针刺对不同分型脑卒中神经功能缺损的疗效观察

目的探讨针刺治疗不同牛津郡社区脑卒中项目（OCSP）分型的脑卒中偏瘫患者的神经功能缺损的疗效。方法按照随机化和多中心的临床试验原则,根据OCSP分型将患者分为腔隙梗死组（LA-CI）、完全前循环梗死组（TACI）、部分前循环梗死组（PACI）和后循环梗死组（POCI）4种亚型,再将患者随机分成2组。2组均予对症治疗,并常规给予阿司匹林肠溶片、硫酸氯吡格雷片口服治疗。治疗组采用针刺治疗,对照组采用不完整针刺,2组均3个月为1个疗程,分别于治疗前及治疗1、3、6、12个月进行改良爱丁堡-斯堪的纳维亚量表（MESSS）评定。结果LAC I亚型治疗组与对照组比较差异无统计学意义（P〉0.05）,PAC I、POC I亚型第3-12个月治疗组与对照组比较差异均有统计学意义（P〈0.05）。TAC I第3个月、第6个月对照组与对照组比较差异均有统计学意义（P〈0.05）。,第12个月治疗组与对照组比较差异无统计学意义（P〉0.05）。结论针刺疗法对不同OCSP分型的脑卒中患者神经功能缺损的康复效果不同,对PAC、IPOC I亚型有明显促进作用。

Effects of acupuncture on neurotic disorder of stroke in 4 subtypes based on the OCSP

Objective To explore the effect of acupuncture on neurotic disorder of stroke in 4 subtypes based on the Oxfordshire community stroke project （OCSP）. Methods Stroke patient were divided into 4 subtypes （LACI, TACI, PACI, POCI） based on the OCSP clinical classification. Patients in each subtype were randomly divided into two groups, treatment group and control group. The patients in treatment group were treated by combination of acupuncture and routine therapy. The patients in control group were treated by routine therapy combined with imperfect acupuncture. The course was three months in two groups. All patients were assessed with the MESSS before treatment and 1st, 3rd, 6th, 12th month after treatment. Results There was no significant difference between control group and treatment group for the score of MESSS in the LACI （ P 〉 0.05）. There was significant difference between treatment group and eontrul group on the score of MESSS in PAC1 and POCI at 3rd, 6th and 12th month after treatment （ P 〈0.05）. In the TACI, there was significant difference between the two groups on the score of MESSS at 3rd and 6th month ＋alter treatment （ P 〈0.05）. Conclusion Acupuncture has different effect on the rehabilitation of neurologic impairment in 4 subtypes based on the OCSP. Acupuncture can obviously improve MESSS in the PACI and POCI.