针刺颞三针为主治疗缺血性中风偏瘫的临床研究
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摘要
1研究目的
缺血性中风也称缺血性脑卒中(Cerebral Ischemic Stroke, CIS),本病具有高死亡率、高复发率及高致残率等特点,严重威胁人类生命及影响生活质量。中风患者多遗留有不同程度的功能障碍,其中以肢体偏瘫(Hemiplegia)发生率最高,是直接影响患者生存质量的主要因素。现代临床研究表明,针灸治疗缺血性中风偏瘫具有十分高的肯定疗效。目前针灸治疗缺血性中风偏瘫主要以国家标准头皮针结合体针治疗为主,我们的前期研究表明,颞三针治疗缺血性中风偏瘫具有显著的临床疗效。
本研究通过随机、对照的临床研究方法,遵循循证医学的原则,观察颞三针结合体针疗法治疗缺血性中风偏瘫的临床疗效,以国家标准头皮针作为对照,并以神经功能缺损评分、肢体运动功能的测定、日常生活能力的评定、经颅彩色多普勒等进行客观评价,从而探讨颞三针治疗该病的临床价值,丰富缺血性中风偏瘫的针灸治疗手段。
2研究方法
(1)分组将入选的60例患者按随机对照的原则分为2组,治疗组(颞三针+体针组)30例,对照组(国家标准头皮针+体针组)30例。
(2)取穴
①颞三针取穴：头颞侧部、耳尖直上,入发际2寸为颞一针,在颞一针水平向前旁开1寸为颞二针,向后旁开1寸为颞三针。
②标准头皮针取穴：即顶颞前斜线,位于头部侧面,头顶至头颞部,自前神聪穴起至悬厘穴的联机,将全穴线分为5等分,下肢瘫痪取对侧运动区上1／5,上肢瘫痪取对侧运动区中2／5,面瘫取对侧运动区下2／5,本研究选取上1／5和中2／5两段运动线区。
③体针取穴：上肢取肩髃,曲池,手三里,内关；下肢取环跳,阳陵泉,委中,阳辅,解溪,昆仑。
④辨证取穴：除上述体针穴位外,肝阳暴亢：另取四关,外关,行间。风痰阻络：另取丰隆,阴陵泉,中脘。痰热腑实：另取支沟,上巨虚,足三里。气虚血瘀：另取足三里,气海,血海。阴虚风动：另取太溪,三阴交,照海。随症取穴：除上述体针穴位如语言不利：另取舌三针,哑门,廉泉。口角歪斜：地仓,颊车,内庭。记忆力低下：四神聪。
(3)操作方法：使用0.30×0.40mm华佗牌一次性不锈钢针灸针,75%酒精皮膺常规消毒後進针。
①标准头皮针操作方法：暴露头皮,分开相应局部头发,针与头皮呈15~20度夹角,快速将针刺入头皮下,沿皮下推进,当针到达帽状腱膜下层时,指下感到不松不紧而有吸针感时,然后使针与头皮平行继续捻转进针30mm,留针30分钟,每隔10分钟以平补平泻手法分别行捻转和提插手法各1次。留针30分钟。每天一次,每周5次,4周为一个疗程,治疗1个疗程後统计。
②颞三针进针方法：取患侧颞部颞一针,垂直向下沿头皮平刺1.5寸。针刺颞一针后,于颞一针水平方向向前1寸处针二针,垂直向下沿头皮平刺1.5寸。后一寸处针颞三针,垂直向下沿头皮平刺1.5寸。留针30分钟,每隔10分钟以平补平泻手法分别行捻转和提插手法各1次。每天一次,每周5次,4周为一个疗程,1个疗程后进行统计
(4)疗效评价方法以神经功能缺损评分对治疗前后患者的神智、语言、肢体运动功能等主症进行综合评定；用Fugl-Meyer评价法来评定患者瘫痪侧上下肢运动功能,治疗前和治疗结束后各评定一次；采用Barthel指分级法来评定日常生活能力；治疗前后行经颅多普勒检查,观察各组治疗前后对脑血流的影响。
3研究结果
(1)颞三针为主治疗缺血性中风偏瘫患者神经功能缺损程度(CSS指数)评分及疗效的影响
经治疗1个疗程后,治疗组的功能评分改善要好于对照组,但经统计学比较无显著性差异；治疗组痊愈率,显效率和总有效率均高于对照组,但经Ridit分析,两组间神经功能缺损疗效不存在统计学差异(p>0.05),亦即在改善神经功能缺损方面,未能汪实颞三针+体针疗法优于国家标准头皮针+体针疗法。
(2)颞三针为主治疗缺血性中风偏瘫患者日常生活能力(ADL指数)评分的影响
治疗组要显著优于对照组,且存在统计学差异,p<0.05,提示颞三针+体针在改善患者生活活动能力方面要优于国家标准头皮针+体针治疗。
