盲针法电针治疗中风的前瞻性临床对照研究

目的 :应用盲针技术 ,用单盲法研究电针对中风后偏瘫的疗效 ,并探讨其可能的作用机制。方法 :6 4例急性期中风病人随机分为治疗组和对照组 ,治疗组以常规电针治疗 ,对照组予以盲针通电治疗。在治疗前、治疗第 10天和第 2 0天行NIHSS、Fugl-Meyer和Barthel指数评分。在治疗前和治疗第 2 0天行SPECT -rCBF脑显像检查 ,记录各脑区脑血流灌注 (rCBF)情况。结果 :治疗后治疗组较对照组运动功能及日常生活指数均有提高 (P <0 .0 5 ) ,且治疗组较对照组双侧额叶皮质运动区rCBF明显增加 (P <0 .0 5 )。结论 :盲针法能够有效用于针灸临床疗效的研究 ,针灸与现代康复理论相结合能有效改善急性期中风患者功能康复的疗效 ,SPECT -rCBF脑显像检查表明其作用机制可能系促进脑功能激活后的重组。

A prospective clinical case-controlled study of electro-acupuncture treatment in patients with acute stroke

Objective: To study the efficacy and mechanism of electro-acupuncture treatment in patients with acute stroke. Methods: A prospective single-blind randomly controlled study was used in patients with stroke. 64 cases was randomly divided into treatment group and control group. Electro-acupuncture therapy was used in treatment group and placebo needle technique was used in control group. Scores of NIHSS, FMA and MBI were recorded before treatment, 10 and 20 days after treatment. Brain SPECT-rCBF image was performed in 33 cases before treatment, and 20 days after treatment. The values of rCBF in each brain region were analyzed. Results: The scores of NIHSS, FMA and MBI in treatment group were significantly higher and values of rCBF in bilateral motor cortexes were significantly increased. Conclusion: Placebo needle technique could be efficiently applied in the study of electro-acupuncture treatment in patients with stroke.Combine electro-acupuncture with modern neuro-rehabilitation theory would effectively improve motor function in patients with stroke. The results of brain SPECT-rCBF image showed that the mechanism of electro-acupuncture treatment may related to neuronal plasticity and brain function reorganization.