摘要
目的:比较针刺素髎与水沟为主对重型颅脑损伤昏迷促苏醒的临床疗效差异,为临床取穴提供参考依据。方法:在神经外科常规急救与手术后的基础上,待病情相对稳定,将82例颅脑损伤昏迷患者随机分为观察组(42例)和对照组(40例)。观察组取素髎为主穴,劳宫、涌泉等为辅穴,内关、三阴交、翳风、完骨等为配穴,施强刺激促苏醒针刺手法治疗;对照组取水沟为主穴,辅穴和配穴同观察组,同样施强刺激促苏醒手法治疗。两组均每日治疗1次,每周5次,10次为一疗程。观察素髎穴与水沟穴针刺后即刻的临床表现,以及两组患者治疗45天、90天后昏迷GCS评分改善程度,评价两组患者苏醒时间和苏醒率,并比较两组临床疗效。结果:观察组针刺后喷嚏反射出现率为85.7%(36/42),较对照组针刺后表现的喷嚏反射反应强烈[25.0%(10/40),P<0.01];观察组平均苏醒时间较对照组明显缩短[(64.6±19.4)天vs(73.8±14.6)天,P<0.05];观察组与对照组苏醒率相当[88.1%(37/42)vs 75.0%(30/40),P>0.05];两组治疗后昏迷GCS评分均较治疗前明显提高(均P<0.01);观察组治疗90天后昏迷GCS评分优于对照组(9.52±2.32vs 8.47±2.14,P<0.05);观察组愈显率为45.2%(19/42),优于对照组的22.5%(9/40,P<0.05)。结论:针刺素髎为主对重型颅脑损伤昏迷患者的促苏醒作用疗效确切,具有特有的促进喷嚏反射和兴奋呼吸中枢的功能,较针刺水沟为主促苏醒作用明显。
Objective To compare the clinical therapeutic effects differences between acupuncture at Suliao （GV 25） and Shuigou （GV 26） on promoting regain of consciousness from coma in severe craniocerebral injury. Methods Based on regular emergency treatments of neurosurgery, eighty-two cases of craniocerebral injury who were under stable condition were randomly divided into an observation group （42 cases） and a control group （40 cases）. Suliao （GV 25） was selected as main aupoint, while Laogong （PC 8） and Yongquan （KI 1）, etc. were selected as adjuvant acupoints and Neiguan （PC 6）, Sanyinjiao （SP 6）, Yifeng （TE 17） and Wangu （GB 12）, etc. were selected as matching acupoints in the observation group where a strong needle manipulation was applied to improve the regain of consciousness. The main acupoint of Shuigou （GV 26） along with identical adjuvant acupoints and matching acupoints in the observation group were selected in the control group with identical strong needle manipulation. The treatment was given once a day in both groups, five times per week and ten times were considered as one session. The immediate clinical symptoms after acupuncture at Suliao （GV 25） and Shuigou （GV 26） were observed as well as Glasgow coma scale （GCS） before the treatment, after 45 days and 90 days of treatment to assess the resuscitation time and rate. Also the clinical efficacy was compared between both groups. Results The occurrence rate of sneezing reflex was 85.7%（36/42） in the observation group, which was higher than 25.0% （10/ 40） in the control group （P〈0.01）. The average resuscitation time was （64. 6±19.4） days in the observation group, which was obviously shorter than （73.8±14.6） days in the control group （P〈0.05）. The resuscitation rate was 88. 1%（37/42） in the observation group, which was similar to 75.0% （30/40） in the control group （P〉 0.05）. Compared before the treatment, GCS were both improved after the treatment in two groups （both P〈0.01）. The 90-day GCS was 9.52±2.32 in the observation group, which was superior to 8. 47±2. 14 in the control group （P〈 0. 05）. The curative and markedly effective rate was 45.2% （19/42） in the observation group, which was superior to 22.5% （9/40） in the control group （P〈0.05）. Conclusion The effect of acupuncture at Suliao （GV 25） on improving regain of consciousness from coma in severe eranioeerebral injury is positive. It could specifically improve sneezing reflex and stimulate respiratory center, which has more obvious effect than acupuncture at Shuigou （GV 26）.
出处
《中国针灸》
CAS
CSCD
北大核心
2014年第6期529-533,共5页
Chinese Acupuncture & Moxibustion
基金
莆田市科技局医学指导项目:莆市科2011D01号
关键词
颅脑损伤
昏迷
针刺疗法
促苏醒
穴
素髎
穴
水沟
cranioeerebral injury
coma
acupuncture therapy
promoting resuseitation
Point GV 25 （Suliao） Point GV 26 （Shuigou）
