“灸刺督脉”疗法联合重复经颅磁刺激治疗卒中后疲劳：随机对照试验

王保国; 曹奕; 杨琪琪; 尹维帅; 孙永旗; 赵娜; 李飞

doi:10.13703/j.0255-2930.20240201-k0003

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“灸刺督脉”疗法联合重复经颅磁刺激治疗卒中后疲劳：随机对照试验

临床研究 | 更新时间：2024-12-12

- “灸刺督脉”疗法联合重复经颅磁刺激治疗卒中后疲劳：随机对照试验
- Moxibustion and acupuncture at acupoints of governor vessel combined with repeated transcranial magnetic stimulation for post-stroke fatigue: a randomized controlled trial
- 中国针灸 2024年44卷第12期页码：1363-1369
- 作者机构：
  
  1.安徽中医药大学第一临床医学院，合肥　230012
  2.安徽中医药大学第二附属医院脑病科，合肥　230061
  3.安徽中医药大学第二附属医院名医堂
  4.安徽中医药大学
  5.安徽中医药大学第二附属医院康复科，合肥　230061
- 作者简介：
  
  王保国，安徽中医药大学博士研究生、副主任医师。E-mail：390220068@qq.com
  ✉李飞，主任医师。E-mail：316029622@qq.com
- 基金信息：
  
  国家中医药管理局青年岐黄学者培养项目(国中医药人教函〔2022〕256号);国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号);安徽中医药大学针灸学科平台依托科研项目(2022ZJPT19);安徽省自然科学基金项目(1908085QH371);安徽省高等学校科学研究重点项目(2023AH050820);安徽省第一届卫生健康骨干人才项目(皖卫函〔2022〕392号);安徽省中医药高水平传承人才支持项目(皖中医药发展秘〔2024〕1号)
- DOI：10.13703/j.0255-2930.20240201-k0003
  中图分类号：
- 收稿：2024-02-01，
  
  网络首发：2024-09-12，
  
  纸质出版：2024-12-12
- 稿件说明：
移动端阅览
王保国, 曹奕, 杨琪琪, 等. “灸刺督脉”疗法联合重复经颅磁刺激治疗卒中后疲劳：随机对照试验[J]. 中国针灸, 2024,44(12):1363-1369.

WANG Baoguo, CAO Yi, YANG Qiqi, et al. Moxibustion and acupuncture at acupoints of governor vessel combined with repeated transcranial magnetic stimulation for post-stroke fatigue: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2024, 44(12): 1363-1369.
王保国, 曹奕, 杨琪琪, 等. “灸刺督脉”疗法联合重复经颅磁刺激治疗卒中后疲劳：随机对照试验[J]. 中国针灸, 2024,44(12):1363-1369. DOI： 10.13703/j.0255-2930.20240201-k0003.

WANG Baoguo, CAO Yi, YANG Qiqi, et al. Moxibustion and acupuncture at acupoints of governor vessel combined with repeated transcranial magnetic stimulation for post-stroke fatigue: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2024, 44(12): 1363-1369. DOI： 10.13703/j.0255-2930.20240201-k0003.

摘要

目的：

观察“灸刺督脉”疗法联合重复经颅磁刺激治疗卒中后疲劳（PSF）的临床疗效。

方法：

将78例PSF患者随机分为观察组（39例，脱落1例）和对照组（39例，脱落1例）。两组均予常规内科基础治疗。对照组采用重复经颅磁刺激治疗，每次20 min；观察组在对照组治疗基础上加用“灸刺督脉”疗法，穴取百会、大椎、神庭、风府、至阳、命门、腰阳关，其中百会采用艾灸治疗，大椎采用刺络治疗，其余腧穴予常规针刺治疗，艾灸及针刺均每次30 min。两组均每日1次，连续治疗2周。分别于治疗前后观察两组患者疲劳严重程度量表（FSS）、匹兹堡睡眠质量指数（PSQI）及Fugl-Meyer运动功能评定（FMA）评分，并检测两组患者血清C反应蛋白（CRP）、白细胞介素（IL）-1β、IL-6含量。

结果：

治疗后，两组患者FSS、PSQI评分及血清CRP、IL-1β、IL-6含量较治疗前降低（

0.05），FMA评分较治疗前升高（

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

0.05），FMA评分高于对照组（

0.05）。观察组患者FSS评分与血清CRP、IL-1β、IL-6含量呈正相关（

0.01）。

结论：

“灸刺督脉”疗法联合重复经颅磁刺激可有效缓解PSF患者疲劳程度，改善其睡眠质量、提高肢体功能，其缓解疲劳程度的机制可能与下调血清炎性因子含量有关。

Abstract

Objective

To observe the clinical efficacy of moxibustion and acupuncture at acupoints of the governor vessel combined with repeated transcranial magnetic stimulation (rTMS) in the treatment of post-stroke fatigue (PSF).

Methods

A total of 78 patients with PSF were randomized into an observation group (39 cases

1 case dropped out) and a control group (39 cases

1 case dropped out). The patients in both groups received conventional medical basic treatment. In the control group

rTMS was adopted

20 min each time. On the basis of the treatment in the control group

therapy of moxibustion and acupuncture at acupoints of the governor vessel was delivered in the observation group

Baihui (GV 20)

Dazhui (GV 14)

Shenting (GV 24)

Fengfu (GV 16)

Zhiyang (GV 9)

Mingmen (GV 4) and Yaoyangguan (GV 3) were selected

Baihui (GV 20) was treated with moxibustion

Dazhui (GV 14) was treated with collateral-pricking

other acupoints were treated with conventional acupuncture

moxibustion and acupuncture were sustained for 30 min. The treatment in both groups was given once a day for continuous two weeks. Before and after treatment

the scores of fatigue severity scale (FSS)

Pittsburgh sleep quality index (PSQI) and Fugl-Meyer motor function assessment (FMA) were observed

and the serum levels of C-reactive protein (CRP)

interleukin (IL)-1β and IL-6 were detected in both groups.

Results

After treatment

in the two groups

the FSS and PSQI scores

as well as the serum levels of CRP

IL-1βand IL-6 were decreased compared with those before treatment (

0.05)

while FMA scores were increased compared with those before treatment (

0.05). After treatment

in the observation group

FSS and PSQI scores

as well as the serum levels of CRP

IL-1β and IL-6 were lower than those in the control group (

0.05)

while FMA score was higher than that in the control group (

0.05). The serum levels of CRP

IL-1β and IL-6 were positively correlated with FSS score in the observation group (

0.01).

Conclusion

Moxibustion and acupuncture at acupoints of the governor vessel combined with rTMS can effectively alleviate the fatigue

improve the sleep quality and limb function in PSF patients

its mechanism on alleviating fatigue may be related to the down-regulation of serum inflammatory factors.

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