芒针透刺联合体针治疗对中风后偏瘫伴中枢性疼痛患者的临床疗效观察:随机对照试验OA北大核心CSTPCDMEDLINE

Objective To investigate the effects of the elongated needling at the points of hand and foot yang meridians and the Governor Vessel combined with the routine acupuncture therapy on pain,balance function and muscle strength of the patients with post-stroke hemiplegia and central post-stroke pain(CPSP),and to investigate whether its therapeutic mechanism is related to antioxidant damage.Methods Ninety-four patients with post-stroke hemiplegia and CPSP admitted from March 2020 to September 2021 were divided into a trial group(47 cases,1 cases dropped out)and a control group(47 cases 3 cases dropped out).In the control group,the rehabilitation exercise com-bined with routine acupuncture therapy was used,and in the trial group,on the base of the treatment as the control group,the elongated needling at the points of hand and foot yang meridians and the Governor Vessel was supple-mented.In the two groups,the treatment was given once daily,and 1 course of treatment was composed of 14 days,a total of 6 courses were required in the trial.Separately,before treatment,and 1,2 and 3 months after treatment,be-tween two groups,the score of visual analogue scale(VAS)and that of Berg balance scale(BBS),as well as muscle strength were compared;the neural function was evaluated using the national institutes of health stroke scale(NIHSS)and the serum contents of nitricoxide synthase(NOS),superoxide dismutase(SOD)and malondialdehyde(MDA)were detected by ELISA in the patients.Results Compared with those before treatment,VAS score and NIHSS score were all decreased(P＜0.05)in the trial and the control group after 1 month,2 months and 3 months of treatment,and BBS score was increased(P＜0.05);and the case proportion of muscle strength grade 4 and 5 was higher(P＜0.05)in the trial group.In the control group,the proportion of grade 4 increased after treatment for 2 months(P＜0.05),and that of grade 4 and 5 increased after treatment for 3 months(P＜0.05).The serum contents of NOS and SOD were increased(P＜0.05),and MDA was decreased(P＜0.05)after 3 months of treatment in the two groups.In comparison with the control group at the same time point,VAS score and NIHSS score were lower(P＜0.05),BBS score higher(P＜0.05)and the muscle strength grade was improved(P＜0.05,P＜0.01)after 1,2 and 3 months of treatment,respec-tively;and the serum contents of NOS and SOD increased(P＜0.05),and MDA decreased(P＜0.05)after 3 months of treatment in the trial group.Conclusion The elongated needling at the points of hand and foot yang meridians and the Governor Vessel,combined with the routine acupuncture therapy alleviates CPSP,improves balance and muscle strength and promotes the recovery of neural function in the patients with post-stroke hemiplegia,the mechanism may be related to antioxidant damage.