本文選題：腦出血 + 病灶對(duì)側(cè)頭針　； 參考：《成都中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：本研究旨在觀察早期病灶對(duì)側(cè)頭電針療法干預(yù)腦出血患者血腫吸收和肢體運(yùn)動(dòng)障礙改善的情況,探討病灶對(duì)側(cè)頭電針療法治療腦出血的療效,為病灶對(duì)側(cè)頭電針療法早期臨床應(yīng)用提供依據(jù)。方法：將96例符合納入標(biāo)準(zhǔn)的腦出血患者隨機(jī)分為試驗(yàn)組(頭電針病灶對(duì)側(cè)組)、對(duì)照組A(頭電針病灶側(cè)組)和對(duì)照組B(基礎(chǔ)治療組),每組32例。對(duì)照組B采用以西醫(yī)內(nèi)科常規(guī)治療、康復(fù)訓(xùn)練及電針患肢為主的基礎(chǔ)治療,對(duì)照組A為基礎(chǔ)治療加上頭電針病灶側(cè)療法,試驗(yàn)組則加用頭電針病灶對(duì)側(cè)療法。三組每日治療1次,10天為一個(gè)療程,每周治療5天,共治療2個(gè)療程。采用測(cè)量CT出血量(血腫體積)、簡化Fugl-meyer運(yùn)動(dòng)功能評(píng)定量表(FMA)、徒手肌力測(cè)量(MMT)為觀察指標(biāo),分別于治療前及第10、20次治療后評(píng)價(jià)各組改善情況；以中醫(yī)癥狀積分為指標(biāo)分別于治療前后比較療效差異及中醫(yī)癥狀改善療效；記錄三組治療期間不良反應(yīng)以評(píng)價(jià)其安全性。結(jié)果：1.臨床療效：組內(nèi)比較,治療前后三組療法對(duì)腦出血患者的療效評(píng)分差異顯著(P0.01)；組間比較,試驗(yàn)組與對(duì)照組A總有效率相當(dāng),無統(tǒng)計(jì)學(xué)差異(P0.05),且均優(yōu)于對(duì)照組B,均有差異(均P0.05)。2.中醫(yī)癥狀方面：組內(nèi)比較,治療后三組療法均可降低中醫(yī)癥狀積分,有統(tǒng)計(jì)學(xué)差異(P0.05)；組間比較,試驗(yàn)組與對(duì)照組A降低評(píng)分程度相當(dāng),無統(tǒng)計(jì)學(xué)差異(P0.05),且均優(yōu)于對(duì)照組B,均有差異(均P0.05)。3.血腫吸收方面：組內(nèi)比較,各時(shí)間點(diǎn)兩兩比較三組血腫體積差異顯著(P0.01),且首次與再次復(fù)查血腫吸收速度差異顯著(P0.01)；經(jīng)組間比較,試驗(yàn)組與對(duì)照組A減小血腫體積程度、促進(jìn)血腫吸收速度相當(dāng),無統(tǒng)計(jì)學(xué)差異(P0.05),均優(yōu)于對(duì)照組B,均有差異(P0.05),且隨治療次數(shù)增多血腫吸收速度增快。4.FMA評(píng)分方面：組內(nèi)比較,各時(shí)間點(diǎn)兩兩比較三組患側(cè)上、下肢FMA評(píng)分差異顯著(P0.01)；經(jīng)組間比較,治療20次后試驗(yàn)組與對(duì)照組A提高患側(cè)上下肢FMA評(píng)分相當(dāng),無統(tǒng)計(jì)學(xué)差異(P0.05),均優(yōu)于對(duì)照組B,均有差異(P0.05)。5.徒手肌力評(píng)定方面：組內(nèi)比較,各時(shí)間點(diǎn)兩兩比較三組患側(cè)上、下肢體遠(yuǎn)近端肌力差異顯著(P0.01)；經(jīng)組間比較,試驗(yàn)組與對(duì)照組A提高患側(cè)肢體遠(yuǎn)近端肌力相當(dāng),無統(tǒng)計(jì)學(xué)差異(P0.05),均優(yōu)于對(duì)照組B,均有差異(P0.05)。6.相關(guān)性分析：出血部位一致時(shí),血腫吸收速度、吸收量與肢體運(yùn)動(dòng)障礙改善呈正相關(guān),均有差異(P0.05)。7.試驗(yàn)過程中共發(fā)生5例不良反應(yīng),其中試驗(yàn)組與對(duì)照組B各有2例,對(duì)照組A有1例,程度均較輕,余未發(fā)生不良反應(yīng)。結(jié)論：三種療法對(duì)于促進(jìn)腦出血患者血腫吸收、肢體運(yùn)動(dòng)障礙改善均有療效,其中頭電針病灶對(duì)側(cè)療法與頭電針病灶側(cè)療法的療效相當(dāng),均優(yōu)于基礎(chǔ)治療；且當(dāng)出血部位一致時(shí),血腫體積減小的越早越快,肢體運(yùn)動(dòng)障礙改善程度越大。
[Abstract]:Objective: to observe the effect of early contralateral electroacupuncture on hematoma absorption and limb motor disorder in patients with intracerebral hemorrhage, and to explore the effect of contralateral head electroacupuncture on intracerebral hemorrhage. To provide evidence for early clinical application of contralateral head electroacupuncture therapy. Methods: 96 patients with intracerebral hemorrhage (ICH) were randomly divided into three groups: experimental group (contralateral group), control group A (lateral group) and control group B (basic treatment group, 32 cases in each group). Control group B was treated with routine western medicine, rehabilitation training and electroacupuncture, while control group A was treated with scalp electroacupuncture lateral therapy, and experimental group was treated with contralateral electroacupuncture therapy. The three groups were treated once a day for 10 days and 5 days a week for 2 courses of treatment. The CT bleeding volume (hematoma volume), simplified Fugl-meyer motor function evaluation scale and free hand muscle strength measurement were used to evaluate the improvement of each group before and after 10 times of treatment. The difference of curative effect and the improvement of TCM symptom were compared before and after treatment, and the adverse reactions during treatment were recorded to evaluate the safety of the three groups. The result is 1: 1. Clinical efficacy: