Acupuncture Intervention in Ischemic Stroke: A Randomized Controlled Prospective Study
Acupuncture Intervention in Ischemic Stroke: A Randomized Controlled Prospective Study
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DOI：
10.1142/s0192415x12500516
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发表时间：
2012-01-01
影响因子：
5.7
通讯作者：
Shi, Xue-Min
中科院分区：
文献类型：
--
作者：
Shen, Peng-Fei;Kong, Li;Shi, Xue-Min
卒中是最常见的死亡原因之一，很少有药物治疗在缺血性卒中中显示出益处。本研究选取290例40-75岁的急性缺血性脑卒中首发患者（发病24 h以上14 d内），采用常规治疗，随机分为干预组（复苏针治疗）和对照组（假穴治疗）。主要结果指标包括Barthel指数（BI），复发和死亡长达6个月。在两组的290例患者中，干预组有1例死亡，对照组有2例死于疾病（p 0：558）。干预组144例中有6例复发，对照组143例中有34例复发（P <0.001）。两组6个月时的BI平均值分别为70：25 +/- 20：37和57：43 +/- 19：61（p < 0：01）。针灸导致两组之间的国立卫生研究院卒中量表（NIHSS）有显著差异，不是在两周时（7.03 +/- 3.201 vs. 8.13 +/- 3.634; p = 0.067），而是在四周时（4.15 +/- 2.032 vs. 6.35 +/- 3.131，p < 0.01）。4周时，中国卒中量表（CSS）显示干预组比对照组改善更多（9.40 ± 4.51 vs. 13.09 ± 5.80，p < 0.001）。6个月时，干预组的卒中特异性生活质量量表（SS-QOL）（166.63 +/- 45.70）高于对照组（143.60 +/- 50.24; p < 0.01）。这项临床试验的结果显示，与在假穴位针刺相比，在六个月结束时，用复苏针灸干预治疗的患者的复发率有临床相关性降低。采用BI、NIHSS、CSS、Oxford Handicap Scale（OHS）、SS-QOL等量表进行评定，复苏针刺干预能提高患者的生活自理能力和生活质量。
Stroke is one of the most common causes of death and few pharmacological therapies show benefits in ischemic stroke. In this study, 290 patients aged 40-75 years old with first onset of acute ischemic stroke (more than 24 hours but within 14 days) were treated with standard treatments, and then were randomly allocated into an intervention group (treated with resuscitating acupuncture) and a control group (treated using sham-acupoints). Primary outcome measures included Barthel Index (BI), relapse and death up to six months. For the 290 patients in both groups, one case in the intervention group died, and two cases in the control group died from the disease (p 0: 558). Six patients of the 144 cases in the intervention group had relapse, whereas 34 of 143 patients had relapse in the control group (p < 0: 001). The mean values for BI at six months were 70: 25 +/- 20: 37 and 57: 43 +/- 19: 61 for the two groups, respectively (p < 0: 01). Acupuncture resulted in a significant difference between the two groups for the National Institute of Health Stroke Scale (NIHSS), not at two weeks (7.03 +/- 3.201 vs. 8.13 +/- 3.634; p = 0.067), but at four weeks (4.15 +/- 2.032 vs. 6.35 +/- 3.131, p < 0.01). The Chinese Stroke Scale (CSS) at four weeks showed more improvement in the intervention group than that in the control group (9.40 +/- 4.51 vs. 13.09 +/- 5.80, p < 0.001). Stroke Specific Quality of Life Scale (SS-QOL) at six months was higher in the intervention group (166.63 +/- 45.70) than the control group (143.60 +/- 50.24; p < 0.01). The results of this clinical trial showed a clinically relevant decrease of relapse in patients treated with resuscitating acupuncture intervention by the end of six months, compared with needling at the sham-acupoints. The resuscitating acupuncture intervention could also improve self-care ability and quality of life, evaluated with BI, NIHSS, CSS, Oxford Handicap Scale (OHS), and SS-QOL.