李莉 王祖红 易荣 曹加伟
(本论文荣获“第四届兰茂论坛”优秀论文二等奖)
[摘要] 目的：观察温阳通督法、常规针刺和常规西药治疗慢性脑供血不足的临床疗效差异。方法：将90例慢性脑供血不足患者随机分为温阳通督组、常规针刺组、药物组，每组30例。药物组口服尼莫地平，每次20mg，2次/d，连续口服10天为一个疗程，治疗2个疗程;常规针刺组穴取百会、大椎、风池(双)、完骨(双)、大杼(双)、颈百劳(双)，采用常规针刺手法;温阳通督组取穴同常规针刺组，只是在所取穴位上加用温针灸，每穴3壮，均每日1次，10天为一疗程，均治疗2个疗程。观察各组患者治疗前后大脑前动脉、基底动脉、大脑中动脉的血流速度变化情况和临床疗效。结果：3种疗法对慢性脑供血不足均有效，温阳通督组总治愈率为53.33 %，明显优于常规针刺组的33.33 %和常规西药治疗组的13.33 %,经颅多普勒检查方面，3组治疗后大脑前动脉、基底动脉、大脑中动脉的平均流速均较前显著上升(p<0.05)，温阳通督法组明显优于常规针刺组和常规针刺组和常规西药组(p<0.05，p<0.01)。结论：温阳通督法是治疗慢性脑供血不足的有效方法，值得临床推广应用。
[关键词]：慢性脑供血不足;温阳通督法;针刺疗法;经颅多普勒
WenYangTong overseers method for the treatment of chronic brain randomized controlled study
Li li, wang zu-hong and cao gawei
(yunnan kunming medical hospital, kunming, yunnan province, yunnan province, 650011)
[ABSTRACT] Objective: to observe the difference of clinical efficacy in the treatment of chronic cerebrovascular deficiency in patients with chronic cerebrovascular disease.Methods: 90 cases of chronic cerebral blood supply were randomly divided into two groups: the group, the normal acupuncture group, the drug group, and 30 patients in each group.The drug group was given a course of 20 mg/d, twice/d, for a course of 10 days and 2 sessions;The conventional acupuncture points, the great vertebrae (double), the great (double), the (double), and the neck (double), and the traditional acupuncture technique;The temperature and yangtong group were treated with the normal acupuncture group, only the acupuncture points were applied to the acupuncture points, each of which was 3 strong, each day 1 time, 10 days for a course of treatment, all treatment 2 sessions.To observe the changes in blood flow rate and clinical efficacy of the anterior cerebral artery, the basal artery, and the arterial artery in the brain before and after treatment.Results: the three kinds of treatments for chronic brain are effective, WenYangTong overseers group total cure rate was 53.33%, significantly better than that of routine acupuncture group were 33.33% and 13.33% of the conventional western medicine treatment group,The average velocity of the anterior cerebral artery, the basal artery, and the arterial artery in the brain was significantly higher in the anterior cerebral artery, the basal artery, and the median of the cerebral artery (p < 0.05).WenYangTong overseers method is superior to conventional acupuncture group and routine acupuncture group and routine western medicine group (p < 0.05, p < 0.01).Conclusion: WenYangTong overseers method is an effective method for treatment of chronic brain, worthy of clinical popularization and application.
[keywords] : chronic brain blood supply is inadequate; The way of the governor; Acupuncture; Transcranial doppler (TCD)
慢性脑供血不足(chronic cerebral circulation insufficiency,CCCI)，又称为慢性脑循环不足，主要是指各种原因导致大脑出现慢性的广泛的供血不足，引发脑部缺血缺氧而出现一系列脑部功能障碍的疾病。临床表现为经常反复出现头晕、头昏重、头痛、伴有心悸、急躁易怒、失眠多梦、记忆力减退等症状。属于中老年常见病、多发病、也是血管性痴呆、阿尔茨海默病、皮质下动脉硬化性脑病等诸多危重病的发展前兆。笔者采用温阳通督法随机对照治疗慢性脑供血不足，现总结如下：
1. 临床资料
1.1一般资料
90例慢性脑供血不足患者，均为我科门诊及住院患者。按照就诊先后顺序随机分为温阳通督组、常规针刺组和常规西药组3组，各30例。3组患者性别、年龄、病程比较差异无统计学意义(均p>0.05),具有可比性，详见表1。
由表2可见，温阳通督组的有效率为100.00%，常规针刺组的有效率为86.66%，常规西药组的有效率为83.33%，相互之间比较无统计学意义(P>0.05)。在治愈方面，温阳通督组和常规针刺组组间比较，差异有统计学意义(P<0.01),表明温阳通督组的临床治愈率明显优于针刺组;温阳通督组和常规西药组间比较，差异有统计学意义(P<0.001),表明温阳通督组的临床治愈率明显优于常规西药组;常规针刺组和常规西药组间比较，差异无统计学意义(P>0.05)。