摘要
目的探讨巨刺治疗对大脑中动脉闭塞型脑梗死患者的神经功能康复及脑血流动力学的影响。方法纳入64例大脑中动脉闭塞型脑梗死住院患者,随机分为对照组和观察组,每组32例。对照组接受常规西医药物治疗,观察组在对照组基础上增加巨刺治疗。治疗前后采用蒙特利尔认知评估量表(MoCA)、简明Fugl-Meyer运动功能评估量表(SFMA)和功能独立性评定量表(FIM)进行评分,比较两组神经功能评分差异。治疗前后通过经颅多普勒(TCD)检查双侧大脑前动脉(ACA)和大脑后动脉(PCA)的平均流速(MV),并计算患侧与健侧的流速比值(MVi ACA/MVc ACA、MVi PCA/MVc PCA),比较两组血流动力学差异。治疗前后进行CT血管造影(CTA)检查,采用Tan评分系统和区域软脑膜评分(rLMC)比较两组患者侧支循环评分差异。3个月后进行随访,比较两组缺血性卒中复发率和全因死亡率差异。结果观察组治疗后SFMA、FIM评分均高于对照组,组间差异有统计学意义(P<0.05)。治疗前后SFMA评分差值、FIM评分差值观察组均高于对照组,差异有统计学意义(P<0.05)。治疗后观察组MoCA评分高于对照组,差异无统计学意义(P>0.05)。治疗后观察组MVi ACA、MVi PCA、MVi ACA/MVc ACA、MVi PCA/MVc PCA均高于对照组,差异有统计学意义(P<0.05)。治疗后两组rLMC评分、Tan评分差异无统计学意义(P>0.05);3个月随访时,两组缺血性卒中复发率及全因死亡率差异无统计学意义(P>0.05)。结论巨刺治疗能够改善大脑中动脉闭塞型脑梗死患者的临床预后,促进运动功能康复,并改善脑血流动力学。
Objective To explore the impact of acupuncture therapy on the neurological rehabilitation and cerebral hemodynamic changes in patients with middle cerebral artery occlusion stroke.Methods A total of 64 hospitalized patients with middle cerebral artery occlusion stroke were randomly divided into a control group and an observation group,each consisting of 32 cases.The control group received conventional western medical treatment,while the observation group received acupuncture therapy in addition to the treatment of the control group.Before and after treatment,the Montreal Cognitive Assessment(MoCA),the Simplified Fugl-Meyer Motor Function Assessment(SFMA),and the Functional Independence Measure(FIM)were used to score and compare the differences in neurological function scores between the two groups.Before and after treatment,transcranial Doppler(TCD)examination was performed to observe the average flow velocity(MV)of the anterior cerebral artery(ACA)and the posterior cerebral artery(PCA)on both sides,and the flow velocity ratio between the affected side and the healthy side(MViACA/MVcACA,MViPCA/MVcPCA)was calculated to compare the differences in hemodynamic changes between the two groups.Before and after treatment,CT angiography(CTA)examination was performed,and the Tan scoring system and regional leptomeningeal collateral(rLMC)scoring were used to compare the differences in collateral circulation scores between the two groups.Follow-up was conducted after 3 months to compare the differences in the recurrence rate of ischemic stroke and all-cause mortality between the two groups.Results After treatment,the SFMA and FIM scores of the observation group were higher than those of the control group,and the differences between the groups were statistically significant(P<0.05).The differences in SFMA and FIM score changes before and after treatment in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the MoCA score of the observation group was higher than that of the control group,but the difference was not statistically significant(P>0.05).After treatment,the MViACA,MViPCA,MViACA/MVcACA,and MViPCA/MVcPCA of the observation group were all higher than those of the control group,and the differences were statistically significant(P<0.05).The differences in rLMC scores and Tan scores between the two groups after treatment were not statistically significant(P>0.05).At the 3-month follow-up,the differences in the recurrence rate of ischemic stroke and all-cause mortality between the two groups were not statistically significant(P>0.05).Conclusion Acupuncture therapy can improve the clinical prognosis of patients with middle cerebral artery occlusion stroke,promote motor function recovery,and improve cerebral hemodynamics.
出处
《浙江临床医学》
2025年第1期56-58,共3页
Zhejiang Clinical Medical Journal
基金
国家自然科学基金青年科学基金资助项目(8210151266)
浙江省中医药科技计划项目(2020ZB119)。
关键词
大脑中动脉闭塞
脑梗死
巨刺
侧支循环
神经康复
Middle cerebral artery occlusion
Cerebral infarction
Acupuncture
Collateral circulation
Neurological rehabilitation
