针刺联合神经肌肉刺激治疗颅脑损伤患者临床观察OA

Objective:To evaluate the clinical efficacy of the governor vessel-unblocking and mind-refreshing acupuncture method combined with neuromuscular stimulation in treating patients with traumatic brain injury,as well as its effects on hemodynamics,limb function,and balance recovery. Methods:A total of 128 patients with traumatic brain injury were selected and randomly divided into three groups using a simple randomization method.The control group(n=42)received neuromuscular stimulation;the acupuncture group(n=43)received governor vessel-unblocking and mind-refreshing acupuncture;and the combined group(n=43)received governor vessel-unblocking and mind-refreshing acupuncture combined with neuromuscular stimulation.The clinical efficacy was assessed after 8 weeks of continuous treatment,and comparisons were made among the groups regarding the traditional Chinese medicine symptom score,limb function[Fugl-Meyer assessment(FMA)score],balance function[Berg balance scale(BBS)score],recovery status[activities of daily living(ADL)score],National Institutes of Health stroke scale(NIHSS)score,and Glasgow coma scale(GCS)score,as well as hemodynamic parameters[mean blood flow velocity(Vm)in bilateral internal carotid arteries,pulsatility index(PI),and peak systolic velocity(PSV)].Treatment safety was also assessed. Results:After treatment,the total effective rate in the combined group was 95.4%,which was higher than 76.2%and 81.4%in the control group and the acupuncture group,respectively(P<0.05);there was no statistically significant difference between the control group and the acupuncture group(P>0.05).Before treatment,there were no statistically significant differences in the scores for unconsciousness and inability to speak,pallor,wheezing in the throat,flaccid paralysis and weakness,cold extremities,or the total TCM symptom score among the three groups(P>0.05);after treatment,the scores for the aforementioned items in all three groups decreased(P<0.05);the combined group's scores were lower than those of the control and acupuncture groups(P<0.05);there was no statistically significant difference between the control group and the acupuncture group(P>0.05).Before treatment,there were no statistically significant differences in the FMA and BBS scores among the three groups(P>0.05);after treatment,the FMA and BBS scores in all three groups increased(P<0.05);the combined group had higher scores than the control and acupuncture groups,with statistical significance(P<0.05);there were no statistically significant differences between the control group and the acupuncture group(P>0.05).Before treatment,there were no statistically significant differences in the NIHSS,GCS,and ADL scores among the three groups(P>0.05).After treatment,NIHSS scores decreased,and GCS and ADL scores increased in all three groups.The combined group had a lower NIHSS score and higher GCS and ADL scores compared to the control and acupuncture groups,with statistical significance(P<0.05);however,there were no statistically significant differences between the control group and the acupuncture group(P>0.05).Before treatment,there were no statistically significant differences in the Vm,PI,or PSV among the three groups(P>0.05);after treatment,the Vm and PI increased,and the PSV decreased in all three groups,with statistically significant differences within each group(P<0.05);patients in the combined group had higher Vm and PI values and a lower PSV value than those in the control and acupuncture groups;the inter-group differences were all statistically significant(P<0.05);there was no statistically significant difference between the control group and the acupuncture group(P>0.05). Conclusion:The combination of governor vessel-unblocking and mind-refreshing acupuncture and neuromuscular stimulation for the treatment of patients with traumatic brain injury is more effective than either therapy used alone,and demonstrates greater advantages in improving patients'hemodynamics,enhancing limb function,and improving balance.