【作者】 郑娜； 丁晶； 李孟汉； 杜元灏； 许迎春； 吴江莹； 吴潇哲； 郭睿婧； 田珍； 何润东； 黄迪； 李培雯； 刘婉玉；

【机构】 天津市环湖医院中医科； 天津中医药大学第一附属医院；

【摘要】 目的:比较针刺联合动脉取栓术与动脉取栓术治疗急性脑梗死的疗效差异。方法:将80例急性脑梗死患者随机分为试验组40例和对照组40例。对照组给予动脉取栓术,试验组取栓术基础上针以百会、风池、内关、曲池、三阴交、足三里、太冲,每日一次,连续治疗14天,观察两组发病90天改良Rankin评分(m RS)、发病90天m RS评分0-2、0-3分分布比例、发病14天美国国立卫生研究院卒中量表(National Institute of Health stoke scale,NIHSS)评分、日常生活能力(Barthel index rating scale for daily living ability,BI)评定量表、Fugl-Meyer运动功能评分量表(Fugl-Meyer assessment scale,FMA)。结果:试验组90天m RS评分2.00(1.00,3.00)与比照组90天m RS评分3.00(1.25,4.00)低,有统计学差异,将90天m RS评分0-3分定义为较好预后,试验组90天m RS评分0-3分比例34(85.00%)高于基线期17(42.50%),两者差异有显著统计学意义;将90天m RS评分0-2分定义为良好预后,验组90天m RS评分0-2分比例25(62.50%)高于基线期7(17.50%),两者差异有显著统计学意义(P=0.000)(P<0.01)。对照组90天m RS评分0-2分比例8(20.00%)高于基线期16(40.00%),两者差异无统计学意义(P=0.051)(P>0.05)。可以看出试验组0-2分的例数比例高于对照组(试验组:25(62.50%),对照组:16(40.00%),二者有统计学差异(P<0.05)。发病第14天试验组NIHSS评分8.00(4.00,11.00)与对照组10.50(3.25,15.75)对比,P=0.226,差异无统计学意义(P>0.05);试验组14天NIHSS评分8.00(4.00,11.00)低于基线期11.50(8.00,14.00),P=0.002,差异有显著统计学意义(P<0.01);对照组14天NIHSS评分10.50(3.25,15.75)与基线期11.00(7.00,13.75))对比,P=0.446,差异无统计学意义(P>0.05)。发病第14天试验组NIHSS评分(8.00(4.00,11.00))与对照组10.50(3.25,15.75)对比,P=0.226,差异无统计学意义(P>0.05);试验组14天NIHSS评分(8.00(4.00,11.00))低于基线期11.50(8.00,14.00),P=0.002,差异有显著统计学意义(P<0.01);对照组14天NIHSS评分10.50(3.25,15.75)与基线期11.00(7.00,13.75)对比,P=0.446,差异无统计学意义(P>0.05)。发病14天试验组FMA评分48.50(24.00,83.75)与对照组52.00(21.25,77.25)比较,P=0.754,差异无统计学意义(P>0.05);试验组14天FMA评分48.50(24.00,83.75)较基线期48.50(31.00,73.50),P=0.000,差异有显著统计学意义(P<0.01);对照组14天FMA评分52.00(21.25,77.25)与基线期57.00(42.25,78.00)对比,P=0.269,差异无统计学意义(P>0.05)。结论:针刺联合动脉取栓能改善急性期脑梗死患者神经功能,疗效优于单纯动脉取栓术治疗。更多还原

【Abstract】 Objective:To compare the efficacy of acupuncture combined with arterial thrombectomy and arterial thrombectomy in the treatment of acute cerebral infarction.Methods:80 patients with acute cerebral infarction were randomly divided into experimental group(40 cases) and control group(40 cases).The control group was given arterial thrombectomy,and the experimental group was treated with Baihui,Fengchi,Neiguan,Quchi,Sanyinjiao,Zusanli and Taichong once a day for 14 days.The 90-day modified Rankin score(mRS),90-day m RS Score 0-2,0-3 distribution ratio,and 14-day National Institute of Health stoke scale were observed in the two groups.Barthel index rating scale for daily living ability,(Barthel index rating scale for daily living ability,NIHSS) BI rating scale and Fugl-Meyer Motor Function Rating Scale(FMA).Results:The m RS Score of test group was lower than that of control group on the 90th day of disease onset,and there was a statistical difference between the two groups(P<0.05).The proportion of m RS 0-2 in test group was higher than that in control group on the 90th day of onset,the difference was statistically significant(P<0.05);the NIHSS score of test group on the 14th day of onset was lower than that in baseline period,the difference was statistically significant(P<0.01);the NIHSS score of control group on the 14th day was lower than that in baseline period,the difference was not statistically significant(P>0.05);The 14-day NIHSS score of experimental group was lower than that of control group,but the difference was not statistically significant(P>0.05).There was no significant difference in BI index between the two groups on the 14th day of onset compared with the baseline period(P>0.05).There was no significant difference in BI index between the experimental group and the control group on the 14th day of disease onset(P>0.05).FMA scores of test groups on the 14th day of onset were higher than those of baseline period,with significant statistical difference(P<0.01),and FMA scores of test groups on the 14th day of onset were higher than those of control group,but the difference was not statistically significant(P>0.05).Conclusion:Acupuncture combined with arterial thrombectomy can improve the short-term and long-term prognosis of patients with acute cerebral infarction,and the efficacy is better than that of arterial thrombectomy alone.更多还原