简介:目的:观察舌咽局部深刺治疗中风后吞咽障碍临床疗效。方法:对85例中风后吞咽障碍患者,采用舌咽局部深刺法,先快速点刺舌面(以舌瘫侧为主)、舌下金津、玉液,次取75mm长度毫针点刺患侧咽后壁约3-4次后快速出针。再取廉泉穴,以75mm长度毫针向舌根方向直刺,针刺得气后,向舌根方向推进留针,深度约60-70mm,此时可令患者做吞咽动作,有障碍感但不疼痛为度,留针30min,期间施捻转补法2次。以上操作每日1次,6天为一疗程,休息1天后进入第2疗程,共治疗4个疗程。以洼田氏饮水试验评价量表进行疗效评定,第2周及第4周结束后各评价1次。结果:治疗初期洼田氏饮水试验评分为5.08±2.28分,采用舌咽局部深刺法治疗第2周后评分为4.56±2.32分,总有效率为89.4%,第4周后评分为2.80±2.12分,总有效率为95.3%,治疗2周、4周后,洼田氏饮水试验评分均较治疗前明显降低(P〈0.05,P〈0.01)。结论:舌咽局部深刺治疗中风后吞咽障碍有较好的临床疗效。
简介:'Mountainburningmanipulation(烧山火)'and'heavenlycool-inducingtechnique(透天凉)'wereearlyseeninGreatCompletionofAcupunctureandMoxibustion:PoemofGoldenNeedle(《针灸大全·金针赋》)writtenbyXuFenginMingdynasty,whicharethebasisofreinforcingandreducingmanipulationofacupuncture.Insuchneedlingmanipulations,severalconditionsareconsidered,suchasthespeedofinsertionandwithdrawalofneedle,liftingandthrustingofneedle,nineyangnumberandsixyinnumber,aswellasopenorcloseofpointafterwithdrawal;additionally,theneedlingmanipulationsareaccomplishedinthreelayers,namedheaven,earthandhumanbeing.Themanipulationsofthesetwotechniquesarecomplicatedandarenoteasilymastered,therefore,thesuccessfulrateoftheclinicalapplicationisratherlowandthemanybeginnersfeeldifficultinlearning.Inrecent20years,onthebasisoftheoriginaltechniques,byconstantdiscussion,akindofsimplemanipulationhasbeendevelopedandthesuccessoftheoperationbecomesquitehigh.During10years,from1978to1997,bythestatisticalanalysisontheclinicaldataof'mountainburningmanipulation(烧山火)'and'heavenlycool-inducingtechnique(透天凉)',thesuccessfulrateinclinichadbeenover90%.Thefollowingistheintroductiononthemodifiedoperation,stepsandclinicalapplication.
简介:目的:探讨醒脑开窍针刺治疗脑梗死恢复期的远期疗效及安全性。方法:脑梗死恢复期患者234例,以SAS编码,随机分配到醒脑开窍针刺组和常规针刺组(简称醒脑组和常规组)。醒脑组116例,接受醒脑开窍针剌(每日1次,共4周)和西医常规治疗;常规组118例,接受常规针刺和西医常规治疗。随访6个月。主要指标:随访期末生存、治疗和复发情况。次要指标:随访期末神经功能评估,针刺过程中不良事件发生率。结果:6个月随访时醒脑组病死率(0.86%)、继续治疗率(36.21%)与常规组(1.69%、36.44%)差异无统计学意义(X^2=0.29,P=0.59;X^2=0.32,P=0.57),在降低复发率、改善神经功能方面醒脑组优于常规组(P〈0.01);两组均未出现严重不良反应。结论:醒脑开窍针刺是安全的,其远期疗效在降低复发率、改善神经功能方面优于常规针刺。