【作者】 梅俊华； 王俊力； 高珊； 陈国华； 张中文； 罗利俊； 魏丹； 邵卫；

【Author】 MEI Jun-hua;WANG Jun-Li;GAO Shan;CHEN Guo-hua;ZHANG Zhong-wen;LUO Li-jun;Wei Dan;SHAO Wei;Department of Neurology,the First Hospital of Wuhan;

【机构】 武汉市第一医院神经内科；

【摘要】 目的:研究慢性酒精中毒性周围神经病(chronic alcoholic peripheral neuropathy CAPN)患者神经心理因素、针刺治疗得气、疗效三者之间的关系,为该病的综合诊治提供依据。方法:对55例CAPN患者采用随机抽样法分为手法组和非手法组进行针刺治疗。行下肢神经损害评分(NIS-LL)及神经系统症状评分(NSS)评价其症状程度及疗效,采用针刺主观感受量表评价针刺得气状态,并对入组患者行卡特尔人格因素测试(16PF)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评价其神经心理状态。结果:治疗第7d、14d、21d、28d针刺视觉模拟评分比较手法组患者得气分值、平均值及医者得气均分值均高于非手法组(P<0.05);行卡特尔十六种人格因素测验,并同时行患者得气量表分析,乐群性、聪慧性、兴奋性、敏感性、独立性因子分高的人群较为容易得气;治疗14d,28d时行HAMA、HAMD、得气量表评分,结果显示同时间点组间抑郁组与正常组得气量表均分差异有统计学意义(aP<0.05),同时间点,焦虑组与正常组得气量表均分差异有统计学意义(bP<0.05);治疗28d时抑郁组及焦虑组NIS-LL及NSS评分与正常组差异有统计学意义(P<0.05);治疗第28d,手法组与非手法组患者NIS-LL、NSS评分与组内治疗前比较明显降低(P<0.05),与非手法组比较,手法组患者治疗第8周时NIS-LL及NSS评分低于非手法组(P<0.05)。结论:针刺治疗是CAPN治疗中的有效手段,得气与否对针刺疗效有很大的影响,神经心理因素在CAPN针刺得气与疗效中发挥重要作用,关注针刺得气、神经心理因素及疗效三者的关系,对该病的诊治有重要参考意义。更多还原

【Abstract】 Objective:Study on relationship among neuropsychological factors,De Qi,and efficacy in acupuncture treatment for chronic alcoholic peripheral neuropathy patients,to provide the basis for the diagnosis and treatment of the disease.Methods:55 chronic alcoholic peripheral neuropathy(CAPN) patients were randomized into acupuncture Manipulation group and non-manipulation group.The degree of symptoms and clinical efficacy in patients were evaluated with Neuropathy Impairment Score in the Lower Limbs(NIS-LL) and Neurological Severity Score(NSS),the levels of De Qi for patients and acupuncturists were assessed by subjective acupuncture sensation scale(SASS),the psychological factors in patients were test with personality tests cartels(Catell-16PF),Hamilton depression scale(HAMD) and Hamilton Anxiety Scale(HAMA).Results:The 7th、 14th、21st、28th day of treatment,the scores of De Qi for patients in manipulation group、 the average scores of it and the average scores of De Qi for acupuncturists in manipulation group were significantly higher than non-manipulation group(P<0.05).The Catell-16 PF and SASS show that the scores of warmth、 independence、 intelligence、 irritability、sensitivity higher patients are more susceptible to De Qi.Thel4th、 28 th day of treatment,the HAMD and SASS show that the average scores of De Qi in depression group and normal group were statistically different(aP<0.05).The HAMA and SASS show that the average scores of De Qi in anxiety group and normal group were statistically different(bP<0.05).The28 th day of treatment,the scores of NIS-LL and NSS in depression group and anxiety group were significantly higher than normal group(P<0.05).The28 th day of treatment,the scores of NIS-LL,NSS in manipulation group and non-manipulation group were lowerthan(P < 0.05) that before treatment.The 8th week of treatment,the scores of NIS-LL,NSS in manipulation group was lower than non-manipulation group(P<0.05).Conclusion:Acupuncture therapy is effective means in treating CAPN,De Qi or not has a great influence on efficacy,neuropsychological factors play an important role in De Qi and efficacy in acupuncture treatment for CAPN,attention on relationship among neuropsychological factors,De Qi,and efficacy in acupuncture treatment for CAPN,has an important reference value for the diagnosis and treatment of the disease.更多还原