芒针透刺联合通督调神法针刺治疗卒中后疲劳：随机对照试验

李静; 周冰原; 程乐; 朱才丰; 周婷; 杨娅; 陈幸生; 刘睿; 王丽; 王金龙; 杨雨婷; 冯颜庆

doi:10.13703/j.0255-2930.20231114-k0008

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芒针透刺联合通督调神法针刺治疗卒中后疲劳：随机对照试验

临床研究 | 更新时间：2024-10-12

- 芒针透刺联合通督调神法针刺治疗卒中后疲劳：随机对照试验
- Treatment of post-stroke fatigue with point-toward-point insertion of elongated needle and Tongdu Tiaoshen therapy of acupuncture: a randomized controlled trial
- 中国针灸 2024年44卷第10期页码：1114-1118
- 作者机构：
  
  1.安徽中医药大学第一临床医学院，合肥　230038
  2.安徽中医药大学第二附属医院老年病科
  3.安徽中医药大学第二附属医院脑病科
  4.阜阳市中医院康复科
- 作者简介：
  
  李静，副主任医师。E-mail：7427458@qq.com
- 基金信息：
  
  安徽省卫生健康委科研项目(AHWJ2022b081);安徽省中医药学术流派传承工作室建设项目(皖中医药发展秘〔2021〕30号);安徽省自然科学基金项目(2208085MH273);安徽省重点研究与开发计划项目(202104J07020012);安徽省医疗卫生重点专科建设项目(皖卫科教发〔2021〕273号)
- DOI：10.13703/j.0255-2930.20231114-k0008
  中图分类号：
- 收稿：2023-11-14，
  
  网络首发：2024-08-02，
  
  纸质出版：2024-10-12
- 稿件说明：
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李静, 周冰原, 程乐, 等. 芒针透刺联合通督调神法针刺治疗卒中后疲劳：随机对照试验[J]. 中国针灸, 2024,44(10):1114-1118.

LI Jing, ZHOU Bingyuan, CHENG Le, et al. Treatment of post-stroke fatigue with point-toward-point insertion of elongated needle and Tongdu Tiaoshen therapy of acupuncture: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2024, 44(10): 1114-1118. DOI: 10.13703/j.0255-2930.20231114-k0008.
李静, 周冰原, 程乐, 等. 芒针透刺联合通督调神法针刺治疗卒中后疲劳：随机对照试验[J]. 中国针灸, 2024,44(10):1114-1118. DOI： 10.13703/j.0255-2930.20231114-k0008.

LI Jing, ZHOU Bingyuan, CHENG Le, et al. Treatment of post-stroke fatigue with point-toward-point insertion of elongated needle and Tongdu Tiaoshen therapy of acupuncture: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2024, 44(10): 1114-1118. DOI: 10.13703/j.0255-2930.20231114-k0008. DOI：

摘要

目的：

观察芒针透刺对卒中后疲劳（PSF）的影响，并探讨其可能的作用机制。

方法：

将64例PSF患者随机分为观察组（32例，脱落2例）和对照组（32例，脱落2例）。在西医基础治疗和康复运动的基础上，对照组采用通督调神法针刺治疗，穴取百会、四神聪、神庭、风府及双侧风池，每次30 min；在对照组治疗基础上，观察组采用芒针透刺治疗，穴取至阳透大椎、神道透腰阳关、腰奇透腰阳关，每次30 min。两组均每日1次，每周6次，连续治疗4周。观察两组患者治疗前后疲劳严重程度量表（FSS）、匹兹堡睡眠质量指数（PSQI）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）和Fugl-Meyer运动功能评估量表（FMA）评分，采用ELISA法检测两组患者治疗前后血清白细胞介素（IL）-1β、IL-6、IL-10、超敏C反应蛋白（hs-CRP）、同型半胱氨酸（Hcy）含量，并评定临床疗效。

结果：

治疗后，两组患者FSS、PSQI、HAMA、HAMD评分及血清IL-1β、IL-6、hs-CRP、Hcy含量均较治疗前降低（

0.05），FMA评分及血清IL-10含量较治疗前升高（

0.05）；观察组FSS、PSQI、HAMA、HAMD评分及血清IL-1β、IL-6、hs-CRP、Hcy含量低于对照组（

0.05，

0.01），FMA评分、血清IL-10含量高于对照组（

0.05）。观察组总有效率为83.3%（25/30），高于对照组的73.3%（22/30，

0.05）。

结论：

芒针透刺可改善PSF患者的疲劳、焦虑、抑郁、睡眠和运动功能，其机制可能与减轻炎性反应有关。

Abstract

Objective

To observe the effect of point-toward-point insertion of elongated needle on post-stroke fatigue and explore its underlying mechanism.

Methods

Sixty-four patients with post-stroke fatigue were randomly divided into an observation group (32 cases

2 cases dropped out) and a control group (32 cases

2 cases dropped out). In addition to the conventional treatment of western medicine and rehabilitation exercises

Tongdu Tiaoshen

(regulating the governor vessel and the spirit) therapy of acupuncture was used in the control group

and acupuncture was applied to Baihui (GV 20)

Sishencong (EX-HN 1)

Shenting (GV 24)

Fengfu (GV 16) and bilateral Fengchi (GB 20) and the needles were retained for 30 min in one treatment. In the observation group

besides the interventions as the control group

point-toward-point insertion of elongated needle was adopted. The needle was inserted from Zhiyang (GV 9) toward Dazhui (GV 14)

from Shendao (GV 11) toward Yaoyangguan (GV 3) and from Yaoqi (EX-B 9) toward Yaoyangguan (GV 3); and the needles were retained for 30 min in one treatment. In the two groups

the acupuncture was delivered once daily

6 times a week

consecutively for 4 weeks. The scores of the fatigue severity scale (FSS)

Pittsburgh sleep quality index (PSQI)

Hamilton anxiety scale (HAMA)

Hamilton depression scale (HAMD)

and Fugl-Meyer assessment (FMA) were observed before and after treatment completion in the two groups. Using ELISA

the levels of serum interleukin (IL)-1β

IL-6

IL-10

high-sensitivity

C-reactive protein (hs-CRP)

and homocysteine (Hcy) were detected before and after treatment completion; and clinical effect was evaluated.

Results

The scores of FSS

PSQI

HAMA and HAMD

as well as the levels of serum IL-1β

IL-6

hs-CRP and Hcy were reduced (

0.05)

and the scores of FMA and the levels of serum IL-10 were increased (

0.05) after treatment in comparison with those before treatment in the two groups. Compared with the control group

in the observation group

the scores of FSS

PSQI

HAMA and HAMD

and the levels of serum IL-1β

IL-6

hs-CRP and Hcy were reduced (

0.05

0.01)

and the score of FMA and the level of serum IL-10 were increased (

0.05). The total clinical effective rate was 83.3% (25/30) in the observation group

which was higher than 73.3% (22/30) of the control group (

0.05).

Conclusion

The point-toward-point insertion of elongated needle alleviates fatigue

anxiety and depression

and ameliorates sleep and motor function in the patients with post-stroke fatigue. It may be related to the attenuation of inflammatory responses.

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