Abstract：
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 combined 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 supplemented. 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, between 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, respectively；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.
CONCLUSIONS: 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.
目的: 观察手足阳经、督脉穴芒针透刺联合体针治疗对中风后偏瘫伴中枢性疼痛（CPSP）患者疼痛、平衡功能、肌力的影响，并探讨其作用机制是否与抗氧化损伤有关。方法: 选取2020年3月至2021年9月收治的94例中风后偏瘫伴CPSP患者，分为研究组（47例，脱落3例）和对照组（47例，脱落1例）。对照组采取康复锻炼联合常规体针治疗，研究组在对照组基础上采取手足阳经、督脉穴芒针透刺治疗，两组均每日治疗1次，14 d为1个疗程，共6个疗程。比较两组患者治疗前和治疗1、2、3个月后的疼痛视觉模拟量尺（VAS）评分、伯格平衡功能评分和肌力，采用神经功能缺损评分（NIHSS）评价患者的神经功能，ELISA法检测患者血清一氧化氮合酶（NOS）、超氧化物歧化酶（SOD）、丙二醛（MDA）含量。结果: 与治疗前比较，治疗1、2、3个月研究组和对照组VAS评分、NIHSS均降低（P<0.05），伯格平衡功能评分升高（P<0.05），研究组的肌力分级4~5级的比例显著升高（P<0.05）；治疗2个月，对照组患者的肌力4级的比例显著升高（P<0.05），治疗3个月，对照组患者的肌力4、5级的比例显著升高（P<0.05）；两组患者治疗3个月后的血清NOS、SOD含量均显著升高（P<0.05），血清MDA含量均显著降低（P<0.05）。与同时点对照组比较，治疗1、2、3个月研究组患者VAS、NIHSS评分均降低（P<0.05），伯格平衡功能评分升高（P<0.05），肌力分级更优（P<0.05，P<0.01）；治疗3个月后的血清NOS、SOD含量升高（P<0.05），MDA含量降低（P<0.05）。结论: 手足阳经、督脉穴芒针透刺联合体针治疗能减轻CPSP，改善偏瘫患者的平衡功能，提高肌力，促进神经功能恢复，其机制可能与抗氧化损伤有关。.
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 combined 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 supplemented. 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, between 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, respectively；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.
CONCLUSIONS: 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.
目的: 观察手足阳经、督脉穴芒针透刺联合体针治疗对中风后偏瘫伴中枢性疼痛（CPSP）患者疼痛、平衡功能、肌力的影响，并探讨其作用机制是否与抗氧化损伤有关。方法: 选取2020年3月至2021年9月收治的94例中风后偏瘫伴CPSP患者，分为研究组（47例，脱落3例）和对照组（47例，脱落1例）。对照组采取康复锻炼联合常规体针治疗，研究组在对照组基础上采取手足阳经、督脉穴芒针透刺治疗，两组均每日治疗1次，14 d为1个疗程，共6个疗程。比较两组患者治疗前和治疗1、2、3个月后的疼痛视觉模拟量尺（VAS）评分、伯格平衡功能评分和肌力，采用神经功能缺损评分（NIHSS）评价患者的神经功能，ELISA法检测患者血清一氧化氮合酶（NOS）、超氧化物歧化酶（SOD）、丙二醛（MDA）含量。结果: 与治疗前比较，治疗1、2、3个月研究组和对照组VAS评分、NIHSS均降低（P<0.05），伯格平衡功能评分升高（P<0.05），研究组的肌力分级4~5级的比例显著升高（P<0.05）；治疗2个月，对照组患者的肌力4级的比例显著升高（P<0.05），治疗3个月，对照组患者的肌力4、5级的比例显著升高（P<0.05）；两组患者治疗3个月后的血清NOS、SOD含量均显著升高（P<0.05），血清MDA含量均显著降低（P<0.05）。与同时点对照组比较，治疗1、2、3个月研究组患者VAS、NIHSS评分均降低（P<0.05），伯格平衡功能评分升高（P<0.05），肌力分级更优（P<0.05，P<0.01）；治疗3个月后的血清NOS、SOD含量升高（P<0.05），MDA含量降低（P<0.05）。结论: 手足阳经、督脉穴芒针透刺联合体针治疗能减轻CPSP，改善偏瘫患者的平衡功能，提高肌力，促进神经功能恢复，其机制可能与抗氧化损伤有关。.
摘要：
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