针 刺治疗急性缺血性脑卒中随机对照观察

目的观察针刺改善急性缺血性脑卒中患者的日常生活能力、降低患者的残障/死亡率的作用。方法将40例急性缺血性脑卒中患者随机分为针刺组和非针刺组各20例。针刺组采用针刺(每周5次,共3～4周)加常规治疗;非针刺组采用常规治疗。结果治疗期末神经功能缺损评分针刺组略优于对照组,但差异无显著性意义(P>0.05);3个月、6个月随访时针刺组残障/死亡率略低于对照组,但差异无显著性意义(P>0.05)。结论早期针刺治疗是安全和可行的。     

Effectiveness of Xinglouchengqi decoction on constipation in patients with acute ischemic stroke: a randomized controlled trial

OBJECTIVE: To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi(XLCQ) decoction for the treatment of constipation in acute ischemic stroke patients, and figure out the role that bowel movements play in the treatment of acute ischemic stroke.METHODS: A total of 317 eligible patients were recruited and randomized to the XLCQ group(211 patients) or the control group(106 patients). In addition to conventional standard medical care and rehabilitation, participants in the XLCQ group received XLCQ decoction, while the control group received clysis therapy using glycerin enemas or lactulose oral solution. Both groups were given treatment for 3 to 6 d, during which they received daily visits to record defecation features and accompanying symptoms. Neurological assessments using the National Institutes of Health Stroke Scale(NIHSS) were conducted before and 1 month after treatment.RESULTS: Patients in the XLCQ group had lower aggregate constipation scores compared with the control group on days 3 and 5(P 0.05). Spontaneous bowel movements tended to reappear more rapidly after taking the XLCQ decoction than after conventional laxative treatment. Both the average aggregate constipation score and the time taken to achieve spontaneous bowel movements showed positive correlations with NIHSS scores before and1 month after treatment(P 0.01).CONCLUSION: Treatment with XLCQ decoction effectively alleviated the overall symptoms of constipation in acute ischemic stroke patients. The status of bowel movements in acute ischemic stroke can reflect the severity of neurological impairment and predict neurological outcomes at 1 month.     

Clinical study on early acupuncture for acute ischemic stroke

目的：观察针刺早期介入治疗急性缺血性中风的临床安全性和有效性。方法：采用临床随机对照试验研究，将90例急性期患者随机分为药物组和针刺组，每组各45例。于治疗前后进行神经功能缺损评分、Bathel指数评分及血液生化指标的测定，对两组进行组间和自身前后对照。结果：急性期针刺治疗前后神经功能评分和ADL评分有显著差异（P〈0．01），两组间相比有显著差异（P〈0．01），血脂与血流变指标无统计学差异。结论：针刺早期介入治疗中风安全性高，可改善患者的致残程度，提高患者的生存质量。     

Effect of Tiaoshen Kaiqiao acupuncture in the treatment of ischemic post-stroke depression:a randomized controlled trial

OBJECTIVE:To observe the effect of Tiaoshen Kaiqiao acupuncture in the treatment of ischemic post-stroke depression.METHODS:This research was a single-blind, positive-controlled trial done in a single entity.Totally58 patients with ischemic post-stroke depression were randomly divided into two groups.The acupuncture group was given Tiaoshen Kaiqiao acupuncture therapy and placebo starch tablets treatment,while the control group was treated with fluoxetine tablets and body acupuncture treatment.Evaluated the clinical efficacy of the two groups with Hamilton Depression Scale(HAMD),Anti Depression Drug Side Effects Rating Scale(SERS), Clinical Global Impression Scale(CGI) respectively before treatment, the fourth weekend of treatment, the eighth weekend of treatment,the twelfth weekend of treatment.The adverse reactions in two groups were observed and documented.RESULTS:The HAMD scale scores of the two groups in different treatment period were significantly decreased compared with that before treatment(P 0.05); the score reduction of HAMD scale between the two groups had no significant differences(P 0.05).There was significant difference between the SERS scores of two groups(P 0.05); the control group had more adverse reactions, and the score would be increased with the extension of treatment time.Effect index(EI) of CGI in the acupuncture group is better than that of control group(P 0.05).CONCLUSION:The effects of Tiaoshen Kaiqiao acupuncture and fluoxetine in the treatment of ischemic post-stroke depression were similar, but the former had no obvious adverse reaction and side effects.     

