盲针法电针治疗中风的前瞻性临床对照研究

目的应用盲针技术研究电针对中风后偏瘫的疗效,并探讨其机制.方法为单盲法前瞻性随机对照临床研究,64例急性期中风患者随机分为治疗组和对照组,治疗组以常规电针治疗,对照组予以盲针通电治疗.在治疗前、治疗第10d和第20d行NIHSS、Fugl-Meyer和Barthel指数评分.在治疗前和治疗第20d行SPECT-rCBF脑显像检查,记录各脑区脑血流灌注(rCBF)情况.结果经治疗后,运动功能及日常生活能力指数均有提高,差异显著(P＜0.05),且治疗组的双侧额叶皮质运动区rCBF明显增加(P＜0.05).结论盲针法能够有效用于针刺的临床疗效研究,针刺与现代神经康复理论相结合,能有效改善急性期中风患者的功能康复,其可能机制系促进脑功能激活后的重组.

A prospective clinical case-controlled study of electro-acupuncture treatment in patients with acute stroke

Objective To study the efficacy and mechanism of electro -acupunc- ture treatment in patients with acute stroke. Methods A prospective single -blind randomly controlled study was used in patients with stroke. 64 cases was randomly di- vided into treatment group and control group. Electro -acupuncture therapy was used in treatment group and placebo needle technique was used in control group. Scores of NIHSS, FMA and MBI were recorded before treatment, 10 and 20 days after treat- ment. Brain SPECT -rCBF image was performed in 33 cases before treatment, and 20 days after treatment. The value of rCBF in each brain region were analyzed. Results The scores of NIHSS, FMA and MBI in treatment group was significantly higher than controled group and value of rCBF in bilateral motor cortexes in trealmard group was signiflicantly increased compared with contreled group. Conclusion Placebo needle technique could be efficiently applied in the study of electro -acupuncture treatment in patients with stroke. Combine electro -acupuncture with modem neuro -rdhabili- tation theory would effectively improve motor function in patients with stroke. The re- sults of brain SPECT -rCBF image showed that the mechanism of electro -acupunc- ture treatment may related to neuronal plasticity and brain function reorganization.