(3)颞三针为主治疗缺血性中风偏瘫患者运动功能评分及疗效的影响
经治疗后,治疗组的评分改善要好于对照组,经统计学比较,差异显著,p<0.05；在临床疗效方面,治疗组为93.33%,对照组为83.33%；具体疗效,治疗组：痊愈率43.33%,显效率23.33%,有效率26.67%,无效6.67%；对照组方面：痊愈率36.67%,显效率13.33%,有效率33.33%,无效16.67%；对上述数据进行Ridit分析显示,两组数据分布存在统计学差异,p<0.05,提示两组在运动功能评分疗效方面存在显著性差异,治疗组要优于对照组。
(4)颞三针为主治疗缺血性中风患者经颅多普勒指标变化的影响
对照组患者VM治疗前后经配对t检验比较,治疗组各个探测血管血流速度均有增快,除PCA外,经统计学比较,差异有显著意义(P<0.05),PI治疗前后经配对t检验比较,5条动脉的差异均无统计学意义(P>0.05)。
治疗组患者Vm治疗前后经配对t检验比较,ACA, MCA于治疗前后差异显著,经统计学比较,(P<0.05); PCA, VA, BA的差异无显著意义(P>0.05)。PI治疗前后经配对t检验比较,5条动脉的差异均无显著意义(P>0.05)。
治疗组Vm,VA.BA的差值均低于对照组,MCA的差值要高于对照组,数据经成组t检验比较,以上差异显著(P＜0.05)；PCA差异无统计学意义(P>0.05)。PI治疗前后差值经成组t检验比较,5条动脉的组间差值均无显著意义(P>0.05)。
4结论
(1)颞三针为主治疗方案与国家标准头皮针治疗均可显著改善缺血性中风偏瘫患者的神经功能缺损症状,但两种方法未体现明显差异。
(2)颞三针为主治疗方案与国家标准头皮针的治疗均可提高患者日常生活能力(ADL指数)评分,提高缺血性中风患者的日常生活能力,但颞三针要明显优于头皮针。
(3)颞三针为主治疗方案与国家标准头皮针的治疗均可有效地改善缺血性中风偏瘫患者的肢体运动功能,两组在评分及临床疗效方面显著差异,颞三针要优于头皮针。
(4)颞三针为主治疗方案与国家标准头皮针的治疗均可有效地改善缺血性中风偏瘫患者的脑血流速度。
1. Research objects
Ischemic stroke is equivalent to cerebral ischemic stroke of Western medicine, the disease has a high mortality rate, high recurrence rate and high rate of disability and so on, a serious threat to human life and the quality of life. Stroke patients usually left with varying degrees of dysfunction, of which the highest rate of hemiplegia occured, directly affect the quality of life in patients with major factors. Modern clinical studies have shown that acupuncture treatment of ischemic stroke hemiplegia have very positive effects. Present acupuncture treatment of ischemic stroke hemiplegia mainly localized the national standard scalp and body acupuncture treatment. Our preliminary studies indicate that acupuncture treatment of Jin's three-needle to ischemic stroke hemiplegia have significant clinical efficacy.