互动式头针治疗脑卒中后认知功能障碍:随机对照研究

目的:比较互动式头针与单纯头针、头针+认知训练治疗脑卒中后认知功能障碍的疗效.方法:将660例脑卒中后认知功能障碍患者随机分为互动式头针组(218例,脱落18例)、单纯头针组(220例,脱落20例)和头针+认知训练组(222例,脱落22例).3组患者均予常规药物及运动康复训练,互动式头针组在认知训练的同时于顶中线,患肢...     

头电针对抑郁症脑功能成像的影响

目的　运用正电子发射型计算机断层显像技术 ,观察头电针对抑郁症患者脑部葡萄糖代谢的影响。方法　 2 0例抑郁症患者均接受头电针治疗 ,取穴为顶中线、额中线和双侧额旁 1线。电针前和治疗 6星期后分别接受 PET检测。框取感兴趣脑区 (ROI) ,将各脑区所得葡萄糖代谢放射性计数采用半定量方式进行治疗前后配对 t检验。结果　头电针能不同程度地升高双侧额叶、尾核、左侧扣带回和右侧小脑的葡萄糖代谢。结论　头电针抑郁症患者能提高部分脑区的葡萄糖代谢。     

针刺治疗急性缺血性卒中的系统评价

目的:评价针灸治疗急性缺血性脑卒中的疗效。方法:检索2007年10月以前的MEDLINE、BIOSIS、CNKI、EMBASE、VIP、CBM、《天坛脑血管病会议2006》论文集、《天坛脑血管病会议2007》论文集、《世界针灸学会联合会成立20周年暨世界针灸学术大会论文摘要汇编》及所获资料的参考文献。按照Cochrane标准,对纳入研究进行分析,用RevMan4.2软件进行统计分析。结果:5篇符合纳入标准的研究。3个研究随访了6个月时的病死率或残疾率(BI≤60),结果显示,差异无统计学意义(P>0.05)。3个研究采用了SSS(scandinavian stroke scale)量表,将治疗组与对照组治疗前后差值进行比较,显示针刺或电针可以改善患者的神经功能,差异有统计学意义(P<0.05)[WMD3.49,95%CI(2.00,4.99)]。结论:尚无法证实针刺可以降低急性缺血性卒中患者的残疾率和病死率;虽然针刺可以改善急性缺血性卒中患者的神经功能,但由于纳入研究存在一定程度的偏倚、质量较低,故目前还不能肯定针刺的疗效。今后应开展高质量、大样本、多中心的随机双盲对照试验以获得更可靠的证据。     

调督解郁法针刺治疗肿瘤相关性抑郁:随机对照研究

目的:观察调督解郁法针刺联合盐酸舍曲林片与单纯盐酸舍曲林片对肿瘤相关性抑郁患者的影响,探讨其作用机制。方法:将120例肿瘤相关性抑郁患者随机分为观察组和对照组,各60例。在肿瘤内科常规治疗基础上,对照组予盐酸舍曲林片口服,每次50 mg,每日1次;观察组在对照组治疗基础上加用调督解郁法针刺治疗,穴取中脘、百会、神庭、心俞、肝俞、脾俞、神门、太冲、太溪,治疗20~40 min,每日1次,每周5次,均治疗6周。观察治疗前,治疗2、4、6周后两组患者抑郁自评量表(SDS)和汉密尔顿抑郁量表(HAMD)评分及治疗前后外周血血清白细胞介素(IL)-2、IL-4、IL-10、γ干扰素(IFN-γ)、转化生长因子β(TGF-β)水平。结果:治疗2、4、6周后,两组患者SDS、HAMD评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,两组患者外周血血清IL-4、IL-10、TGF-β水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);外周血血清IL-2、IFN-γ水平均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。结论:调督解郁法针刺联合盐酸舍曲林片可有效缓解肿瘤相关性抑郁患者的抑郁状态,疗效优于单纯盐酸舍曲林片,其作用机制可能与调节机体免疫相关细胞因子表达有关。     

Effect of hand-ear acupuncture on chronic low-back pain: a randomized controlled trial

