芒针透刺督脉组穴联合平衡区电针治疗脑卒中后小脑性共济失调临床研究

目的 观察芒针透刺督脉组穴联合平衡区电针对脑卒中后小脑性共济失调患者的临床疗效，并探讨其与脑血流速度、脑血流阻力的关系。方法 将60例脑卒中后小脑性共济失调患者随机分为治疗组、对照组，每组30例。对照组予以平衡区电针治疗，治疗组在对照组的基础上联合芒针透刺督脉组穴，每日1次，每次留针30 min，两组均治疗2周。两组治疗前后分别采用国际合作共济失调评定量表（international cooperative ataxia rating scale，ICARS）、Berg平衡量表（Berg balance scale，BBS）评定患者的平衡能力，采用改良Barthel指数（modified Barthel index，MBI）评定患者生活自理能力，采用经颅多普勒超声检测两组患者椎动脉和基底动脉的收缩期峰值血流速度（ peak systolic velocity，PSV）和搏动指数（pulsatility index，PI）。结果 与治疗前比较，两组患者治疗后ICARS评分和椎动脉、基底动脉PI均显著降低（P＜0.05）；BBS、MBI评分和椎动脉、基底动脉PSV均显著升高（P＜0.05）；且治疗后治疗组ICARS评分和椎动脉、基底动脉PI降低程度以及BBS、MBI评分和椎动脉、基底动脉PSV升高程度均显著大于对照组（P＜0.05）。结论 芒针透刺督脉组穴联合平衡区电针疗法可显著改善脑卒中后小脑性共济失调患者平衡功能及生活自理能力。

Clinical Effect of Elongated Needle Acupuncture at Paired Acupoints of the Governor Vessel Combined with Electroacupuncture at the Balance Area in Treatment of Post-stroke Cerebellar Ataxia

Objective To investigate the clinical effect of elongated needle acupuncture at paired acupoints of the governor vessel combined with electroacupuncture at the balance area in the treatment of post-stroke cerebellar ataxia, as well as its association with cerebral blood flow velocity and cerebral blood flow resistance. Methods A total of 60 patients with post-stroke cerebellar ataxia were randomly divided into treatment group and control group, with 30 patients in each group. The patients in the control group were given electroacupuncture at the balance area, and those in the treatment group were given elongated needle acupuncture at paired acupoints of the governor vessel in addition to the treatment in the control group, once a day with needle retaining for 30 minutes each time; the course of treatment was 2 weeks for both groups. Before and after treatment, the International Cooperative Ataxia Rating Scale (ICARS) and Berg Balance Scale (BBS) were used to evaluate balance ability, modified Barthel Index (MBI) was used to evaluate self-care ability of daily living, and transcranial Doppler was used to measure the peak systolic velocity (PSV) and pulsatility index (PI) of the vertebral artery and the basilar artery. Results After treatment, both groups had significant reductions in ICARS score and PI values of the vertebral artery and the basilar artery (P<0.05) and significant increases in BBS and MBI scores and PSV values of the vertebral artery and the basilar artery (P<0.05); compared with the control group, the treatment group had significantly greater reductions in ICARS score and PI values of the vertebral artery and the basilar artery and significantly greater increases in BBS and MBI scores and PSV values of the vertebral artery and the basilar artery (P<0.05). Conclusion Elongated needle acupuncture at paired acupoints of the governor vessel combined with electroacupuncture at the balance area can significantly improve balance ability and self-care ability of daily living in patients with cerebellar ataxia.