“通督调神”灸法干预脊髓损伤肠道功能障碍：随机对照研究

目的:比较"通督调神"灸法联合康复训练与单纯康复训练治疗脊髓损伤(SCI)肠道功能障碍的临床疗效。方法:将60例SCI肠道功能障碍患者随机分为综合治疗组与康复组,每组30例(每组各脱落3例)。在常规西医治疗及康复训练基础上,康复组予以排便训练及直肠功能训练,每天1次;综合治疗组在康复组的治疗基础上予以"通督调神"灸法,穴取腰阳关、命门、至阳、大椎、百会等,每天1次,每次30 min。两组均4周为一疗程,共治疗3个疗程。分别于治疗前与治疗4、8、12周后行神经源性肠功能障碍(NBD)评分、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分,并于治疗12周后评定临床疗效。结果:治疗后,综合治疗组总有效率为88.9%(24/27),高于康复组的74.1%(20/27,P<0.05)。治疗4、8、12周后,两组患者NBD评分均较治疗前明显降低(均P<0.01);治疗8、12周后,综合治疗组NBD评分均低于康复组(均P<0.05)。治疗4、8、12周后,两组患者WHOQOL-BREF心理、生理、社会环境、环境各领域评分均高于治疗前(均P<0.01);治疗4周后...     

基于ASL和PWI技术探讨通督调神针刺对缺血性脑卒中高危患者脑血流的影响

目的:通过动脉自旋标记(ASL)和磁共振灌注成像(PWI)技术观察通督调神针刺与西药对缺血性脑卒中(CIS)高危患者脑血流的影响并评价其临床疗效。方法:将180例短暂性脑缺血发作(TIA)/缺血性小卒中(MIS)患者随机分成针刺1组、针刺2组和药物组,每组60例。针刺1组予以"通督调神针刺法",穴取百会、风府、哑门、大椎、身柱、至阳、命门、腰阳关、颈夹脊,每天针刺1次;针刺2组取穴同针刺1组,隔天针刺1次;药物组予口服尼莫地平片,每次30 mg,早中晚各1片。3组均治疗4周。分别于治疗前后对患者行ASL、PWI(相对脑血容量(rCBV)、相对脑血流量(rCBF)、相对平均通过时间(rMTT)、相对达峰时间(rTTP))检测,比较治疗前后各项检测指标的变化,并评定疗效。结果:治疗后,3组患者ASL正常灌注例数较治疗前明显增多(均P0.01),针刺1组正常灌注例数多于针刺2组(P0.05),与药物组比较差异无统计学意义(P0.05)。治疗后,3组患者rCBV、rCBF均较治疗前明显升高(均P0.01),rMTT、rTTP均较治疗前明显降低(均P0.01);针刺1组治疗后rCBV、rCBF高于针刺2组,rMTT、rTTP低于针刺2组(均P0.05);针刺1组与药物组相比,治疗后PWI各参数差异无统计学意义(均P0.05)。针刺1组、针刺2组和药物组总有效率分别是88.3%(53/60)、73.3%(44/60)与90.0%(54/60),针刺1组总有效率优于针刺2组(P0.05),与药物组比较差异无统计学意义(P0.05)。结论:通督调神针刺干预能有效改善CIS高危患者脑血流低灌注情况,降低严重CIS的发病率,且针刺每天1次优于隔天1次。     

点刺金津、玉液配合言语训练治疗脑卒中后构音障碍疗效观察

目的 通过运用点刺金津、玉液配合言语训练的方法对脑卒中后构音障碍患者进行治疗,观察该法的临床疗效。方法 按照入组顺序将120例分为治疗组和对照组,每组60例,治疗组采用点刺金津、玉液配合言语训练进行治疗,其中金津穴、玉液穴向舌根方向针刺1～1.2寸,点刺放血,每次每穴放血3~6滴,隔日1次,4周为1个疗程。对照组单纯使用言语训练方法治疗,4周为1个疗程。治疗前后采用Frenchay构音障碍评价量表对两组患者进行疗效评定。结果 两组治疗后Frenchay构音障碍评定量表a项数与治疗前比较,差异均有统计学意义（P<0.05）,两组差值比较,差异有统计学意义（P<0.05）;两组临床疗效分布比较,差异有统计学意义（P<0.05）。结论 点刺金津、玉液配合言语训练对脑卒中后构音障碍的改善优于单纯言语训练。     