compared with the control group, there was a significant difference in the scores of the three groups before and after treatment (P 0.01), the total effective rate of the trial group and the control group A was the same as that of the control group A, there was no statistical difference (P 0.05), and all of them were better than that of the control group B (all P 0.05 n. 2). In terms of TCM symptoms, the scores of TCM symptoms in the three groups were significantly lower than those in the control group (P 0.05), and the scores of the experimental group and the control group were reduced by the same degree as those of the control group. There was no statistical difference (P 0.05), and all of them were superior to the control group (P 0.05. 3). Hematoma absorption: there were significant differences in hematoma volume between the three groups at each time point, and the difference of hematoma absorption velocity between the first and second reexamination was significant (P0.01A), and the hematoma volume was reduced by comparison between the test group and the control group A, after comparison between the two groups, there was a significant difference in hematoma volume between the three groups. Promote hematoma absorption speed is the same, there is no statistical difference (P 0.05), better than the control group (P 0.05), and with the increase of treatment times hematoma absorption speed increase. 4. FMA score: intragroup comparison, two points of each time to compare the affected side of the three groups, The difference of FMA score of lower extremity was significant (P 0.01). After 20 times of treatment, the FMA score of the upper and lower extremities in the test group and the control group was similar to that in the control group A, but there was no statistical difference (P 0.05), which was better than that in the control group (P 0.05. 5). In the evaluation of unarmed muscle strength, there were significant differences in the muscle strength of the upper and lower extremities between the three groups at different time points (P 0.01), and by comparison between the two groups, the muscle strength of the patients in the test group and the control group A was similar to that in the control group, and there was no significant difference between the three groups in the muscle strength of the distal and proximal extremities of the affected side. There was no statistical difference (P 0.05), which was better than that of control group B (P 0.05). Correlation analysis: the absorption velocity and absorption amount of hematoma were positively correlated with the improvement of limb motor disorder when the bleeding location was the same (P0.05. 7). There were 5 cases of adverse reactions in the course of the experiment, including 2 cases in the test group and 2 cases in the control group B, and 1 case in the control group A, the degree of which was mild, and there was no adverse reaction in the rest. Conclusion: the three kinds of therapy are effective in promoting hematoma absorption and improving limb motor disorder in patients with intracerebral hemorrhage. The contralateral therapy of scalp electroacupuncture is equivalent to the lateral therapy of scalp electroacupuncture, which is superior to the basic treatment. When the bleeding position is the same, the volume of hematoma decreases sooner and faster, and the improvement of limb motor disorder is greater.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.6

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