| 摘要: | 中醫針刺對急性期腦血管疾病之治療效果常有所爭議,現代醫學治療其方向皆為希望減低腦壓、增加腦部血液灌流,以期減少急性期腦細胞之傷害,獲得日後病患功能之最大保留和恢復,而現在科技已可直接測量腦內壓,知道腦部血流之情況及各種治療的療效,本實驗以此技術瞭解針刺對急性腦血管疾病生理影響和療效。方法:篩選60例出血型腦中風的患者作為研究對象,手術24小時後按隨機分組法分為實驗組、對照組各30例,所有研究對象均在加護病房持續測定腦內壓、中央靜脈壓、心跳、血壓,實驗組針刺:人中, 雙側內關,三陰交;對照組:不予針刺。兩組皆在施術前後測量上述各參數值,實驗組並加電針維持針感,30分鐘後再測各參數值;另外使用中谷義雄於1950 年發表,沿用迄今的十二個良導點為測量位置,左右側共廿四個電透點,記錄針刺前後其十二經絡皮膚電阻各良導點電阻值變化之狀況。以上病人針刺每日一次,連續三日,每次留針30分鐘。將所測參數值與基本值每組數據以平均值.plmin.標準差表示,然後用Student's-t test及單因子變異數分析計算其p值,若p<0.05則認為有統計學上之意義,以此來評估研究針刺對腦灌流的影響。主要發現:由研究顯示針刺結果可以降腦內壓,促進腦組織的灌注,雖暫時無明顯臨床症狀改善,但對急性期出血性腦中風病患術後腦傷的改善、腦功能的保護及體質的調整仍有正面的意義。經絡電阻測定出血性中風手術後針刺前後電流變化情形發現,針刺可增加經穴導電度,顯示體能化隨之升高。
The efficacy of Acupuncture for CVA is always argumentative. The contemporary medical treatments are often concentrated on reducing the cerebral pressure and increasing the cerebral circulation, in order to decrease further cerebral injury. Therefore, hopefully most of the motor and sensory functions can be maintained and also shorten the recovery period. Nowadays medical technologies can be used to measure cerebral pressure or by using intracranial pressure monitor, cerebral circulation can be monitored and therefore, the effectiveness of the treatment can be evaluated. These medical facilities can be used to investigate cerebral pressure and circulation during acupuncture treatment, in order to understand the physiological changes and evaluate the treatment efficacy. Sixty CVA subjects were selected for this study. Random selection method was used to group 60 patients evenly into treatment group and control group. All subjects were under respiratory, cardiac and blood pressure monitoring at the ICU. Intracranial pressure and Central Vein Pressure were measured continuously. Acupoints, such as, Gv26, Pc6 (both) and Sp6 (both) were punctured in treatment group. No treatment for control group but adhesive circular band aids with 0.3cm diameter were used to place on the same acupoints in the treatment group. Reading for the both groups were obtained before treatment. Electro-acupuncture was used in treatment group. 30 minutes later post-treatment reading was obtained. In addition, the electrical resistance of the 12 Electro-permable points that based on Dr. Nakatani and his related colleagues, which published in 1950, were measured before and after the treatment. Also the changes of the subcutaneous resistance before and after the treatment were obtained and analysis. Treatment was given once a day in 3 concessive days.Needles were retained for 30 minutes. All data were statistics by Student's-t test If the p value <0.05 they would show significance on statistics. This study shows that the datas of intracranial pressure decrease, cerebral prefusion promote, these coordinate with the increase of GCS and in the electronic value of Electro-permable points after Acupuncture. It means that acupuncture on some special acupoints may promote Qi especial in weakness body. |
