[1]林生君,仇 珺,赵 明.通窍醒神方、头针联合经皮穴位电刺激治疗脑卒中临床研究[J].陕西中医,2021,(2):247-251.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.028]
　LIN Shengjun,QIU Jun,ZHAO Ming.Stroke treated by Tongqiao Xingshen prescription and scalp acupuncture combined with percutaneous electrical acupuncture[J].,2021,(2):247-251.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.028]
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通窍醒神方、头针联合经皮穴位电刺激治疗脑卒中临床研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2021年2期
页码:
247-251
栏目:
针灸经络
出版日期:
2021-02-05

文章信息/Info

Title:
Stroke treated by Tongqiao Xingshen prescription and scalp acupuncture combined with percutaneous electrical acupuncture
作者:
林生君1; 仇 珺1; 赵 明2
(1.青海红十字医院中医针灸科,青海 西宁 810000; 2.荆州市第一人民医院神经内科,湖北 荆州 434000)
Author(s):
LIN Shengjun; QIU Jun; ZHAO Ming
(Acupuncture Department of Traditional Chinese Medicine in Qinghai Red Cross Hospital,Xining 810000,China)
关键词:
通窍醒神方;  头针;  经皮穴位电刺激;  脑卒中单侧空间忽略;  日常生活能力;  认知功能;  焦虑状态;  生活质量
Keywords:
Tongqiao Xingshen prescription;  Scalp needle;  Electric stimulation of percutaneous acupoint;  Unilateral spatial neglect of stroke;  Ability for daily life;  Cognitive function;  Anxious state;  The quality of life
分类号:
R 743.3
DOI:
DOI:10.3969/j.issn.1000-7369.2020.02.028
文献标志码:
A
摘要:
目的:观察用通窍醒神方、头针联合经皮穴位电刺激治疗脑卒中单侧空间忽略的临床效果。方法:选择脑卒中单侧空间忽略患者116例,将其随机分为对照例和观察组各58例。两组患者均给予常规康复训练,对照组患者在此基础上给予经皮穴位电刺激疗法,观察组在对照组基础上加用通窍醒神方、头针联合治疗,两组均连续治疗8周。评价患者的忽略程度、日常生活能力、认知功能、焦虑、生活质量变化,测定血液流变学指标、血清中相关因子含量变化。结果:治疗后,两组患者的数字消去试验、画钟试验、平分直线试验评分均有所降低(均P<0.05),组间比较,观察组显著低于对照组(均P<0.05); 与对照组相比,观察组患者治疗后的日常生活能力ADL、认知能力MMSE评分均显著升高(均P<0.05); 观察组患者治疗后8周、随访8周、随访12周的焦虑SAS评分均显著降低(均P<0.05),生活质量评分显著升高(t=8.002,8.155,5.697,P<0.05); 与对照组相比,观察组患者的全血高切黏度、全血低切黏度、血浆黏度均显著降低(均P<0.05); 观察组的治疗后血清中TNF-α、sICAM-1水平均显著降低,IL-2水平则显著升高(均P<0.05)。结论:通窍醒神方、头针联合经皮穴位电刺激更利于减轻脑卒中单侧空间忽略患者的病情,提高日常生活能力、认知功能,缓解焦虑,提高生活质量,远期效果确切,其起效可能与改变血液流变、调控TNF-α、sICAM-1、IL-2水平以调节免疫稳态、抑制炎症反应有关。
Abstract:
Objective:To observe the clinical effect of Tongqiao Xingshen prescription and scalp acupuncture combined with percutaneous electrical stimulation in the treatment of unilateral spatial neglect of stroke.Methods:A total of 116 stroke patients with unilateral spatial neglect were selected and randomly divided into the control group and observation group,58 patients in each group.Patients in the two groups were given conventional rehabilitation training,patients in the control group were given percutaneous electric acupoint stimulation therapy on the basis of this,patients in the observation group were added with Tongqiao Xingshen prescription and scalp acupuncture combined treatment on the basis of the control group,and the two groups were treated consecutively for 8 weeks.The changes of patients' neglect degree,daily life ability,cognitive function,anxiety and quality of life were evaluated,and the changes of hemorheology indexes and the content of related factors in serum were measured.Results:After treatment,the number elimination test,bell drawing test and bisexualline test scores of patients in both groups were reduced(all P<0.05),and the comparison between groups was significantly lower in the observation group than in the control group(P<0.05).Compared with the control group,the scores of daily life ability ADL and cognitive ability MMSE in the observation group were significantly increased after treatment(all P<0.05).In the observation group,the anxiety SAS scores at 8 weeks after treatment,8 weeks after follow-up,and 12 weeks after follow-up were significantly reduced(all P<0.05),and quality of life scores were significantly increased(all P<0.05).Compared with the control group,the patients in the observation group had significantly decreased whole blood high-cut viscosity,whole blood low-cut viscosity and plasma viscosity(all P<0.05).After treatment,serum levels of TNF-α and sICAM-1 in the observation group were significantly decreased,while those of IL-2 were significantly increased(all P<0.05).Conclusion:Tongqiao Xingshen prescription and scalp acupuncture combined with percutaneous electrical stimulation are more beneficial to reduce the condition of stroke patients with unilateral spatial neglect,improve their daily life ability and cognitive function,relieve anxiety,and improve their quality of life.The long-term effect is definite.Its effect may be related to changing hemorrheology,regulating L levels of TNF-α,sICAM-1,and IL-2 to regulate immune homesteadiness and inhibit inflammatory response.

