【作者】 黄博辉；

【导师】 刘伍立；

【作者基本信息】 湖南中医药大学 ， 针灸推拿学， 2006， 博士

【摘要】 对减少偏瘫上肢的积分分别为2.89±0.62、1.70±0.58和1.69±0.38;三组对减少偏瘫下肢积分为3.36±0.94、2.86±0.84和2.76±0.60;三组对减少中风面瘫积分为0.51±0.14、0.49±0.12和0.48±0.17;对减少语言障碍积分为2.85±0.80、2.18±0.43和2.12±0.54。健肢与患肢皮肤平均温差:治疗一组治疗前为2.19±0.06,治疗后为0.52±0.07。治疗三组治疗前为2.06±0.01,治疗后为0.69±0.10。偏瘫患肢阴经与阳经的温差:治疗一组治疗前为0.98±0.28,治疗后为0.12±0.34;治疗三组治疗前为0.90±0.06,治疗后为0.26±0.06。结论:(1)文献研究:中风病病名的表述宜规范和统一,临床宜采用中风病的多级诊断;应探讨中风病病因的生活语言表达以更好地用于中风病的一级预防;进一步探讨中风病证侯的临床应用规律,比较古今各种治疗中风病的针灸方法的优劣,探讨灸法的应用及针灸治疗的最佳治疗方案。(2)临床研究:中风病生命体征稳定后,针刺较早期介入治疗,其整体疗效和进步的等级均优于较晚期介入;中风病患侧肢体皮肤温度低于健侧,患肢阴经皮温低于阳经,针刺通过疏通经络,促进阳气的输布,能提高肢体皮温,同而改善肢体功能。更多还原

【Abstract】 Objective: Through literature study, we systematically summarize and analyze the general situation about the naming, the cause, pathogenesis, symptoms and acupunctural therapy of Stroke. It brings up the clinical diagnosis and acupunctural treatment of Stroke, especially the method to find the pportune moment for treatment. By clinically observing the effect of introducing acupuncture on stroke patients at different stages, we compare the differences of their therapeutic effect, the difference in skin temperature between the affected limb and normal limb, as well as the difference between the Ying and Yang meridians on the affected limb. These provide some reference materials for choosing the suitable time to introduce acupun -crural therapy on stroke patients.Method: (1) Literature study: Papers, which are published after Internal Classic, about Stroke Disease are collected. They are being reviewed and classified according to the disease name, the cause, pathogenesis, symptoms and syndrome, as well as acupunctural therapy. From the reports concerning acupun -crural treatment of Stroke in recent 20 years, we have some generalization and comment on three aspects. It includes early treatment versus recovery treatment, integral treatment versus partial treatment, single treatment versus combined treatment. (2) Clinical study: We have 97 cases of Ischemic stroke patients who are divided into three groups. They are correspondingly given acupunctural therapy 2 weeks, 3 weeks, and 4 weeks after their conditions become stable. Marks and the progression of grading before and after treatment are compared according to "the diagnosis standard and the therapeutic effect judging standard of Stroke by Traditional Chinese Medicine (TCM)". In Treatment Group ONE and THREE, we also compare the differences in skin temperature of (a) the affected and normal limb; and (b) the Ying and Yang meridians on the affected limb.Results: (1) Literature study: TCM documents usually have general discussion on the naming of Stroke; however there are not enough standardization and unification about the descrip -tion of the disease name and clinical diagnosis. "Wind", "Fire", "Phlegm", "Qi", "Blood-stasis", "Deficiency" etc. have been comparatively concluded to be the causes and pathogenesis of Stroke. But this kind of recognition is inadequate for doing primary prevention effectively. There are many discussions about the symptoms and syndrome of Stroke in TCM, but lack of clinical studies on the principle of changes. In addition, the method of acupuncrural therapy for Stroke are largely reported while the comparative study about the method of acupuncture and moxibustion are not sufficient, especially moxibustion is seldom used clinically nowadays. (2) Clinical study: the overall therapeutic effect of Treatment Group ONE, TWO and THREE are 88.24%, 65.71% and 64.28% respectively; The effect of reducing marks on the paralyzed upper limb are 2.89±0.62, 1.70±0.58, 1.69±0.38. By the way, marks decreased on paralyzed lower limb are 0.51±0.14, 0.49±0.12 and 0.48±0.17; marks reduced in aphasia are 2.85±0.8, 2.18±0.43 and 2.12±0.54 respectively in the three Treatment Groups. The difference in temperature on the Yin and Yang meridians of the paralyzed limb: In Treatment Group ONE, the difference before treatment is 0.98±0.28, which is narrowed to 0.12±0.4 after treatment; And in Treatment Group THREE, the difference before and after treatment are 0.90±0.06 and 0.26±0.06 respectively.Conclusion: (1) Literature study: The name of Stroke should be standardize and unified. In clinical practice, multi-grading should be adopted for Stroke diagnosis. Moreover, the causes of Stroke should be described in an ordinary way in order to launch primary prevention effectively. Besides, advanced investigations on the principle of clinical administration about the syndrome of Stroke should be done. Comparison of the good and bad of the various acupunctural treatments on Stoke in ancient and modern time, and the investigation of the use of moxibustion should be carried out in order to search for the best protocol of acupuncture and moxibustion treatment. (2) Clinical study: When the vital signs of stroke patients become stable, acupuncture should be introduced at early stage because its overall therapeutic effect and the progression of grading are better than those adding acupuncture at latter stage. From the study, the skin temperature of affected limb is lower than that of the normal limb, while the skin temperature of Ying Meridian is lower than that of the Yang Meridian. Acupuncture deoppilate meridians and promote the distribution of Yang Qi. Therefore, increasing the skin temperature of the body to improve the functions of limbs.更多还原