This study was used stratified random, controlled clinical research methods, to follow the principles of evidence-based medicine, to observe the clinical effects of Jin's three-needle combined with body acupuncture to the hemiplegia after ischemic stroke, and compared with the national standard scalp acupuncture treatment. The Efficacy evaluation indexes included the neurological deficit score, limb motor function of the measured Assessment of activities of daily living, transcranial Doppler and so on. so as to explore the clinical value of Jin's three-needle treatment for the disease.
2. Research Methods
(1) Grouping:60 patients have been selected randomly stratified into 2 groups control principle, the treatment group (Temporal three-needle+body acupuncture group) 30 cases, the control group (the national standard scalp body acupuncture group) 30 cases.
(2) Acupoints
①Temporal three-needle:Department of temporal head, tip, straight, into the hairline 2 inches for the TemporalⅠneedle, needle in the temporal levelⅠ, next to open an inch forward for the TemporalⅡneedle,1 inch for the back side to open the TemporalⅢneedle.
②Scalp Acupoints:Top temporal pre-slash, at the head side, head to head and temporal, from the previous point until Shen-Cong hanging PCT point of connection, the whole point line is divided into five decile, lower limb paralysis to take on the contralateral motor area 1/5, upper limb paralysis in the motor area contralateral to take 2/5, facial paralysis contralateral motor area to take the next 2/5, in this study on the 1/5 and in 2/5, two sports (?)ine area.
③Body acupuncture acupoints:upper shoulder Jian Yu, Qu Chi, Shou San Li, Nei Guang; leg to take Huan Tiao, Yanglingquan, Wei Zhong, Yang Fu, Xue Hai, Kunlun.
④Dialectical acupoints:In addition to the body acupuncture points, the liver yang hyperactivity:Another take Si Guan, Wai Guan, Xing Jian. Wind phlegm:for Fong Long, Yin Ling Quan, Zhong Wan. Phlegm Fu Real:Another take Zhi Kou, Shang Ju Xu, Zusanli. Qi deficiency and blood stasis:Zusanli, Qi Hai, Xue Hai. Yin Wind:Another take Tai Xi, Sanyinjiao, Zhao Hai. Acupoints with the disease:In addition to the body acupuncture points, such as language disadvantage:tongue three needles, Yamen, Lian Quan. Mouth askew:Di Cang, Jia Che, Nei Ting. Memory loss:Si Shen Cong.
(3) Method of operation:Routine disinfection, exposure scalp, separate the corresponding local hair, use a diameter of 0.30mm,80 mm long stainless steel needle, needle showed a 15-20 degree angle with the scalp, quickly penetrate the scalp then quickly needle under the skin along the advance, when the needle reaches aponeurosis of occipitofron talis muscle, when feel a sense of aspiration needle, and then continue to twisting the needle parallel to 20mm, the right hand twisting fast speed for 2 minutes, frequency speed is 180-200 times/minute, and with the other hand while rubbing the scalp motor area along the meridians around the area, to encourage the gas to the disease area. Needle retention for 30 minutes, every 10 minutes manipulating needle one time, temporal three needle puncture method is as follows:first take in the temporalⅠneedle puncture vertically down along the 1.5-inch scalp level, temporalⅠacupuncture needle, the needle in the horizontal temporalⅠforward 1 inch needle temporal DepartmentⅡneedle puncture vertically down along the 1.5-inch scalp level. DepartmentⅢTemporomandibular inch needle after needle puncture vertically down along the scalp,1.5 square inch. Every 10 minutes to level up flat line twisting and diarrhea were mentioned means to intervene Act 1 each. Once a day,5 times a week for 4 weeks as a course of treatment efficacy after 1 courses of statistics, other Chinese and Western medical treatment were the same.
