针刺对脑出血急性期脑血流量改善程度时效关系的临床研究

目的观察针刺对脑出血急性期脑血流量改善程度的时效关系,确定针刺治疗脑出血介入的最佳时间。方法将300例脑出血急性期患者按照随机数字表法随机分为治疗1组、治疗2组、治疗3组、治疗4组和对照组,每组60例。对照组采用脑出血常规治疗,治疗1组、治疗2组、治疗3组、治疗4组在对照组治疗基础上采用针刺治疗,针刺介入时间分别为发病24 h、72 h、1星期和2星期。各组患者均在治疗前后测量脑血流情况并进行统计分析。结果治疗1组、治疗2组、治疗3组和治疗4组治疗前后脑血流量各项指标(大脑前动脉、大脑中动脉、大脑后动脉及相应的动脉指数)差值与对照组比较,差异均具有统计学意义(P0.05)。治疗1组治疗前后脑血流量各项指标差值与治疗2组、治疗3组和治疗4组比较,差异均具有统计学意义(P0.05)。治疗2组治疗前后脑血流量各项指标差值与治疗3组和治疗4组比较,差异均具有统计学意义(P0.05)。治疗3组治疗前后脑血流量各项指标差值与治疗4组比较,差异具有统计学意义(P0.05)。结论针刺在脑出血急性期的介入时间越早,对脑血流量改善程度越显著,提示在脑出血早期即应给予针刺治疗。

Clinical Study of the Relationship between Acupuncture Time and its Improving Effect of on Cerebral Blood Flow in the Acute Stage of Cerebral Hemorrhage

Objective To investigate the relationship between time and the improving effect of acupuncture on cerebral blood flow in the acute stage of cerebral hemorrhage and determine the optimal intervention time for acupuncture treatment of cerebral hemorrhage. Methods Three hundred patients with acute-stage cerebral hemorrhage were allocated, using a random number table, to treatment groups 1, 2, 3 and 4 and a control group, 60 cases each. The control group received routine treatment for cerebral hemorrhage. Treatment groups 1, 2, 3 and 4 received acupuncture at 24 hrs, 72 hrs, one week and two weeks after the attack, respectively, in addition to the treatment for the control group. Cerebral blood flow was measured in every group of patients before and after treatment. The results were statistically analyzed. Results There were statistically significant pre-treatment differences in cerebral blood flow indices （anterior cerebral artery, middle cerebral artery, posterior cerebral artery and corresponding artery indices） between group 1, 2, 3 or 4 and the control group （P〈0.05）. There were statistically significant pre-treatment differences in pre-/post-treatment cerebral blood flow indices difference values between group 1 and group 2, 3 or 4 （P〈0.05）, between group 2 and group 3 or 4 （P〈0.05） and between groups 3 and 4 （P〈0.05）. Conclusion The earlier acupuncture intervention is made in the acute stage of cerebral hemorrhage, the more markedly cerebral blood flow is improved, suggesting that acupuncture treatment should be administered in the early stage of cerebral hemorrhage.