脑梗死患者上肢瘫针刺治疗方案的优选及其对内皮素的影响

目的：优选脑梗死上肢瘫针刺治疗方案，分析优选方案获效机理。方法：以脑梗死上肢瘫为观察对象，以Fugl-Meyer肢体运动功能积分、血清内皮素（ET）为指标，应用正交设计法，对影响脑梗死针刺疗效的4因素3水平搭配组合方案进行优选。结果：在脑梗死病程3天内，采用头穴加阴阳经体穴交替针刺的针刺方法，并予中刺激量刺激法，可分别获得最佳的Fugl-Meyer积分效应和调整血清ET水平的效应。结论：在脑梗死病程3天内，采用头穴加阴阳经体穴交替针刺可列为优选方案，其优点可能是通过调整血清ET水平，舒张脑血管，改善脑血流，达到其治疗作用的。

Optimization of Acupuncture Treatment Program for Upper Limb Paralysis and Its Effect on Blood Endothelin in Patients with Cerebral Infarction

Objective: To select the optimal treatment program of acupuncture for upper limb paralysis in patients with cerebral infarction, and to analyse the mechanism of its therapeutic effect. Methods: Taken the Fugl-Meyerlimb motor function score and blood endothelin (ET) as indexes, the orthogonal design was adopted for optimization of combined programs of 4 factors at 3 levels that influenced the therapeutic effect of acupuncture in treating patients of cerebral infarcion with upper limb paralysis. Results: The best effect for getting Fugl-Meyer motor function score and regulating blood ET level could be obtained by applying acupuncture at scalp acupoints plus body acupoint of Yin and Yang Channels alternately, with medium stimulus within the first three days after onset of the illness. Conclusion: The optimal treatment program of acupuncture is to apply acupuncture at scalp acupoints plus body acupoints of Yin and Yang Channels alternately within the first three days after onset. Its mechanism may be through the optimal regulation on blood ET level to dilate the cerebral vessels so as to improve the cerebral blood supply.