(4) Clinical Evaluation:With neurological deficit score before and after treatment in patients with sanity, language, motor functions of a comprehensive assessment of the primary disease; with the Fugl-Meyer assessment method to evaluate patients with paralysis of limbs on motor function, before treatment and once after the end of the assessment; means the classification method used to evaluate the Barthel activities of daily living; TCD examination before and after treatment were observed before and after treatment on cerebral blood flow.
3. Research results
(1) The efficacy of Temporal three-needle therapy on ischemic stroke patients with hemiplegia neurologic impairment (CSS Index) score In the CSS score and effect analysis, after a course of treatment, the treatment group scores improved better than the control group, but by statistical comparison, have no significant difference; treatment group cure rate, markedly effective rate and total effective rate high than the control group, but after Ridit analysis, neurological impairment between the two groups there is no significant difference in efficacy (p> 0.05), which is to improve the neurological deficit, the failure to confirm the temporal three-pin+body acupuncture is better than national standards Scalp Acupuncture+body acupuncture.
(2) The effect of Temporal three-needle therapy On the activities of daily living (ADL index) score.
As for ADL score, the treatment group is better than the control group, and there was significant difference, p<0.05, suggest temporal three-body acupuncture needle+activity in improving aspects of life of patients is better than the national standard scalp+body acupuncture.
(3) The efficacy and the effect of Temporal three-needle therapy on Ischemic stroke patients with hemiplegia motor function and score
In motor function score and the effect of the analysis, after treatment, the treatment group's score improved better than the control group, by statistical comparison, significant difference, p<0.05; in clinical efficacy in the treatment group was 93.33% in the control group was 83.33%; specific efficacy in the treatment group:43.33% cure rate, markedly effective rate was 23.33%, efficiency 26.67%,6.67% invalid; control group:the recovery rate of 36.67%, markedly effective rate 13.33%, efficiency 33.33% 16.67% invalid; Ridit the above data analysis, two sets of data distribution was significantly different, p<0.05, suggest efficacy of the two groups in motor function score there was significant difference in the treatment group is better than the control group.
(4)The effects of Temporal three-needle therapy on ischemic stroke by transcranial Doppler indexes
Control group before and after treatment in patients with VM compared by paired t test, each treatment group were detected faster blood flow velocity, in addition to PCA, the economic statistics, the difference was significant (P<0.05), PI before and after treatment by paired t test comparison, five arteries were no significant differences (P> 0.05).
Treatment group Vm before and after treatment by paired t test comparison, ACA, MCA before and after treatment significantly different by statistical comparison, P<0.05; PCA, VA, BA of the difference was not statistically significant ((P> 0.05). PI before and after treatment compared by paired t test, five arteries showed no significant (P> 0.05).
Treatment group Vm, VA, BA was lower than the control group the difference, MCA to be higher than the difference of the data by group t test comparison, the above significant difference (P<0.05); PCA difference was not statistically significant. Difference before and after treatment by PI group t test comparison between groups arteries 5 There was no significant difference (P> 0.05).
4. Conclusion
(1) Both Temporal Three Acupuncture treatment program and the national standard scalp acupuncture can significantly improve ischemic stroke patients with hemiplegia of neurological deficit, but does not reflect the significant difference between both methods.
(2) Both Temporal Three Acupuncture program and the national standards can improve the treatment of scalp acupuncture in patients with activities of daily living (ADL index) score, to improve the daily lives of patients with ischemic stroke capacity, the three temporal scalp acupuncture needle is superior.
(3) Both Temporal Three Acupuncture program and the national standard treatment of scalp acupuncture can be improved effectively the patients with ischemic stroke hemiplegic limb motor function, both groups score and clinical efficacy in the significant difference in the temporal scalp acupuncture is better than the three-pin.
(4) Temporal three-needle treatment programs with national standards scalp acupuncture treatment can be effective in improving ischemic stroke patients with hemiplegia of cerebral blood flow.