参考文献/References:

[1] Bernadette CT,Andrea W,Ruud HK,et al.Patients' experiences of unilateral spatial neglect between stroke onset and discharge from inpatient rehabilitation:A thematic analysis of qualitative interviews[J].Disability and Rehabilitation,2020,42(11):1578-1587.
[2] Tsujimoto K,Mizuno K,Kobayashi Y,et al.Right as well as left unilateral spatial neglect influences rehabilitation outcomes and its recovery is important for determining discharge destination in subacute stroke patients[J].Eur J Phys Rehabil Med,2020,56(1):5-13.
[3] 王 萍,单春雷,王 健.单侧空间忽略的康复研究进展[J].中国康复理论与实践,2020,26(1):59-61.
[4] 马 琳,石树君.补气活血中药合经皮穴位电刺激治疗脑梗死后单侧空间忽略疗效及对血液流变学指标水平的影响[J].现代中西医结合杂志,2020,29(4):399-402.
[5] 戈 蕾,薛 茜,王振民,等.头针疗法联合重复经颅磁刺激对脑卒中后单侧空间忽略康复疗效研究[J].辽宁中医药大学学报,2020,22(10):217-220.
[6] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2019)[J].中华神经科杂志,2019,52(12):994-995.
[7] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-667.
[8] 国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56.
[9] Bickerton WL,Samson D,Williamson J,et al.Separating forms of neglect using the apples test:Validation and functional prediction in chronic and acute stroke[J].Neuropsychol,2011,25(5):567-580.
[10] 王玉龙.神经康复学评定方法[M].北京:人民卫生出版社,2015:402-403,411,519.
[11] 汪向东,姜长青,马 弘.心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志社,1999:235-237.
[12] Williams LS,Weinberger M,Harris LE,et al.Development of a stroke-specific quality of lifescale[J].Stroke,1999,30(7):1362-1369.
[13] Rebeca LE,Alberto GM,Jaume LC,et al.Visual search in unilateral spatial neglect:The effects of distractors on a dynamic visual search task[J].Appl Neuropsychol,2019,26(5):401-410.
[14] 朱玉辉,翟丽杰,张双福,等.灯盏细辛注射液联合尤瑞克林治疗气虚血瘀型早期急性缺血性脑卒中临床研究[J].陕西中医,2020,41(5):609-611.
[15] 庄玲玲,陈水凤,谢平英.经皮穴位电刺激改善脑卒中单侧空间忽略患者认知障碍的研究[J].护理实践与研究,2017,14(17):11-13.
[16] 王 娅,陈 英.活血醒脑汤对脑梗死患者血脂、血液流变学及神经功能的影响[J].四川中医,2019,37(5):155-157.
[17] 雷 敏,吴丽荣,刘 英.丁苯酞对脑卒中后抑郁患者血清同型半胱氨酸、神经细胞因子、单胺类递质和炎症因子的影响研究[J].陕西医学杂志,2019,48(7):853-855.
[18] 周文静,闫宇晨,张 萌,等.黄芪防治缺血性脑卒中的网络药理学研究[J].世界中西医结合杂志,2020,15(8):1473-1479.
[19] 马 竞,何文龙,高重阳,等.党参多糖介导Nrf2通路对缺氧缺血性脑损伤的抗氧化和神经保护作用[J].中国临床解剖学杂志,2019,37(4):403-408.
[20] 郭现军,李 哲,蔡西国.运动训练联合地黄多糖对脑缺血再灌注大鼠神经功能的影响[J].中华物理医学与康复杂志,2020,26(4):289-294.
[21] 胡 科,张保朝,贾东佩,等.毛冬青皂酮胶囊对急性脑梗死模型大鼠神经保护作用[J].中医学报,2020,35(9):1950-1956.
[22] 夏小雯,孙 亚,宋春红,等.芍药苷抗抑郁的相关研究进展[J].世界科学技术-中医药现代化,2019,21(5):912-917.

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备注/Memo

备注/Memo:
基金项目:湖北省卫生健康委员会科研项目(WJ2019Q017)
更新日期/Last Update: 2021-01-28