“通督调神”法针刺联合颈动脉内膜剥脱术治疗颈动脉狭窄：随机对照研究

目的:观察"通督调神"法针刺联合颈动脉内膜剥脱术(CEA)与单纯CEA治疗颈动脉狭窄(CAS的临床疗效。方法:将60例CAS患者随机分为观察组(30例,脱落2例)和对照组(30例,脱落3例)。两组患者均采用外翻式颈动脉内膜剥脱术(eCEA)治疗。对照组患者予内科常规及抗血小板聚集药物(阿司匹林肠溶片或硫酸氢氯吡格雷片)治疗4周,观察组在对照组的基础上采用"通督调神"法针刺治疗,穴取百会、风府、哑门、颈夹脊、大椎等,每日1次,治疗6 d后休息1 d,2周为一疗程,共治疗2个疗程。采用超声诊断仪检测两组患者治疗前后颈动脉内膜中层厚度(IMT),比较两组患者治疗前后及治疗结束后6个月随访时的中医症状积分,评定两组患者临床疗效,并记录1年内终点事件发生情况。结果:治疗后,两组患者颈动脉IMT、中医症状积分均较治疗前降低(P<0.05),且观察组降低幅度大于对照组(P<0.05)。随访时,两组患者中医症状积分均较治疗前降低(P<0.05)。观察组总有效率为96.4%(27/28),高于对照组的88.9%(24/27,P<0.05)。1年内随访,观察组发生脑卒中1例;对照组...

Tongdu Tiaoshen acupuncture combined with carotid endarterectomy for carotid artery stenosis:a randomized controlled trial

Objective To observe the clinical therapeutic effect of Tongdu Tiaoshen acupuncture combined with carotid endarterectomy(CEA)and simple CEA on carotid artery stenosis(CAS).Methods A total of 60 patients with CAS were randomized into an observation group(30 cases,2 cases dropped off)and a control group(30 cases,3 cases dropped off).Both groups were treated with eversion CEA(eCEA).The conventional treatment of internal medicine and antiplatelet drugs i.e.aspirin enteric-coated tablet and clopidogrel hydrogen sulfate tablet were given in the control group for 4 weeks.On the basis of the treatment in the control group,Tongdu Tiaoshen acupuncture was applied at Baihui(GV 20),Fengfu(GV 16),Yamen(GV 15),cervical Jiaji(EX-B 2),Dazhui(GV 14),etc.in the observation group,once a day,1-day rest was taken after 6-day treatment,2 weeks were as one course and totally 2 courses were required.The carotid intima-media thickness(IMT)before and after treatment was detected by ultrasonic diagnostic apparatus,the TCM symptom score was compared before and after treatment and in the follow-up of 6 months after treatment,the clinical efficacy was evaluated in the two groups.The occurrence of endpoints within 1 year was recorded.Results After treatment,the carotid IMT and TCM symptom scores were decreased compared before treatment in the both groups(P<0.05),and the changes in the observation group were greater than the control group(P<0.05).In the follow-up,the TCM symptom scores were decreased compared before treatment in the both groups(P<0.05).The total effective rate was 96.4%(27/28)in the observation group,which was superior to 88.9%(24/27)in the control group(P<0.05).There were 1 case of stoke in the observation group and 2 cases of stroke in the control group within 1-year follow-up,and there was no significant difference in the number of endpoints between the two groups within 1 year(P>0.05).Conclusion Tongdu Tiaoshen acupuncture combined with CEA can effectively reduce the IMT in patients with CAS,improve the TCM symptom score,the efficacy is superior to simple CEA treatment.