OBJECTIVE: To evaluate the effect of hand-ear acupuncture on chronic low-back pain(cLBP).METHODS: This was an open, randomized and controlled trial in The General Hospital of Western Theater Command, Sichuan Province. The trial was registered with ClinicalTrials.gov, NCT02260284. All the 152 participates with cLBP were randomly assigned to hand-ear acupuncture(n = 54), standard acupuncture(n = 50), or usual care groups(n = 48).Eighteen treatments were provided over 7 weeks.Back-related dysfunction and symptom severity were assessed by the Roland-Morris Disability Questionnaire(RMDQ) and the Visual Analogue Scale(VAS), which were collected at baseline, 2 months and 6 months post to the treatment.RESULTS: At 6 months, the RMDQ scores improved by 7.74 points of hand-ear acupuncture group. Significant improvement of VAS and RMDQ was observed in hand-ear acupuncture group(P 0.001),but no significant changes of RMDQ were observed in both standard acupuncture group and usual care group. We also observed an overall efficacy rate of 88.89% in hand-ear acupuncture group, as evaluated by Diagnosis and Curative Effect Standard for Symptom pattern of Traditional Chinese Medicine, which was much higher than 45.84% in the usual care group(H = 16.000, P 0.001).CONCLUSION: Both of the hand-ear acupuncture and standard acupuncture modes have beneficial and persistent effectiveness against cLBP compared with the usual care. Furthermore, hand-ear acupuncture is significantly more effective than the standardized acupuncture, especially in the long term.     

针刺在急性缺血性脑卒中溶栓治疗中的作用

急性缺血性脑卒中的处理应强调早期诊断、早期治疗、早期康复和早期预防再发,静脉用重组组织型纤维蛋白溶酶原激活剂是唯一美国食品和药物管理局认证的药理学治疗。静脉用重组组织型纤维蛋白溶酶原激活剂在脑卒中后只有最多4.5 h治疗时间窗,限制溶栓药物的使用。针刺疗法长期在临床上被用于治疗急性缺血性脑卒中。针刺急性期/超早期干预缺血性脑卒中的研究显示,针刺治疗可以改善脑局部循环障碍与神经功能缺损,减轻炎性损伤。文章综述针刺在缺血性脑卒中超早期介入治疗及在溶栓过程中的临床与机制研究现状,以期为中医药特别是针刺在缺血性脑卒中急性期的应用提供研究策略。     

阴阳对刺法治疗急性缺血性中风的临床研究

目的观察阴阳对刺法治疗急性缺血性中风的临床疗效。方法将65例急性缺血性中风患者随机分为2组。治疗组34例予患侧肢体阴阳对刺法治疗。对照组31例予患侧肢体阳明经刺法治疗。2组均6d为1个疗程,疗程间休息1d,连续治疗4个疗程后评定疗效。观察血脂指标、血液流变学指标、日常生活活动能力(ADL)评分的变化及临床疗效。结果治疗组血脂指标、血液流变学指标及ADL评分的改善情况均优于对照组(P0.05);治疗组总显效率为94.11%,对照组总显效率为77.42%,2组比较差异有统计学意义(P0.05)。结论阴阳对刺法可显著提高急性缺血性中风的临床疗效。     

针刺与电刺激治疗脑卒中后吞咽障碍随机对照研究

目的:比较针刺配合康复训练与电刺激配合康复训练治疗脑卒中后吞咽障碍的疗效。方法:选取97例脑卒中后发生吞咽障碍的患者,随机分为针刺组(32例)、电刺激组(35例)和康复组(30例)。康复组给予常规治疗(神经内科常规治疗方法及康复训练),针刺组给予常规治疗配合针刺治疗,穴取风池、扶突、额三针等;电刺激组给予常规治疗配合电刺激治疗。采用洼田饮水试验、咯痰功能计分及吞咽功能透视检查进行吞咽功能疗效评估。结果:治疗后针刺组总有效率为96.9%(31/32),电刺激组为94.3%(33/35),均优于康复组的66.7%(20/30)(P0.01)。治疗后各组吞咽功能较治疗前均有显著改善(均P0.05),治疗后针刺组与电刺激组均优于康复组(均P0.05)。结论:针刺和电刺激配合康复训练比单纯的康复训练疗效更好,针刺与电刺激治疗吞咽障碍的疗效相当。     

