【作者】 吴志敏；

【导师】 陈兴华；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2012， 硕士

【摘要】 缺血性中风是指各种原因所致脑部血液供应障碍,导致脑组织缺血、缺氧性坏死,出现相应神经功能缺损。现代医学将缺血性中风分为脑血栓形成、脑栓塞、腔隙性脑梗死三种类型。其作为神经系统的常见病,是目前导致人类死亡的三大主要疾病之一,并且存活的患者遗留不同程度的残疾,严重影响患者的生活及工作。目的：本研究将腕踝针应用于缺血性中风偏瘫的临床治疗,并与对照组比较,通过比较患者治疗前后Barthel指数评分(MBI)和神经功能缺损程度评分(NDS),观察腕踝针结合电针治疗缺血性中风偏瘫的临床疗效。探寻治疗缺血性中风的有效的治疗方案。方法：1通过复习文献研究,总结缺血性中风的中西医发病机制及治疗的研究进展,以探究本治疗方案的理论依据及可行性。2临床研究方面,将60例缺血性中风的患者,按随机简单数字表法将其分为治疗组和对照组各30例。对照组采用电针治疗,治疗组采用腕踝针结合电针,隔日一次,疗程为28天。治疗前后分别对两组患者进行Barthel指数评分(MBI)和神经功能缺损程度评分(NDS),并统计两组的临床疗效。结果：1治疗前,治疗组与对照组的一般情况、MBI评分和NDS评分经统计学处理后,P>0.05,无显著差异,无统计学意义,具有可比性。2经治疗后,在临床疗效上,治疗组总有效率为93.3%,对照组的为73.3%,治疗组和对照组的总有效率比较,差异具有统计学意义(P<0.05),说明治疗组疗效明显优于对照组。3两组缺血性中风患者Barthel指数评分比较：经不同的针刺干预后,两组患者Barthel指数评分均有提高,治疗组与对照组Barthel指数评分比较,两组间Barthel指数评分差异具有统计学意义(P<0.05),表明腕踝针结合电针能显著改善患者日常生活能力,且疗效优于对照组。4两组缺血性中风患者NDS评分比较：经不同的针刺干预后,两组患者NDS评分均有降低,治疗组与对照组NDS评分比较,两组间NDS评分差异比较具有统计学意义(P<0.05),表明腕踝针结合电针能明显改善患者神经功能,且疗效优于对照组。结论：1腕踩针结合电针疗法可以明显提高患者Barthel指数评分,显著改善患者日常生活能力,其临床疗效明显优于对照组。2腕踝针结合电针疗法可以明显降低患者神经功能缺损评分,明显改善患者神经功能,且其临床疗效明显优于对照组。3通过对纳入病例的综合评价,腕踝针结合电针治疗缺血性中风偏瘫具有较好的临床疗效。更多还原

【Abstract】 schemic stroke is brain blood supply obstacle caused by various of reasons, which leads to cerebral ischemia, oxygen deficiency necrosis, thereby appears the corresponding neural function defect. Modern medicine divides ischemic stroke into cerebral thrombosis, cerebral embolism and lacunar infarction three types. As a common disease of the nervous system, Ischemic stroke is one of the three major diseases that lead to human death at present, and the survival patients are living with varying degrees of disability, which have serious affect on patient’s life and work.Objective:The study use wrist-ankle acupuncture for Ischemic Stroke hemiplegia treatment, by comparing with the control group, the MB I and NDS scores of patients before and after treatment, to observe the clinical efficacy for Ischemic Stroke hemiplegia when using wrist-ankle acupuncture combined with acusector, so as to find out a more-effective treatment for Ischemic Stroke hemiplegia.Methods:1Based on study and review of literature,to summarize the pathogenesis and research progress on treatment of Ischemic Stroke hemiplegia in Traditional Chinese Medicine and modern medicine, in order to disscuss the theoretical foundation and feasibility of this treatment program.2In the clinical research,60patients with Ischemic Stroke hemiplegia were randomly divided into two groups(treatment group30cases and control group30cases). The control group use acusector for treatment and the treatment group were treated by wrist-ankle acupuncture combined with acusector.Both of the two groups were treated once every other day, a period of treatment is28days. MBI and NDS scores of the two groups of patients were observed before and after the treatment respectively and the clinical efficacy of two groups were analysed.Results:1Before treatment, there was no significant difference in general conditions, MBI and NDS scores between the two groups after statistic analysis (P>0.05), comparability was available.2After the treatment, in clinical efficacy, the total effective rate was93..3%for the treatment group and73.3%for the cotrol group. There was significant difference between the two groups total effective rate (P<0.05), which suggests the treatment group better than the control group in clinical efficacy.3MBI Scale test for two groups:after different acupuncture intervention, the scores of MBI for both group were improved, there was significant difference in MBI between the two groups (P<0.05), it indicates that Wrist ankle acupuncture combined with acusector can improve patients’daily living skills significantly and the clinical efficacy is better than the cotrol group.4NDS Scale test for two groups:after different acupuncture intervention,the scores of NDS for both group were declined, there was significant difference in NDS scores between the two groups (P<0.05), it indicates that Wrist ankle acupuncture combined with acusector can improve patients’neurological functions and the clinical efficacy is better than the cotrol group.Conlusion:1Wrist ankle acupuncture combined with acusector can markedly improve patients’s MBI scores and daily living skills, the clinical efficacy is significantly better than the cotrol group.2Wrist ankle acupuncture combined with acusector can markedly reduce patients’s NDS score, it can improve patients’neurological functions significantly, the clinical efficacy is obviously better than the cotrol group.3According to the overall evalution of the caces accepted, wrist-ankle acupuncture combined with acusector has good clinical curative effect on ischemic stroke hemiplegia.更多还原