缺血性中风也称缺血性脑卒中(Cerebral Ischemic Stroke, CIS),本病具有高死亡率、高复发率及高致残率等特点,严重威胁人类生命及影响生活质量。中风患者多遗留有不同程度的功能障碍,其中以肢体偏瘫(Hemiplegia)发生率最高,是直接影响患者生存质量的主要因素。现代临床研究表明,针灸治疗缺血性中风偏瘫具有十分高的肯定疗效。目前针灸治疗缺血性中风偏瘫主要以国家标准头皮针结合体针治疗为主,我们的前期研究表明,颞三针治疗缺血性中风偏瘫具有显著的临床疗效。
本研究通过随机、对照的临床研究方法,遵循循证医学的原则,观察颞三针结合体针疗法治疗缺血性中风偏瘫的临床疗效,以国家标准头皮针作为对照,并以神经功能缺损评分、肢体运动功能的测定、日常生活能力的评定、经颅彩色多普勒等进行客观评价,从而探讨颞三针治疗该病的临床价值,丰富缺血性中风偏瘫的针灸治疗手段。
2研究方法
(1)分组将入选的60例患者按随机对照的原则分为2组,治疗组(颞三针+体针组)30例,对照组(国家标准头皮针+体针组)30例。
(2)取穴
①颞三针取穴：头颞侧部、耳尖直上,入发际2寸为颞一针,在颞一针水平向前旁开1寸为颞二针,向后旁开1寸为颞三针。
②标准头皮针取穴：即顶颞前斜线,位于头部侧面,头顶至头颞部,自前神聪穴起至悬厘穴的联机,将全穴线分为5等分,下肢瘫痪取对侧运动区上1／5,上肢瘫痪取对侧运动区中2／5,面瘫取对侧运动区下2／5,本研究选取上1／5和中2／5两段运动线区。
③体针取穴：上肢取肩髃,曲池,手三里,内关；下肢取环跳,阳陵泉,委中,阳辅,解溪,昆仑。
④辨证取穴：除上述体针穴位外,肝阳暴亢：另取四关,外关,行间。风痰阻络：另取丰隆,阴陵泉,中脘。痰热腑实：另取支沟,上巨虚,足三里。气虚血瘀：另取足三里,气海,血海。阴虚风动：另取太溪,三阴交,照海。随症取穴：除上述体针穴位如语言不利：另取舌三针,哑门,廉泉。口角歪斜：地仓,颊车,内庭。记忆力低下：四神聪。
(3)操作方法：使用0.30×0.40mm华佗牌一次性不锈钢针灸针,75%酒精皮膺常规消毒後進针。
①标准头皮针操作方法：暴露头皮,分开相应局部头发,针与头皮呈15~20度夹角,快速将针刺入头皮下,沿皮下推进,当针到达帽状腱膜下层时,指下感到不松不紧而有吸针感时,然后使针与头皮平行继续捻转进针30mm,留针30分钟,每隔10分钟以平补平泻手法分别行捻转和提插手法各1次。留针30分钟。每天一次,每周5次,4周为一个疗程,治疗1个疗程後统计。
②颞三针进针方法：取患侧颞部颞一针,垂直向下沿头皮平刺1.5寸。针刺颞一针后,于颞一针水平方向向前1寸处针二针,垂直向下沿头皮平刺1.5寸。后一寸处针颞三针,垂直向下沿头皮平刺1.5寸。留针30分钟,每隔10分钟以平补平泻手法分别行捻转和提插手法各1次。每天一次,每周5次,4周为一个疗程,1个疗程后进行统计
(4)疗效评价方法以神经功能缺损评分对治疗前后患者的神智、语言、肢体运动功能等主症进行综合评定；用Fugl-Meyer评价法来评定患者瘫痪侧上下肢运动功能,治疗前和治疗结束后各评定一次；采用Barthel指分级法来评定日常生活能力；治疗前后行经颅多普勒检查,观察各组治疗前后对脑血流的影响。
3研究结果
(1)颞三针为主治疗缺血性中风偏瘫患者神经功能缺损程度(CSS指数)评分及疗效的影响
经治疗1个疗程后,治疗组的功能评分改善要好于对照组,但经统计学比较无显著性差异；治疗组痊愈率,显效率和总有效率均高于对照组,但经Ridit分析,两组间神经功能缺损疗效不存在统计学差异(p>0.05),亦即在改善神经功能缺损方面,未能汪实颞三针+体针疗法优于国家标准头皮针+体针疗法。
(2)颞三针为主治疗缺血性中风偏瘫患者日常生活能力(ADL指数)评分的影响
治疗组要显著优于对照组,且存在统计学差异,p<0.05,提示颞三针+体针在改善患者生活活动能力方面要优于国家标准头皮针+体针治疗。
(3)颞三针为主治疗缺血性中风偏瘫患者运动功能评分及疗效的影响