腕踝针对急性腰痛的即时镇痛作用:随机对照研究

目的:评价腕踝针对急性腰痛的即时镇痛作用及其与患者预期的关系。方法:采用随机单盲假针刺对照试验,60例急性腰痛患者随机分成两组,每组30例。观察组采用腕踝针治疗,针刺双侧下5、下6针刺点,不要求得气;对照组用不刺入的假针刺法。两组均治疗1次,留针30min。治疗前3min和治疗过程中第5、10、15、30分钟(拔针后),用简式McGill疼痛问卷(Short-formMcGill Pain Questionnaire,SF-MPQ)记录受试者腰部活动时的疼痛等情况;用重复改良Schober试验(Modified-Modified Schober,MMS)观察腰椎前屈情况;用预期和治疗信任度问卷(Expecta-tion and Treat ment Credibility Scale,ETCS)分析患者治疗前的预期与疗效的关系;记录不良反应。结果:两组治疗前SF-MPQ、MMS和ETCS各项差异均无统计学意义(均P0.05)。进针后第5分钟,观察组SF-MPQ各项评分均低于对照组(P0.05,P0.01);第10分钟,观察组SF-MPQ各项评分均低于对照组,且观察组MMS高于对照组(P0.05);第15分钟,观察组SF-MPQ除感觉项外其他各项评分低于对照组(P0.05,P0.01);第30分钟,观察组SF-MPQ中的情感项和疼痛视觉模拟评分低于对照组(P0.05,P0.01)。观察组在进针前对治疗的预期与进针后第5、10、15、30分钟的疼痛视觉模拟评分呈负相关(P0.05),而对照组则无相关性(P0.05)。两组均未出现不良反应。结论:腕踝针能显著减轻急性腰痛患者的疼痛,起效迅速;患者对腕踝针镇痛疗效预期越高,镇痛作用越好;该疗法具有很高的安全性。     

Efficacy and safety of Xinglouchengqi decoction for acute ischemic stroke with constipation: study protocol for a randomized controlled trial

OBJECTIVE: To investigate the efficacy and safety of Xinglouchengqi(XLCQ) decoction in treatment of acute ischemic stroke with constipation.METHODS: In this prospective, multicenter, assessor-blinded, randomized controlled trial, 360 eligible participants will be randomized to the XLCQ group or the control group. Participants in the XLCQ group will receive XLCQ decoction, while those in the control group will undergo clysis therapy using glycerin enemas or oral administration of lactulose solution. Both groups will undergo a treatment period of(5 ± 2) d and a 1-month follow-up.The primary outcome measure will be the Constipation Scale score. The secondary outcome measures will include scores on the National Institutes of Health Stroke Scale, the Traditional Chinese Medicine(TCM) Stroke Scale, the Diagnostic Scale for TCM Syndromes of Ischemic Stroke and TCM Scale for Syndrome of Phlegm-heat and Fu-organ Excess.Therapeutic mechanism outcomes and safety outcomes will also be assessed. Assessments will be conducted at baseline, at the end of the treatment period, and at the follow-up. Moreover, daily visits will be scheduled to grade the status of constipation during the treatment period.DISCUSSION: The results of this study will provide scientific and objective data with which to assess the efficacy and safety of XLCQ decoction for patients with acute ischemic stroke and constipation.     

Clinical study on acupuncture and ischemic stroke

目的：观察针刺治疗缺血性中风的临床疗效及其对血浆内皮素1的影响。方法：将63例患者按随机数字表分为2组,治疗组31例,对照组32例。治疗组用针刺加内科一般治疗,对照组用内科一般治疗。7天为1个疗程,疗程间休息2天,治疗4星期后评定两组患者临床疗效,并比较治疗前后血浆内皮素1的变化。结果：治疗组总有效率96．8％,对照组为75％,两组比较差异有统计学意义（P〈0．05）;治疗后两组血浆内皮素1差异有统计学意义（P〈0．05）;本组治疗前、后血浆内皮素1比较,治疗组差异有统计学意义（P〈0．01）,对照组无差异。结论：针刺治疗缺血性中风患者有较好临床疗效,并能降低缺血性中风患者血浆内皮素l水平。     

银杏达莫注射液与前列地尔注射液治疗急性脑梗塞的疗效比较

目的 比较银杏达莫注射液和前列地尔注射液治疗急性脑梗塞的疗效.方法 将我院收治的120例患者随机分为银杏达莫组和前列地尔组,分别按疗程给予两种药治疗.观察神经功能缺损评分改变和血液流变学变化.结果 两组在治疗前后神经功能缺损评分均有统计学意义上(P＜0.05),两组总有效率无统计学差异(P＜0.01).银杏达莫组和前列地尔组的全血黏度高切变、全血低切变、血沉在治疗后均降低,有统计学意义(P均＜0.05).银杏达莫组的血沉下降幅度更大(P＜0.05).结论 银杏达莫和前列地尔均可有效治疗急性脑梗塞,按疗程使用疗效相当.     