通督调神灸结合康复训练对中风偏瘫患者上肢运动功能恢复的影响

Objective: To observe the impacts of the combined treatment of Tongdu Tiaoshen moxibustion (moxibustion for promoting the circulation of the governor vessel and regulating the spirit) and rehabilitation training on the motor function recovery in the patients with apoplectic hemiplegia.Methods: A total of 50 patients with apoplectic hemiplegia and qualified in the trial recruitment criteria were divided into two groups according to random number table, 25 cases in each group. In the control group, the simple rehabilitation training was provided. In the observation group, on the base of the treatment as the control group, Tongdu Tiaoshen moxibustion was given. Main acupoints: Băihuì (百会GV20), Fēngfŭ (风府GV16) and Dàzhuī (大椎GV14). The treatment was given once a day, 6 treatments a week, 4 weeks as one course and two courses of treatment were required. Before and after treatment, the scores of Fugle-Meyer assessment (FMA), the modified Barthel index (MBI) and action research arm test (ARAT) were detected before and after treatment in the two groups separately.Results: After 4 and 8 weeks of treatment, the scores of FMA, MBI and ARAT were all improved obviously as compared with those before treatment respectively in patients of the two groups(all P < 0.01). After 8 weeks of treatment, the score of each scale in the observation group was more obviously improved as compared with the control group (all P < 0.05). The difference in the clinical therapeutic effect was significant statistically between the two groups (P = 0.005).Conclusion: The combined treatment of Tongdu Tiaoshen moxibustion and rehabilitation training promotes the recovery of the upper limb motor function and improves the self-ability of living activities in the patients with apoplectic hemiplegia. The long-term effect of this combined therapy is superior to that of simple rehabilitation training.     

灸法治疗脊髓损伤后遗症研究概况

临床中治疗脊髓损伤后遗症常用以下灸法:重灸法、艾条灸法、温灸器灸法、温针灸法、隔物灸法、脐灸法、热敏灸法、"随年壮灸法"等。目前,灸法治疗脊髓损伤的取穴大部分是取任脉或者背俞穴,其针对不同的后遗症效果也不尽相同。而脊髓损伤从中医角度看属于督脉受损,是否能够将取穴集中于督脉上,如百会、风府、大椎、筋缩、至阳、命门等穴,通过不同艾灸方法作用于督脉穴位观察其对大脑的影响,从而治疗或者改善脊髓损伤后遗症,这给临床医者提供一种新方向。当前临床研究中,缺乏对灸法治疗脊髓损伤作用机理的研究,以及治疗脊髓损伤更有效的治疗方法,这是目前需要解决的问题。     

通督调神灸对脊髓损伤大鼠运动功能及炎性因子表达的影响

目的：观察通督调神灸对脊髓损伤(spinal cord injury, SCI)大鼠运动功能及炎性因子表达的影响。方法：60只雄性SD大鼠采用改良Allens法制作脊髓中度损伤模型,将造模成功的大鼠随机分为模型组和通督调神灸组,每组各30只。造模完成后,模型组大鼠仅给予预防感染等处理,通督调神灸组大鼠除预防感染外予以通督调神灸治疗,取百会、大椎、至阳、命门等穴,每穴5 min,每天1次,连续7 d。分别于术后第1天、第3天、第7天各取10只大鼠,选择Basso-Beattie-Bresnahan(BBB)评分法评估脊髓损伤后的运动功能;ELISA法检测脊髓组织中高迁移率族蛋白B1(high mobility group protein 1,HMGB1)、白细胞介素-1β(interleukin-1β,IL-1β)、IL-18、核转录因子-κB(nuclear factor kappa B,NF-κB)的蛋白表达水平。结果：术后第1天,各组大鼠双下肢均出现迟缓性瘫痪,未见明显双下肢各关节的活动;术后第3天,各组大鼠双下肢部分关节有轻度活动;术后第7天,模型组大鼠双下肢各关节能够轻度伸缩运...     

针刺加刺络与卡马西平治疗偏头痛效应差异的观察

Objective:To observe the clinical therapeutic effect on migraine treated with acupuncture combined with blood-letting therapy. Methods:A total of 90 patients of...