经治疗后,治疗组的评分改善要好于对照组,经统计学比较,差异显著,p<0.05；在临床疗效方面,治疗组为93.33%,对照组为83.33%；具体疗效,治疗组：痊愈率43.33%,显效率23.33%,有效率26.67%,无效6.67%；对照组方面：痊愈率36.67%,显效率13.33%,有效率33.33%,无效16.67%；对上述数据进行Ridit分析显示,两组数据分布存在统计学差异,p<0.05,提示两组在运动功能评分疗效方面存在显著性差异,治疗组要优于对照组。
(4)颞三针为主治疗缺血性中风患者经颅多普勒指标变化的影响
对照组患者VM治疗前后经配对t检验比较,治疗组各个探测血管血流速度均有增快,除PCA外,经统计学比较,差异有显著意义(P<0.05),PI治疗前后经配对t检验比较,5条动脉的差异均无统计学意义(P>0.05)。
治疗组患者Vm治疗前后经配对t检验比较,ACA, MCA于治疗前后差异显著,经统计学比较,(P<0.05); PCA, VA, BA的差异无显著意义(P>0.05)。PI治疗前后经配对t检验比较,5条动脉的差异均无显著意义(P>0.05)。
治疗组Vm,VA.BA的差值均低于对照组,MCA的差值要高于对照组,数据经成组t检验比较,以上差异显著(P＜0.05)；PCA差异无统计学意义(P>0.05)。PI治疗前后差值经成组t检验比较,5条动脉的组间差值均无显著意义(P>0.05)。
4结论
(1)颞三针为主治疗方案与国家标准头皮针治疗均可显著改善缺血性中风偏瘫患者的神经功能缺损症状,但两种方法未体现明显差异。
(2)颞三针为主治疗方案与国家标准头皮针的治疗均可提高患者日常生活能力(ADL指数)评分,提高缺血性中风患者的日常生活能力,但颞三针要明显优于头皮针。
(3)颞三针为主治疗方案与国家标准头皮针的治疗均可有效地改善缺血性中风偏瘫患者的肢体运动功能,两组在评分及临床疗效方面显著差异,颞三针要优于头皮针。
(4)颞三针为主治疗方案与国家标准头皮针的治疗均可有效地改善缺血性中风偏瘫患者的脑血流速度。
1. Research objects
Ischemic stroke is equivalent to cerebral ischemic stroke of Western medicine, the disease has a high mortality rate, high recurrence rate and high rate of disability and so on, a serious threat to human life and the quality of life. Stroke patients usually left with varying degrees of dysfunction, of which the highest rate of hemiplegia occured, directly affect the quality of life in patients with major factors. Modern clinical studies have shown that acupuncture treatment of ischemic stroke hemiplegia have very positive effects. Present acupuncture treatment of ischemic stroke hemiplegia mainly localized the national standard scalp and body acupuncture treatment. Our preliminary studies indicate that acupuncture treatment of Jin's three-needle to ischemic stroke hemiplegia have significant clinical efficacy.
