针刺调节缺血性脑卒中患者颅内动脉血流动力学参数临床观察

目的 采用经颅彩色多普勒检查评价针刺对缺血性脑卒中患者脑血流动力学参数的影响.方法 将100例缺血性脑卒中患者随机分为联合组和对照组,每组50例.联合组采用针刺风池、风府配合常规针刺治疗,对照组采用常规针刺治疗.采用改良爱丁堡+斯堪的纳维亚评分观察两组临床疗效;针刺后即刻、针刺2个疗程后,分别测定两组颅内各动脉平均血流速度(mean flow velocity,Vm)和血管搏动指数(pulsatility index,PI).结果 ①联合组临床疗效优于对照组(P<0.05).②针刺后即刻,联合组各动脉Vm较针刺前均显著增加(P<0.01),且联合组大脑后动脉(posterior cerebral artery,PCA)、大脑前动脉(anterior cerebral artery,ACA)、椎动脉(vertebral artery,VA)、基底动脉(basilar artery,BA)Vm较对照组显著增加(P<0.05,或P<0.01);两组各动脉PI值与针刺前比较,及两组之间比较,差异均无统计学意义(P>0.05).③针刺2个疗程后,两组各动脉Vm均较针刺前显著增加(P<0.01);且联合组各动脉Vm均显著高于对照组(P<0.05);联合组PCA、VA、BA的PI值较针刺前显著降低(P<0.05,或P<0.01),且联合组PCA、VA的PI值显著低于对照组(P<0.05).结论 针刺风池、风府配合常规针刺对缺血性脑卒中有较好的治疗作用,且脑血流量增加,脑血液循环改善明显.

Clinical Observation of Regulating Effect of Acupuncture on Intracranial Artery Hemodynamic Parameters in Patients with Ischemic Stroke

Objective To investigate the regulating effect of acupuncture on intracranial artery hemodynamic parameters in patients with ischemic stroke through transcranial color Doppler. Methods One hundred patients with ischemic stroke were randomly divided into combination treatment group (n=50) and control group (n=50). The combination treatment group received acupuncture at points Fengchi (GB20) and Fengfu (DU16) plus conventional acupuncture, while the control group received conventional acupuncture alone. The clinical effects were evaluated using modified Edinburgh Scandinavia stroke scale.The mean flow velocity (Vm) and pulsatility index (PI) of cerebral arteries in each group were measured immediately after acupuncture and after two periods of treatment. Results The clinical effect was significantly better in the combination treatment group than that in the control group (P<0.05). Immediately after acupuncture, the Vm of each intracranial artery in the combination treatment group increased significantly compared with that before acupuncture (P<0.01); the Vms of posterior cerebral artery (PCA), anterior cerebral artery (ACA), vertebral artery (VA), and basilar artery (BA) in the combination treatment group increased significantly compared with those in the control group (P<0.05,or P<0.01);the PI of each intracranial artery in either group was not significantly different from that before acupuncture, and this index showed no significant difference between the two groups (P>0.05).After two periods of treatment, the Vm of each intracranial artery in both groups increased significantly compared with that before acupuncture (P<0.01); the Vms of all intracranial arteries in the combination treatment group were significantly higher than those in the control group (P<0.05); the PIs of PCA, VA, and BA in the combination treatment group decreased significantly compared with those before acupuncture (P<0.05,or P<0.01), and the PIs of PCA and VA were significantly lower in the combination treatment group than those in the control group (P<0.05). Conclusion Acupuncture at points Fengchi (GB20) and Fengfu (DU16) plus conventional acupuncture has a better clinical effect in patients with ischemic stroke and can improve cerebral blood flow and cerebral blood circulation.