【作者】 李忠；

【导师】 何扬子；

【作者基本信息】 暨南大学 ， 中西医结合临床， 2009， 硕士

【摘要】 目的:本研究从循证医学的角度出发,评价针刺治疗缺血性中风的临床疗效,为针灸临床提供可靠的依据。方法:采用循证医学的方法,全面检索近10年来针刺治疗缺血性中风的临床研究文献共98篇,系统分析采用SPSS 13.0及EXCEL 2003统计软件,Meta分析时采用Revman4.2根据文献异质性检验结果,采用选择随机效应模型或采用固定效应模型进行计算。对于二分类变量资料计算相对危险度R R及合并效应量假设检验及95%可信区间(CI)估计。结果:Meta分析不论A级,B级或不分级的资料文献中发现针刺治疗缺血性中风的针刺合并其它治疗对比单一非针刺治疗、针刺加西药对比西药之有效率、总显效率及痊愈率有差异,有统计学意义(P＜0.01),显示针刺合并其它治疗方案、针刺加西药治疗方案较优胜。针刺治疗缺血性中风腧穴应用频率以头颈部取穴最多,针刺参数以每次治疗运针2次,每次运针2分钟最好,捻转手法及补法应用最多,留针不超过60分钟及每日针刺治疗1次为宜。结论:根据1998至2008年文献中的统计数据显示:针刺治疗缺血性中风是有效的,缺血性中风非针刺疗法只要加入针刺治疗一般也可把其疗效提高。针刺治疗缺血性中风要多取阳经及头部腧穴,每次治疗应运针2次,且每次运针2分钟以上,并运针过程中要有得气感;要熟练捻转手法及施补法,留针不超过60分钟,每日针刺治疗1次。每疗程结束时应做1次疗效评估。更多还原

【Abstract】 Objective:In view of evidence-based medicine(EBM) analysis,the purpose of this study is to systematically assesses the efficacy of Ischemic Stroke(IS) Patients by acupuncture so as to providing the reliable scientific evidence for medical health care practice.Methods:The study first captures extensive literature reviews on the clinical trials(RCTs) that use acupuncture as the main intervention to treat Ischemic Stroke since 2000s.98 reports were collected for the study.SPSS 13.0 and EXCEL 2003 software packages were used to analyze the data.Statistical heterogeneity among these RCTs was performed by using the statistical software Review Manager(RevMan 4.2),and a fixed effect model or random effect model was selected with combined RR and 95%CI calculated.Results:98 papers were included,of which there were A or B under JADAD measurement.The findings disclose that there were highly significant statistical difference between two groups in excellence and total effective rates(P＜0.01),the therapeutic effect of acupuncture with other treatments to treat IS was better than that of non-acupuncture.With the same reason,acupuncture with western medicine treatments was superior to western medicine.For the reliable curative effect of IS patients,the acupoints in the area of head and neck were mostly treated with acupuncture needle,and the needles were normally kept for not more than 60 minutes once a day.Striving for better results,twirling manipulation and notification method had been widely employed in clinical IS patients for 2 minutes at a time,twice per treatment.Conclusion:According to statistic analysis of literature from 1998 to 1998 statistics:acupuncture treatment of ischemic stroke is effective,the non-acupuncture therapy of ischemic stroke could general improve its curative effect as treatment with acupuncture.Acupuncture treatment of ischemic stroke to take the acupoints of Yang meridians and head,were mostly treated above 2 minutes at a time,twice per treatment above,also with sensitive.Twirling and Giving Method manipulation were highly recommended but the needles were normally kept for not more than 60 minutes at a time and treatment once a day.An analysis of curative effect should be taking per period of treatment.更多还原