头皮针联合不同针刺技术治疗急性脑梗死临床疗效对照研究

发布时间：2018-05-26 12:43

本文选题：针刺 + 脑梗死　；参考：《南京中医药大学》2016年硕士论文

【摘要】：目的：通过头皮针联合不同针刺技术在急性脑梗死(ACI)规范化诊疗方案中临床疗效的对比研究,验证头-体针、头-平衡针、头-腹针在脑梗死急性期的临床疗效。为不同针刺技术在该病规范化诊疗方案中应用提供可靠科学依据。方法：从徐州市中医院针灸脑病科住院患者中选取100例符合试验纳入标准的患者,按照患者的入院顺序用随机数字法分成四组,分别为对照组、头-体针组、头-平衡针组和头-腹针组。四组患者入院后均采用常规治疗。头-体针组、头-平衡针组、头-腹针组在此基础上分别加用头皮针联合体针,头皮针联合平衡针,头皮针联合腹针治疗。疗程均为3周。治疗前后均运用神经功能缺损评分(NIHSS)对患者进行综合性的评定,采用Barthel评分对患者的日常生活能力(ADL)进行评定,采用中医症候记分表对患者症候评定。最后采用SPSS 18.0统计软件进行数据分析。结果：1.运用NIHSS评分对四组患者治疗前后神经功能缺损进行比较,治疗前各组数据无明显差异(P0.05),治疗后各组NIHSS评分均较治疗前降低,有统计学差异(P0.05),治疗后各针刺组与对照组在NIHSS评分及疗效方面比较均有显著差异(P0.05),说明治疗后神经功能缺损程度均有所改善,但针刺组效果好于对照组,各针刺组间无明显差异(P0.05)。2.选用Barthel评分对四组患者治疗前后日常生活活动能力进行比较,治疗前各组间无明显差异(P0.05),治疗后各组与治疗前相比Barthel评分均有增加,且差异有统计学意义(P0.05),治疗后各针刺组与对照组Barthel评分比较有显著差异(P0.05),说明各组都能改善ADL,且针刺组优于对照组,各针刺组间差异不显著(P0.05)。3.采用中医症候记分对各组患者治疗前后临床症候进行比较,治疗前四组间差异不明显(P0.05),治疗后各组中医症候记分与治疗前比较均有下降,差异有统计学意义(P0.05),治疗后各针刺组与对照组比较中医症候记分及疗效均存在显著差异(P0.05),说明各组均可改善中医症候,各针刺组效果优于对照组,各针刺组间差异不明显(P0.05)。结论：头皮针联合体针、平衡针、腹针治疗急性脑梗死具有显著的疗效,能够提高患者生活质量和日常生活活动能力,改善中医症候。
[Abstract]:Objective: to compare the clinical efficacy of scalp acupuncture combined with different acupuncture techniques in the diagnosis and treatment of acute cerebral infarction (ACI), and to verify the clinical efficacy of head body acupuncture, head balanced acupuncture and head abdominal acupuncture in acute cerebral infarction. To provide a reliable scientific basis for the application of different acupuncture techniques in the standardized diagnosis and treatment of the disease. Methods: 100 inpatients with acupuncture and encephalopathy were selected from Xuzhou Hospital of traditional Chinese Medicine. According to the admission order of the patients, they were randomly divided into four groups: control group and head-body acupuncture group. Head-balanced acupuncture group and head-abdominal acupuncture group. All the patients in the four groups were treated with routine therapy after admission. Scalp acupuncture combined with scalp acupuncture, scalp acupuncture combined with balanced acupuncture and scalp acupuncture combined with abdominal acupuncture were added to the scalp-body acupuncture group, the head-balanced acupuncture group and the head-abdominal acupuncture group. The course of treatment was 3 weeks. Before and after treatment, the patients were assessed with the neurological impairment score (NIHSS), the patients' daily living ability (ADL) with the Barthel score, and the patients' symptoms with the TCM symptom score table. Finally, SPSS 18.0 statistical software was used to analyze the data. The result is 1: 1. NIHSS score was used to compare the neurological function defect of the four groups before and after treatment. There was no significant difference in the data of each group before and after treatment (P 0.05). The NIHSS score of each group was lower than that before treatment. There was significant difference in NIHSS score and curative effect between the acupuncture group and the control group after treatment, indicating that the degree of nerve function defect was improved after treatment, but the effect of acupuncture group was better than that of control group. There was no significant difference among the acupuncture groups (P 0.05. 2). The activity of daily living (ADL) of the four groups was compared before and after treatment with Barthel score. There was no significant difference between the four groups before and after treatment (P 0.05). After treatment, the Barthel scores in each group were increased compared with those before treatment. The difference was statistically significant (P 0.05). After treatment, there were significant differences in Barthel scores between the acupuncture group and the control group (P 0.05), which indicated that the acupuncture group was superior to the control group, and there was no significant difference between the acupuncture group and the control group. The clinical symptoms of each group were compared before and after treatment by using TCM symptom score. There was no significant difference between the four groups before and after treatment (P0.05). After treatment, the score of TCM symptom in each group was lower than that before treatment. The difference was statistically significant (P 0.05). After treatment, there were significant differences in the score of TCM symptom and the curative effect between the acupuncture group and the control group. It showed that each group could improve the symptoms of traditional Chinese medicine, the effect of each acupuncture group was better than that of the control group, and the difference between the acupuncture group and the control group was not significant (P 0.05). Conclusion: scalp acupuncture combined with acupuncture, balanced acupuncture and abdominal acupuncture are effective in treating acute cerebral infarction, which can improve the quality of life and activities of daily life of patients and improve the symptoms of traditional Chinese medicine.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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