This study was used stratified random, controlled clinical research methods, to follow the principles of evidence-based medicine, to observe the clinical effects of Jin's three-needle combined with body acupuncture to the hemiplegia after ischemic stroke, and compared with the national standard scalp acupuncture treatment. The Efficacy evaluation indexes included the neurological deficit score, limb motor function of the measured Assessment of activities of daily living, transcranial Doppler and so on. so as to explore the clinical value of Jin's three-needle treatment for the disease.
2. Research Methods
(1) Grouping:60 patients have been selected randomly stratified into 2 groups control principle, the treatment group (Temporal three-needle+body acupuncture group) 30 cases, the control group (the national standard scalp body acupuncture group) 30 cases.
(2) Acupoints
①Temporal three-needle:Department of temporal head, tip, straight, into the hairline 2 inches for the TemporalⅠneedle, needle in the temporal levelⅠ, next to open an inch forward for the TemporalⅡneedle,1 inch for the back side to open the TemporalⅢneedle.
②Scalp Acupoints:Top temporal pre-slash, at the head side, head to head and temporal, from the previous point until Shen-Cong hanging PCT point of connection, the whole point line is divided into five decile, lower limb paralysis to take on the contralateral motor area 1/5, upper limb paralysis in the motor area contralateral to take 2/5, facial paralysis contralateral motor area to take the next 2/5, in this study on the 1/5 and in 2/5, two sports (?)ine area.
③Body acupuncture acupoints:upper shoulder Jian Yu, Qu Chi, Shou San Li, Nei Guang; leg to take Huan Tiao, Yanglingquan, Wei Zhong, Yang Fu, Xue Hai, Kunlun.
④Dialectical acupoints:In addition to the body acupuncture points, the liver yang hyperactivity:Another take Si Guan, Wai Guan, Xing Jian. Wind phlegm:for Fong Long, Yin Ling Quan, Zhong Wan. Phlegm Fu Real:Another take Zhi Kou, Shang Ju Xu, Zusanli. Qi deficiency and blood stasis:Zusanli, Qi Hai, Xue Hai. Yin Wind:Another take Tai Xi, Sanyinjiao, Zhao Hai. Acupoints with the disease:In addition to the body acupuncture points, such as language disadvantage:tongue three needles, Yamen, Lian Quan. Mouth askew:Di Cang, Jia Che, Nei Ting. Memory loss:Si Shen Cong.
(3) Method of operation:Routine disinfection, exposure scalp, separate the corresponding local hair, use a diameter of 0.30mm,80 mm long stainless steel needle, needle showed a 15-20 degree angle with the scalp, quickly penetrate the scalp then quickly needle under the skin along the advance, when the needle reaches aponeurosis of occipitofron talis muscle, when feel a sense of aspiration needle, and then continue to twisting the needle parallel to 20mm, the right hand twisting fast speed for 2 minutes, frequency speed is 180-200 times/minute, and with the other hand while rubbing the scalp motor area along the meridians around the area, to encourage the gas to the disease area. Needle retention for 30 minutes, every 10 minutes manipulating needle one time, temporal three needle puncture method is as follows:first take in the temporalⅠneedle puncture vertically down along the 1.5-inch scalp level, temporalⅠacupuncture needle, the needle in the horizontal temporalⅠforward 1 inch needle temporal DepartmentⅡneedle puncture vertically down along the 1.5-inch scalp level. DepartmentⅢTemporomandibular inch needle after needle puncture vertically down along the scalp,1.5 square inch. Every 10 minutes to level up flat line twisting and diarrhea were mentioned means to intervene Act 1 each. Once a day,5 times a week for 4 weeks as a course of treatment efficacy after 1 courses of statistics, other Chinese and Western medical treatment were the same.
