【作者】 楚佳梅；

【导师】 孙忠人；

【作者基本信息】 黑龙江中医药大学 ， 针灸推拿学， 2003， 博士

【摘要】 假性球麻痹是脑卒中常见的合并症，其中吞咽困难与致残率和死亡率的增高均有关，并可独立影响死亡率。各种并发症的发生影响脑卒中的康复进程，其防治工作已成为临床治疗中的一个热点。 本文选取颈项部腧穴为主治疗多发性脑梗塞所致的假性球麻痹，设立对照组，通过对吞咽、言语功能的疗效判定、听觉诱发电位、经颅多普勒超声和并发症发生率进行了对比研究，结果显示：1．项针可明显改善假性球麻痹病人的吞咽和言语障碍，提高吞咽和言语功能分级，疗效评定优于对照组，且吞咽功能的恢复优于言语功能；2．项针可减少假性球麻痹病人并发症的发生率，且针刺后无明显不良反应；3．项针能有效缩短假性球麻痹病人BAEP各波潜伏期和峰间潜伏期，重现和提高各波波幅；4．项针能明显改善椎-基底动脉的血液供应。以上结果提示项针治疗假性球麻痹的机理可能是提高了病人脑神经细胞的兴奋性，使可逆神经细胞复活或被抑制的神经细胞觉醒，项针对脑血液循环的改善可能是脑神经功能改善的基础。 此外，本文还对影响针刺疗效的因素进行了分析，结果显示：针刺疗效与发病次数和病灶数有关，而与年龄、病程、病变部位无关。更多还原

【Abstract】 Pseudobulbar palsy is combined symptom of cerebral apoplexy, thereinto dysphagia correlate with high death and disability rate,while it can independently effect death rate. Because various combined symptom effect rehabilitation processes of cerebral apoplexy.it’s still an important research subject in present medicine field.The thesis selected acupoint of nuchal region to treat pseudobulbar palsy due to multi-infarct,while the controlled group was established.The controlled study was carried out by effect determination of swallowing and Language function , auditory evoked potential , transcranial Doppler, incidence of combined symptom.The results indicated: 1.Nape needle can obviously ameliorate swallowing and Language function handicap of the patients with pseudobulbar palsy and improve swallowing and Language function grade.Its clinical effect was better than the controlled group,while the recovery of swallowing function exceed Language function.2. Nape needle can decrease incidence of combined symptom of the patients with pseudobulbar palsy,while it hadn’t obvious ill effect.3. Nape needle can effectively shorten incubation period of BAEP and two peak interval of the patients with pseudobulbar palsy,and can reappear and improve amplitude of wave.4. Nape needle can obviously ameliorate blood supply of vertebro basilar artery.The above-mentioned results illustrate: the mechanism of pseudobulbar palsy treated with nape needle was possible that it could improve excitabilitv of cranial nerve cell, resurrect reversible nerve cell and awaken inhibited nerve cell. Nape needle could ameliorate cranial nerve function by improving cranial blood circulation.In addition,the thesis analyzed the factor which can influenc acupuncture effect.The results showed: acupuncture effect correlated with morbidit frequency and focal number, while didn’t correlated with age, course, locus.更多还原