灸刺督脉治疗气虚血瘀型缺血性脑卒中临床观察

目的 观察评价灸刺督脉疗法治疗气虚血瘀型缺血性脑卒中的临床疗效。方法 将气虚血瘀型缺血性脑卒中患者41例，随机分为对照组（20例）和治疗组（21例）。两组均予以基础病管理，对照组采用脑卒中气虚血瘀型常规针刺治疗，取穴为顶颞前后斜线、极泉、尺泽、内关、委中、足三里、三阴交、气海、血海；治疗组在常规针刺治疗基础上加用灸刺督脉疗法，取通督七穴（水沟、神庭、百会、风府、大椎、命门、腰阳关），其中百会艾灸，大椎刺络，其余腧穴予以针刺治疗。治疗周期为14 d。疗程结束后以美国国立卫生研究院卒中量表（National Institute of Health stoke scale，NIHSS）及改良Rankin量表（modified Rankin scale，MRS）评分结果评价两组的临床疗效。结果 两组患者治疗后NIHSS及MRS评分均较治疗前显著降低（P<0.05），治疗组NIHSS及MRS评分差值与对照组比较，差异均有统计学意义（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 灸刺督脉疗法治疗气虚血瘀型缺血性脑卒中临床疗效确切，优于常规针刺治疗。

Clinical Effect of Acupuncture and Moxibustion at the Governor Vessel in Treatment of Ischemic Stroke with Qi Deficiency and Blood Stasis

Objective To investigate the clinical effect of acupuncture and moxibustion at the governor vessel in the treatment of ischemic stroke with Qi deficiency and blood stasis. Methods A total of 41 patients with ischemic stroke with Qi deficiency and blood stasis were randomly divided into control group with 20 patients and treatment group with 21 patients. In addition to the management of underlying disease, the patients in the control group were given conventional acupuncture for stroke with Qi deficiency and blood stasis at the acupoints of the anterior and posterior oblique parietotemporal lines, Jiquan, Chize, Neiguan, Weizhong, Zusanli, Sanyinjiao, Qihai, and Xuehai, and those in the treatment group were given acupuncture and moxibustion along the governor vessel (at the seven acupoints of Shuigou, Shenting, Baihui, Fengfu, Dazhui, Mingmen, and Yaoyangguan) in addition to the treatment in the control group, with moxibustion at Baihui, blood-letting puncture at Dazhui, and acupuncture at the other five acupoints. The course of treatment was 14 days for both groups. National Institute of Health stoke scale (NIHSS) and modified Rankin scale (MRS) were used to evaluate clinical outcome. Results Both groups had significant reductions in NIHSS and MRS scores after treatment (P<0.05), and the treatment group had significantly greater reductions than the control group (P<0.05). There was a significant difference in the distribution of clinical outcomes between the two groups (P<0.05). Conclusion Acupuncture and moxibustion at the governor vessel has a good clinical effect in the treatment of ischemic stroke with Qi deficiency and blood stasis, with a better clinical effect than conventional acupuncture.