(4) Clinical Evaluation:With neurological deficit score before and after treatment in patients with sanity, language, motor functions of a comprehensive assessment of the primary disease; with the Fugl-Meyer assessment method to evaluate patients with paralysis of limbs on motor function, before treatment and once after the end of the assessment; means the classification method used to evaluate the Barthel activities of daily living; TCD examination before and after treatment were observed before and after treatment on cerebral blood flow.
3. Research results
(1) The efficacy of Temporal three-needle therapy on ischemic stroke patients with hemiplegia neurologic impairment (CSS Index) score In the CSS score and effect analysis, after a course of treatment, the treatment group scores improved better than the control group, but by statistical comparison, have no significant difference; treatment group cure rate, markedly effective rate and total effective rate high than the control group, but after Ridit analysis, neurological impairment between the two groups there is no significant difference in efficacy (p> 0.05), which is to improve the neurological deficit, the failure to confirm the temporal three-pin+body acupuncture is better than national standards Scalp Acupuncture+body acupuncture.
(2) The effect of Temporal three-needle therapy On the activities of daily living (ADL index) score.
As for ADL score, the treatment group is better than the control group, and there was significant difference, p<0.05, suggest temporal three-body acupuncture needle+activity in improving aspects of life of patients is better than the national standard scalp+body acupuncture.
(3) The efficacy and the effect of Temporal three-needle therapy on Ischemic stroke patients with hemiplegia motor function and score
In motor function score and the effect of the analysis, after treatment, the treatment group's score improved better than the control group, by statistical comparison, significant difference, p<0.05; in clinical efficacy in the treatment group was 93.33% in the control group was 83.33%; specific efficacy in the treatment group:43.33% cure rate, markedly effective rate was 23.33%, efficiency 26.67%,6.67% invalid; control group:the recovery rate of 36.67%, markedly effective rate 13.33%, efficiency 33.33% 16.67% invalid; Ridit the above data analysis, two sets of data distribution was significantly different, p<0.05, suggest efficacy of the two groups in motor function score there was significant difference in the treatment group is better than the control group.
(4)The effects of Temporal three-needle therapy on ischemic stroke by transcranial Doppler indexes
Control group before and after treatment in patients with VM compared by paired t test, each treatment group were detected faster blood flow velocity, in addition to PCA, the economic statistics, the difference was significant (P<0.05), PI before and after treatment by paired t test comparison, five arteries were no significant differences (P> 0.05).
Treatment group Vm before and after treatment by paired t test comparison, ACA, MCA before and after treatment significantly different by statistical comparison, P<0.05; PCA, VA, BA of the difference was not statistically significant ((P> 0.05). PI before and after treatment compared by paired t test, five arteries showed no significant (P> 0.05).
Treatment group Vm, VA, BA was lower than the control group the difference, MCA to be higher than the difference of the data by group t test comparison, the above significant difference (P<0.05); PCA difference was not statistically significant. Difference before and after treatment by PI group t test comparison between groups arteries 5 There was no significant difference (P> 0.05).
4. Conclusion
(1) Both Temporal Three Acupuncture treatment program and the national standard scalp acupuncture can significantly improve ischemic stroke patients with hemiplegia of neurological deficit, but does not reflect the significant difference between both methods.
(2) Both Temporal Three Acupuncture program and the national standards can improve the treatment of scalp acupuncture in patients with activities of daily living (ADL index) score, to improve the daily lives of patients with ischemic stroke capacity, the three temporal scalp acupuncture needle is superior.
(3) Both Temporal Three Acupuncture program and the national standard treatment of scalp acupuncture can be improved effectively the patients with ischemic stroke hemiplegic limb motor function, both groups score and clinical efficacy in the significant difference in the temporal scalp acupuncture is better than the three-pin.
(4) Temporal three-needle treatment programs with national standards scalp acupuncture treatment can be effective in improving ischemic stroke patients with hemiplegia of cerebral blood flow.
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