针刺治疗急性脑梗死的临床疗效观察及磁共振波谱分析
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摘要
目的:观察针刺治疗急性脑梗死的临床疗效,并进行磁共振波谱分析。方法:将116例确诊为急性脑梗死患者随机分成对照组和针刺组,每组58例。对照组患者给予常规西医治疗;针刺组在上述治疗基础上,加用中医针刺疗法,每日1次,7次为1疗程。完成4个疗程后,比较两组患者NIHSS、FMA及ADL评分改善情况,并首次采用磁共振波谱分析脑组织损伤改善情况,最后评价临床疗效。结果:治疗后,两组患者NIHSS、FMA及ADL评分均有一定程度改善,且针刺组患者改善程度均明显优于对照组(P<0.05)。磁共振波谱分析显示针刺治疗显著降低了患者神经元细胞受损程度,显著缓解了酸中毒状态。针刺组总有效率达91.38%,高于对照组总有效率(70.69%),差异具有统计学意义(P<0.05)。结论:首次借助磁共振波谱分析手段,证实了针刺疗法在急性脑梗死治疗中的优势,奠定了更多的数据支持。
Objective:To observe the therapy effect of acute cerebral infarction(ACI) with acupuncture treatment and analyze the improvement using magnetic resonance spectroscopy(MRS).Methods:116 eligible ACI patients were randomized into controlled group and acupuncture group with 58 cases in each group.The patients in the controlled group were given with conventional therapy,while the patients in the acupuncture group were received with conventional therapy as well as acupuncture for treatment.Acupuncture treatment was performed once to each patient per day and seven times served as one course.After four courses finished,the improvements of NIHSS,FMA and ADL scores were compared before and after the treatment,and then MRS was used to analyze the improvement of cerebral injury with acupuncture treatment for the first time.Finally,therapeutic efficiencies were evaluated.Results:After the treatment,the NIHSS,FMA and ADL scores were improved in both groups.Especially,the acupuncture group showed better improvements of NIHSS,FMA and ADL scores compared to the controlled group(P<0.05).MRS analysis displayed that acupuncture treatment significantly reduced the degree of neuronal cell injury and relieve the acidosis in patients.Therapeutic efficiency of the acupuncture group was 91.38% which was obviously higher than the controlled group(70.69%) by statistics analysis(P<0.05).Conclusion:MRS analysis for the first time was used to confirm the advantages of acupuncture in the treatment for ACI,which laid the data base on clinical application of acupuncture.
Objective:To observe the therapy effect of acute cerebral infarction(ACI) with acupuncture treatment and analyze the improvement using magnetic resonance spectroscopy(MRS).Methods:116 eligible ACI patients were randomized into controlled group and acupuncture group with 58 cases in each group.The patients in the controlled group were given with conventional therapy,while the patients in the acupuncture group were received with conventional therapy as well as acupuncture for treatment.Acupuncture treatment was performed once to each patient per day and seven times served as one course.After four courses finished,the improvements of NIHSS,FMA and ADL scores were compared before and after the treatment,and then MRS was used to analyze the improvement of cerebral injury with acupuncture treatment for the first time.Finally,therapeutic efficiencies were evaluated.Results:After the treatment,the NIHSS,FMA and ADL scores were improved in both groups.Especially,the acupuncture group showed better improvements of NIHSS,FMA and ADL scores compared to the controlled group(P<0.05).MRS analysis displayed that acupuncture treatment significantly reduced the degree of neuronal cell injury and relieve the acidosis in patients.Therapeutic efficiency of the acupuncture group was 91.38% which was obviously higher than the controlled group(70.69%) by statistics analysis(P<0.05).Conclusion:MRS analysis for the first time was used to confirm the advantages of acupuncture in the treatment for ACI,which laid the data base on clinical application of acupuncture.
引文
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[9]张云平,李仰康,刘晨阳,等.高场磁共振频谱在急性缺血缺氧损伤早期小鼠脑代谢物乳酸测定中的应用及其意义[J].吉林大学学报:医学版,2016,42(4):690~693
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[2]吴明华,胡华白,张秀胜,等.自拟痰瘀阻络方治疗急性脑梗死痰瘀阻络证的临床疗效观察和磁共振波谱分析[J].四川中医,2012,9):60~63
[3]任彦景,艾炳蔚.针灸治疗急性脑梗死临床研究[J].吉林中医药,2011,31(1):49~50
[4]中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,1):55~56
[5]王新德.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,6):379~380
[6]陈洪琳,关放.醒脑开窍、疏通经络针刺法对脑梗死急性期患者血液循环、运动功能及日常生活能力的影响研究[J].陕西中医,2016,37(4):488~489
[7]脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,6)
[8]昌丽艳,许宏伟.针刺治疗急性脑梗死35例疗效观察[J].湖南中医杂志,2015,31(7):93~95
[9]张云平,李仰康,刘晨阳,等.高场磁共振频谱在急性缺血缺氧损伤早期小鼠脑代谢物乳酸测定中的应用及其意义[J].吉林大学学报:医学版,2016,42(4):690~693
[10]胡华白.通脑饮治疗急性脑梗死痰瘀阻络证的临床疗效观察和磁共振波谱分析[D].南京中医药大学,2012