摘要
目的:观察用通窍醒神方、头针联合经皮穴位电刺激治疗脑卒中单侧空间忽略的临床效果。方法:选择脑卒中单侧空间忽略患者116例,将其随机分为对照例和观察组各58例。两组患者均给予常规康复训练,对照组患者在此基础上给予经皮穴位电刺激疗法,观察组在对照组基础上加用通窍醒神方、头针联合治疗,两组均连续治疗8周。评价患者的忽略程度、日常生活能力、认知功能、焦虑、生活质量变化,测定血液流变学指标、血清中相关因子含量变化。结果:治疗后,两组患者的数字消去试验、画钟试验、平分直线试验评分均有所降低(均P<0.05),组间比较,观察组显著低于对照组(均P<0.05);与对照组相比,观察组患者治疗后的日常生活能力ADL、认知能力MMSE评分均显著升高(均P<0.05);观察组患者治疗后8周、随访8周、随访12周的焦虑SAS评分均显著降低(均P<0.05),生活质量评分显著升高(t=8.002,8.155,5.697,P<0.05);与对照组相比,观察组患者的全血高切黏度、全血低切黏度、血浆黏度均显著降低(均P<0.05);观察组的治疗后血清中TNF-α、sICAM-1水平均显著降低,IL-2水平则显著升高(均P<0.05)。结论:通窍醒神方、头针联合经皮穴位电刺激更利于减轻脑卒中单侧空间忽略患者的病情,提高日常生活能力、认知功能,缓解焦虑,提高生活质量,远期效果确切,其起效可能与改变血液流变、调控TNF-α、sICAM-1、IL-2水平以调节免疫稳态、抑制炎症反应有关。
Objective:To observe the clinical effect of Tongqiao Xingshen prescription and scalp acupuncture combined with percutaneous electrical stimulation in the treatment of unilateral spatial neglect of stroke.Methods:A total of 116 stroke patients with unilateral spatial neglect were selected and randomly divided into the control group and observation group,58 patients in each group.Patients in the two groups were given conventional rehabilitation training,patients in the control group were given percutaneous electric acupoint stimulation therapy on the basis of this,patients in the observation group were added with Tongqiao Xingshen prescription and scalp acupuncture combined treatment on the basis of the control group,and the two groups were treated consecutively for 8 weeks.The changes of patients’neglect degree,daily life ability,cognitive function,anxiety and quality of life were evaluated,and the changes of hemorheology indexes and the content of related factors in serum were measured.Results:After treatment,the number elimination test,bell drawing test and bisexualline test scores of patients in both groups were reduced(all P<0.05),and the comparison between groups was significantly lower in the observation group than in the control group(P<0.05).Compared with the control group,the scores of daily life ability ADL and cognitive ability MMSE in the observation group were significantly increased after treatment(all P<0.05).In the observation group,the anxiety SAS scores at 8 weeks after treatment,8 weeks after follow-up,and 12 weeks after follow-up were significantly reduced(all P<0.05),and quality of life scores were significantly increased(all P<0.05).Compared with the control group,the patients in the observation group had significantly decreased whole blood high-cut viscosity,whole blood low-cut viscosity and plasma viscosity(all P<0.05).After treatment,serum levels of TNF-αand sICAM-1 in the observation group were significantly decreased,while those of IL-2 were significantly increased(all P<0.05).Conclusion:Tongqiao Xingshen prescription and scalp acupuncture combined with percutaneous electrical stimulation are more beneficial to reduce the condition of stroke patients with unilateral spatial neglect,improve their daily life ability and cognitive function,relieve anxiety,and improve their quality of life.The long-term effect is definite.Its effect may be related to changing hemorrheology,regulating L levels of TNF-α,sICAM-1,and IL-2 to regulate immune homesteadiness and inhibit inflammatory response.
作者
林生君
仇珺
赵明
LIN Shengjun;QIU Jun;ZHAO Ming(Acupuncture Department of Traditional Chinese Medicine in Qinghai Red Cross Hospital,Xining 810000,China)
出处
《陕西中医》
2021年第2期247-251,共5页
Shaanxi Journal of Traditional Chinese Medicine
基金
湖北省卫生健康委员会科研项目(WJ2019Q017)。
关键词
通窍醒神方
头针
经皮穴位电刺激
脑卒中单侧空间忽略
日常生活能力
认知功能
焦虑状态
生活质量
Tongqiao Xingshen prescription
Scalp needle
Electric stimulation of percutaneous acupoint
Unilateral spatial neglect of stroke
Ability for daily life
Cognitive function
Anxious state
The quality of life
