病灶对侧头电针干预脑出血血肿吸收和肢体运动障碍改善的临床研究

发布时间：2018-05-30 12:40

本文选题：脑出血 + 病灶对侧头针　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：本研究旨在观察早期病灶对侧头电针疗法干预脑出血患者血肿吸收和肢体运动障碍改善的情况,探讨病灶对侧头电针疗法治疗脑出血的疗效,为病灶对侧头电针疗法早期临床应用提供依据。方法：将96例符合纳入标准的脑出血患者随机分为试验组(头电针病灶对侧组)、对照组A(头电针病灶侧组)和对照组B(基础治疗组),每组32例。对照组B采用以西医内科常规治疗、康复训练及电针患肢为主的基础治疗,对照组A为基础治疗加上头电针病灶侧疗法,试验组则加用头电针病灶对侧疗法。三组每日治疗1次,10天为一个疗程,每周治疗5天,共治疗2个疗程。采用测量CT出血量(血肿体积)、简化Fugl-meyer运动功能评定量表(FMA)、徒手肌力测量(MMT)为观察指标,分别于治疗前及第10、20次治疗后评价各组改善情况；以中医症状积分为指标分别于治疗前后比较疗效差异及中医症状改善疗效；记录三组治疗期间不良反应以评价其安全性。结果：1.临床疗效：组内比较,治疗前后三组疗法对脑出血患者的疗效评分差异显著(P0.01)；组间比较,试验组与对照组A总有效率相当,无统计学差异(P0.05),且均优于对照组B,均有差异(均P0.05)。2.中医症状方面：组内比较,治疗后三组疗法均可降低中医症状积分,有统计学差异(P0.05)；组间比较,试验组与对照组A降低评分程度相当,无统计学差异(P0.05),且均优于对照组B,均有差异(均P0.05)。3.血肿吸收方面：组内比较,各时间点两两比较三组血肿体积差异显著(P0.01),且首次与再次复查血肿吸收速度差异显著(P0.01)；经组间比较,试验组与对照组A减小血肿体积程度、促进血肿吸收速度相当,无统计学差异(P0.05),均优于对照组B,均有差异(P0.05),且随治疗次数增多血肿吸收速度增快。4.FMA评分方面：组内比较,各时间点两两比较三组患侧上、下肢FMA评分差异显著(P0.01)；经组间比较,治疗20次后试验组与对照组A提高患侧上下肢FMA评分相当,无统计学差异(P0.05),均优于对照组B,均有差异(P0.05)。5.徒手肌力评定方面：组内比较,各时间点两两比较三组患侧上、下肢体远近端肌力差异显著(P0.01)；经组间比较,试验组与对照组A提高患侧肢体远近端肌力相当,无统计学差异(P0.05),均优于对照组B,均有差异(P0.05)。6.相关性分析：出血部位一致时,血肿吸收速度、吸收量与肢体运动障碍改善呈正相关,均有差异(P0.05)。7.试验过程中共发生5例不良反应,其中试验组与对照组B各有2例,对照组A有1例,程度均较轻,余未发生不良反应。结论：三种疗法对于促进脑出血患者血肿吸收、肢体运动障碍改善均有疗效,其中头电针病灶对侧疗法与头电针病灶侧疗法的疗效相当,均优于基础治疗；且当出血部位一致时,血肿体积减小的越早越快,肢体运动障碍改善程度越大。
[Abstract]:Objective: to observe the effect of early contralateral electroacupuncture on hematoma absorption and limb motor disorder in patients with intracerebral hemorrhage, and to explore the effect of contralateral head electroacupuncture on intracerebral hemorrhage. To provide evidence for early clinical application of contralateral head electroacupuncture therapy. Methods: 96 patients with intracerebral hemorrhage (ICH) were randomly divided into three groups: experimental group (contralateral group), control group A (lateral group) and control group B (basic treatment group, 32 cases in each group). Control group B was treated with routine western medicine, rehabilitation training and electroacupuncture, while control group A was treated with scalp electroacupuncture lateral therapy, and experimental group was treated with contralateral electroacupuncture therapy. The three groups were treated once a day for 10 days and 5 days a week for 2 courses of treatment. The CT bleeding volume (hematoma volume), simplified Fugl-meyer motor function evaluation scale and free hand muscle strength measurement were used to evaluate the improvement of each group before and after 10 times of treatment. The difference of curative effect and the improvement of TCM symptom were compared before and after treatment, and the adverse reactions during treatment were recorded to evaluate the safety of the three groups. The result is 1: 1. Clinical efficacy: compared with the control group, there was a significant difference in the scores of the three groups before and after treatment (P 0.01), the total effective rate of the trial group and the control group A was the same as that of the control group A, there was no statistical difference (P 0.05), and all of them were better than that of the control group B (all P 0.05 n. 2). In terms of TCM symptoms, the scores of TCM symptoms in the three groups were significantly lower than those in the control group (P 0.05), and the scores of the experimental group and the control group were reduced by the same degree as those of the control group. There was no statistical difference (P 0.05), and all of them were superior to the control group (P 0.05. 3). Hematoma absorption: there were significant differences in hematoma volume between the three groups at each time point, and the difference of hematoma absorption velocity between the first and second reexamination was significant (P0.01A), and the hematoma volume was reduced by comparison between the test group and the control group A, after comparison between the two groups, there was a significant difference in hematoma volume between the three groups. Promote hematoma absorption speed is the same, there is no statistical difference (P 0.05), better than the control group (P 0.05), and with the increase of treatment times hematoma absorption speed increase. 4. FMA score: intragroup comparison, two points of each time to compare the affected side of the three groups, The difference of FMA score of lower extremity was significant (P 0.01). After 20 times of treatment, the FMA score of the upper and lower extremities in the test group and the control group was similar to that in the control group A, but there was no statistical difference (P 0.05), which was better than that in the control group (P 0.05. 5). In the evaluation of unarmed muscle strength, there were significant differences in the muscle strength of the upper and lower extremities between the three groups at different time points (P 0.01), and by comparison between the two groups, the muscle strength of the patients in the test group and the control group A was similar to that in the control group, and there was no significant difference between the three groups in the muscle strength of the distal and proximal extremities of the affected side. There was no statistical difference (P 0.05), which was better than that of control group B (P 0.05). Correlation analysis: the absorption velocity and absorption amount of hematoma were positively correlated with the improvement of limb motor disorder when the bleeding location was the same (P0.05. 7). There were 5 cases of adverse reactions in the course of the experiment, including 2 cases in the test group and 2 cases in the control group B, and 1 case in the control group A, the degree of which was mild, and there was no adverse reaction in the rest. Conclusion: the three kinds of therapy are effective in promoting hematoma absorption and improving limb motor disorder in patients with intracerebral hemorrhage. The contralateral therapy of scalp electroacupuncture is equivalent to the lateral therapy of scalp electroacupuncture, which is superior to the basic treatment. When the bleeding position is the same, the volume of hematoma decreases sooner and faster, and the improvement of limb motor disorder is greater.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

【相似文献】