针刺对脑挫裂伤缺血半暗区血流变化的半定量研究

目的观察针灸即时和治疗后对脑挫裂伤局部血流变化影响结果,以确定缺血半暗区(IP)的存在和针灸疗效。方法将60例脑挫裂伤患者随机分成2组,针灸组30例,在常规治疗基础上加用针刺疗法;对照组30例采用常规治疗。通过ECT脑显像分别进行针灸组针刺前后及治疗14d后、对照组治疗前后及治疗14d后的局部脑血流量(rCBF)对比观察。结果脑挫裂伤损伤部位存在血流量减低的IP,针灸组首次针灸前后rCBF比较有极显著差异(P<0.001),治疗14d后其变化差异亦极显著(P<0.001)。对照组治疗前后rCBF比较差异极显著(P<0.001),两组治疗后rCBF比较差异亦极显著(P<0.005)。结论脑显像可直观的反映脑挫裂伤病人损伤区局部脑血流变化,提示脑挫伤区存在着IP,针刺治疗能明显改善局部脑血流量,为针刺治疗脑挫裂伤提供了依据。

Semi-quantitative research on the effect of acupuncture on rCBF in ischemic penumbra of patients with cerebral contusion and laceration

Objective To observe the therapeutic effect of acupuncture on regional cerebral blood flow (rCBF) of patients with cerebral contusion and laceration immediately and after 14 days, in order to confirm the existence of the ischemic penumbra and effect of acupuncture treatment. Methods 60 cases with cerebral contusion and laceration were randomly divided into treatment and control groups. In the treatment group (n=30), acupuncture was performed besides conventional treatment after injury or operation, and the control group (n=30) were conventionally treated solely. Observation on curative effect on rCBF was conducted by using single-photon emission computed tomography after needling immediately and at day 14 in the two groups. Results Local ischemia penumbra area was detected in patients with cerebral contusion and laceration and rCBF dropped immediately after head injury, and greatly improved within the first acupuncture treatment (P<0.001), especially with statistical significance at day 14 (P<0.001). After a 14-days treatment, an increased rCBF was observed even in the control group (P<0.001), and the values of rCBF were more significantly increased in ischemic penumbra at treatment group than those in the control group (P<0.005). Conclusion 99mTc-ECD SPECT and acupuncture therapy can easily demonstrate a variation of rCBF and discover the existence of the ischemic penumbra in patients with cerebral contusion and laceration, which, therefore, offers a basis for the resumption of blood flow in ischemic penumbra area by acupuncture therapy.