针刺治疗急性缺血性脑卒中的国内外研究对比

目的:研究国内外对针刺治疗缺血性脑卒中研究的差异及下一步研究的必要性和应注意的问题.方法:总结近20年来相关文献的内容,比较国内外研究在结论和临床试验方法学的差异,并指出了国内研究的不足.结论:为了证实针刺治疗脑卒中的有效性,有必要采用国际公认的具有高质量论证强度的研究方法,并且疗效指标应选择长期终点指标.     

缺血性脑卒中急性期针灸干预对肩痛发生率的影响(英文)

目的:探讨针灸干预是否能改善缺血性脑卒中患者并发症肩痛的发生,初步探索长时间针灸随访研究的可行性。方法:300例符合研究标准并自愿参与研究的患者被随机分配到针灸组和常规治疗组。针灸组150例,接受电针结合灸熨治疗和常规治疗,共4周;常规治疗组150例,接受常规治疗。观察随访期末1、2、3、6、12个月时的肩痛发生人数,治疗4周进行简化Fugl-Meyer上肢功能活动评定,随访期末6个月用改良Rankin修订量表评估相对独立患者人数及患者对针灸治疗认同程度。结果:治疗4周结束时,尽管肩痛发生人数及简化Fugl-Meyer上肢功能活动评定两组差异不具统计学意义(P0.05),但针灸组随访期末2、3、6及12个月肩痛发生人数与常规治疗组比较,差异有统计学意义(P0.05),同时在随访期末6个月时采用改良Rankin修订量表评估相对独立患者人数,针灸组多于常规治疗组(P0.05),针灸组出院后坚持针灸康复治疗人数较常规治疗组多(P0.05)。结论:缺血性脑卒中急性期的针灸干预不仅能有效降低患者肩痛并发症的发生,并且对改善患者独立生活能力具有帮助作用,同时系统的针灸复诊治疗在对针灸学科专病专技建设方面可能具有一定意义。     

化痰祛瘀汤配合针刺治疗缺血性中风急性期的研究

目的观察不同治疗方案治疗缺血性中风急性期的疗效。方法将150例缺血性中风急性期患者随机分为联合治疗组、针刺组、常规治疗组,采用单一或联合治疗方案进行治疗,观察不同方案对临床症状评分的影响。结果各治疗方案对缺血性中风患者生存质量及临床症状评分均有一定效果(P均<0.01),联合治疗组效果最佳(P<0.01或0.05)。结论针刺联合化痰祛瘀汤治疗缺血性中风是一种行之有效的方法。     

Effect of acupuncture plus conventional treatment on brain activity in ischemic stroke patients: a regional homogeneity analysis

OBJECTIVE: To determine differences in cerebral activity evoked by acupuncture and conventional stroke treatment, and identify the treatment targets.METHODS: In total, 21 patients were randomly divided into two groups. Group A(11 patients) received both acupuncture and conventional treatment, while group B(10 patients) received conventional treatment only. Resting-state functional magnetic resonance imaging(f MRI) was performed on each participant before and after treatment. Regional homogeneity analysis was performed to investigate the potential mechanism of acupuncture treatment by comparing differences in cerebral activity between treatments.RESULTS: Group A showed higher Re Ho in the frontal lobe(BA6, BA46), supra-marginal gyrus(BA40),middle temporal gyrus(BA21), cerebellum, and insula. Group B showed higher Re Ho in the frontal lobe(BA6) and parietal lobe(BA3, BA7).CONCLUSION: Acupuncture and conventional treatment triggered relatively different clinical efficacy and brain responses. Acupuncture treatment more significantly improved the symptoms of stroke patients. More marked changes in sensory,emotional, and motor areas(including the frontal lobe, middle temporal gyrus, cerebellum, and insula) might reflect the specific acupuncture mechanism.