| 摘要: |
| 目的：观察朱琏针灸兴奋Ⅱ型手法治疗脑梗死恢复期合并呼吸功能障碍45例联合常规康复方案治疗脑梗死恢复期呼吸功能障碍患者的临床疗效。方法：将100例脑梗死恢复期呼吸功能障碍患者随机分为治疗组和对照组，每组各50例。对照组予以西医常规治疗，治疗组在对照组基础上联合朱琏针灸兴奋Ⅱ型手法治疗，2组均连续治疗3周。于治疗前、治疗后1周及治疗后3周观察2组6分钟步行距离（6-minute walk distance，6MWD）及改良Borg呼吸困难评分结果变化；于治疗前后观察2组血气分析指标［动脉血氧分压（arterial partial pressure of oxygen，PaO2）、动脉血二氧化碳分压（arterial partial pressure of carbon dioxide，PaCO2）］值、肺功能指标［用力肺活量（forced vital capacity，FVC）、第1秒用力呼气容积（forced expiratory volume in one second，FEV1）、峰值呼气流速（peak expiratory flow，PEF）］的变化；并评价临床疗效。结果：治疗期间，治疗组脱落5例，对照组脱落6例；最终纳入治疗组45例，对照组44例。总有效率治疗组为95.56%（43/45），对照组为79.55%（35/44），2组比较，差异有统计学意义（P<0.05）。2组6MWD及Borg呼吸困难评分治疗后1周、治疗后3周与本组治疗前比较，以及治疗后3周组间比较，差异均有统计学意义（P<0.05）。2组血气分析指标中，PaO2水平治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P<0.05）；PaCO2水平治疗前后组内比较及治疗后组间比较，差异均无统计学意义（P>0.05）。2组肺功能指标中，FVC、FEV1及PEF治疗前后组内比较，以及FVC值治疗后组间比较，差异均有统计学意义（P<0.05）；FEV1、PEF治疗后组间比较，差异均无统计学意义（P>0.05）。结论： 朱琏针灸兴奋Ⅱ型手法联合常规治疗对脑梗死恢复期呼吸功能障碍患者具有一定的临床疗效，可改善患者运动耐力、呼吸困难程度，提高动脉血氧分压和肺通气功能，其作用机制可能与呼吸肌功能改善、神经调节及肺氧合功能优化等多个方面有关。 |
| 关键词: 呼吸功能障碍 脑梗死恢复期 朱琏针灸兴奋Ⅱ型手法 肺功能 Borg评分 动脉血氧分压 6分钟步行距离 |
| DOI： |
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| Clinical effect of Zhu Lian’s Acupuncture Excitation Type II Therapy in treatment of respiratory dysfunction in the convalescent stage of cerebral infarction: An analysis of 45 cases |
| HE Wei,LI Hongying,WANG Han |
| (The Seventh People’s Hospital of Nanning, Nanning 530012, Guangxi, China) |
| Abstract: |
| Objective： To investigate the clinical effect of Zhu Lian’s Acupuncture Excitation Type II Therapy combined with conventional rehabilitation regimen in the treatment of patients with respiratory dysfunction in the convalescent stage of cerebral infarction. Methods： A total of 100 patients with respiratory dysfunction in the convalescent stage of cerebral infarction were randomly divided into treatment group and control group, with 50 patients in each group. The patients in the control group received conventional Western medicine treatment, while those in the treatment group received Zhu Lian’s Acupuncture Excitation Type II Therapy in addition to the treatment in the control group, and both groups were treated for 3 consecutive weeks. The two groups were observed in terms of 6-minute walk distance （6MWD） and modified Borg dyspnea score before treatment and at 1 and 3 weeks after treatment, as well as the changes in blood gas parameters （arterial partial pressure of oxygen ［PaO2］ and arterial partial pressure of carbon dioxide ［PaCO2］） and pulmonary function parameters （forced vital capacity ［FVC］, forced expiratory volume in one second ［FEV1］, and peak expiratory flow ［PEF］） after treatment, and clinical outcome was assessed for both groups. Results： Five patients in the treatment group and 6 patients in the control group were lost during the treatment period, and finally 45 patients in the treatment group and 44 patients in the control group were included for analysis. There was a significant difference in overall response rate between the treatment group and the control group ［95.56% （43/45） vs 79.55% （35/44）, P < 0.05］. Both groups had significant changes in 6MWD and Borg dyspnea score at 1 and 3 weeks after treatment, and there were significant differences in these two indicators between the two groups at 3 weeks after treatment （P < 0.05）. As for blood gas parameters, both groups had a significant change in PaO2 after treatment, with a significant difference between the two groups after treatment （P < 0.05）, and there was no significant change in PaCO2 after treatment in either group, with no significant difference between the two groups after treatment （P > 0.05）. For pulmonary function parameters, both groups had significant changes in FVC, FEV1, and PEF after treatment, and there was a significant difference in FVC between the two groups after treatment （P < 0.05）, while there were no significant differences in FEV1 and PEF between the two groups after treatment （P > 0.05）. Conclusion： Zhu Lian’s Acupuncture Excitation Type II Therapy combined with conventional treatment has a certain clinical effect in the treatment of patients with respiratory dysfunction in the convalescent stage of cerebral infarction and can improve exercise tolerance ,dyspnea, and pulmonary ventilation function, and its mechanism may involve various aspects such as improvement of respiratory muscle function, neural regulation, and optimization of pulmonary oxygenation function. |
| Key words: respiratory dysfunction convalescent stage of cerebral infarction Zhu Lian’s Acupuncture Excitation Type II Therapy pulmonary function Borg score arterial partial pressure of oxygen 6-minute walk distance |
