine deox yglucose (18FDG), a developer (radioactive form of glucose) for showing the levels of the brain functional activity was given to the patients intravenously. SPM software was used to deal with the data of each pixel point by unilateral t-test (Ts: P = 0.05), then, the regions showing increase/decrease of the glucose metabolism were obtained. Results: After acupuncture stimulation, significant increase of glucose metabolism was found to be in the first somatic motor cortical region (Ml), supplementary motor area (SMA), premotor area (PMC), and the superior parietal lobule (LPs) on the healthy side of the brain; while the decrease of glucose metabolism found in MI, PMC and LPs on the focus side. In addition to the cerebral regions related to the motor function, changes of glucose metabolism were also found in the parietal lobule and basal ganglion area, central parietal gyrus, superior parietal gyrus, putamen, cerebellum, etc. .Conclusion: Acupuncture of Qubin (GB 7) and Baihui (GV 20) can activate motor-related cerebral structures in the bilateral cerebral hemisphere and induce excitement reaction of the potentially correlative motor area so as to compensate or assist the injured motor area to play a role in improving motor function in stroke patients.

Treatment of 85 patients with dysphagia after stroke with deep needling at local glossopharyngeum

Objective To observe the clinical efficacy of deep needling at local glossopharyngeum in treatment of dysphagia after stroke. Methods Deep needling at local glossopharyngeum was applied in 85 patients with dysphagia after stroke. Firstly, quick prick was conducted on lingual surface（mainly at the side of paralysis lingualis）, Jīnjīn（金津 EX-HN 12） and Yùyè（玉液 EX-HN 13） under the tongue; secondly, filiform needle with the length of 75 mm was used to perform quick prick at posterior wall of pharynx at the affected side about three or four times, and then the needle was removed rapidly. Filiform needle with the length of 75 mm was inserted perpendicularly at Liánquán（廉泉 CV 23） towards root of tongue; after deqi, the needle was pushed towards root of tongue in the depth of 60–70 mm, and the needle was retained for 30 min. Meanwhile, the patient was asked to swallow, and the feeling of abnormal deglutition without pain was considered as most appropriate. During needle retention, twirling for reinforcement was applied for two times. The manipulation was conducted once daily, and six days was considered as one course of treatment. Between two courses, one day was free of treatment; and there were four courses in total. Kubota＇s drinking water test evaluation scale was applied to assess the efficacy after the treatment for two weeks and four weeks. Results The score of Kubota＇s drinking water test at the early stage of treatment was 5.08 ± 2.28, the score of evaluation of treatment with deep needling at local glossopharyngeum after treatment for two weeks was 4.56 ± 2.32, and the total effective rate was 89.4%; the score of evaluation after treatment for four weeks was 2.80 ± 2.12, and the total effective rate was 95.3%. Compare before the treatment, the score of Kubota＇s drinking water test was reduced after treatment for two and four weeks（P〈0.05, P〈0.01）. Conclusion Deep needling at local glossopharyngeum in treatment of dysphagia after stroke has good effect.

Effect of Acupuncture and Rehabilitation Training on Barthel Index in Early-stage of Stroke Cases

Objective： To study the effect of combined acupuncture and rehabilitation training on early-stage Barthel index of ischemic stroke cases. Method： Fifty ischemic stroke cases were randomized into a treatment group of 24 cases and control group of 26 cases. In addition to routine internal treatment methods, rehabilitation training was applied to cases in the control group, and combined acupuncture and rehabilitation training were applied to cases in the treatment group. Warming and reinforcing manipulations were applied to Jianyu （LI 15）, Quchi （LI 11）, Hegu （LI 4）, Yanglingquan （GB 34）, Yinlingquan （SP 9）, Zusanli （ST 36）, and Sanyinjiao （SP 6）, 20 rain of needle retaining for each point in one treatment. Then the scores of clinical neurological impairment and Barthel index of stroke cases were evaluated before the treatment and 3 weeks after respectively. Results： The significant progress and progress cases in the treatment group were 14 and 12 respectively, whereas that in the control group were 6 and 11 respectively, coupled with 7 cases of no progress. The therapeutic effect in the treatment is substantially better than the control group （P〈0.05）. There was no significant difference （P〉0.05） in neurological impairment and scores of Barthel index of the two groups before the treatment, whereas significant difference （P〈0.05） after the treatment. The scores of neurological impairment in the treatment group were significantly reduced after the treatment （P〈0.05）, and the scores of Barthel index were significantly increased （P〈0.05）. Conclusion： Combined acupuncture and rehabilitation training can produce significantly better effect on early neurological impairment and Barthel index of stroke cases than rehabilitation training alone.

Clinical Observation of Electroacupuncture and Rehabilitation Training in Treating Cerebral Infarction

Objective： To observe the clinical efficacy of electroacupuncture and rehabilitation exercises in the treatment of cerebral infarction. Methods： Seventy-four patients with cerebral infarction were randomized into treatment group and control group in visit sequence. Thirty-seven cases in treatment group were treated with electroacupuncture and rehabilitation exercises, and other 37 cases in control group were treated with electro- acupuncture alone. The treatment was given once a day and there was a 2-day interval after any consecutive 5 treatments. After total 30 treatments, Fugl-Meyer scale was used to evaluate motor function and Barthel Index to evaluate the activities of daily living. Results： After treatments, the motor function of paralyzed limb and activities of daily living were obviously improved in both groups, with more significant improvement in treatment group than in control group （P〈0.05）. Conclusion： Combination of electroacupuncture and rehabilitation exercises has better effects than simple electroacuvuncture in the treatment of cerebral infarction.