针刺联合血管内治疗急性脑梗死随机对照研究OA

Objective To observe the effects of acupuncture on the incidence of symptomatic intracranial hemorrhage(sICH),any intracranial hemorrhage(ICH)within 14 days,decompressive craniectomy rate,adverse events,and vital signs in patients with acute cerebral infarction(ACI)undergoing endovascular therapy.Methods Eighty ACI patients receiving endovascular therapy were randomly assigned to experimental group(40 cases)and control group(40 cases).The experimental group received acupuncture pretreatment 30 minutes before the procedure and once daily for 14 days after the procedure at Baihui(GV20),Fengchi(GB20),Jingbi(EX-HN26),Quchi(LI11),Neiguan(PC6),Yanglingquan(GB34),Zusanli(ST36),Sanyinjiao(SP6),and Taichong(LR3).The control group received endovascular therapy alone.The primary outcomes included sICH within 48 hours and ICH classified according to the Heidelberg Bleeding Classification(HBC).Secondary outcomes encompassed any bleeding event within 14 days,decompressive craniectomy rate,vital signs(heart rate,blood pressure,mean arterial pressure)on days 1,3,7,and 14,electrocardiographic abnormalities,and adverse events.Results Within 48 hours,the incidence of HBC-defined parenchymal hemorrhage type 2(PH2)ICH and PH2-type sICH was significantly lower in the experimental group than the control group(P＜0.05).No significant differences were observed between groups in the rates of any bleeding event within 14 days,decompressive craniectomy,asymptomatic ICH,adverse events,or electrocardiographic abnormalities(all P＞0.05).Changes in heart rate and blood pressure over time did not differ significantly between groups(P＞0.05).Conclusion Adjunctive acupuncture reduces the risk of sICH in ACI patients after endovascular therapy without increasing adverse events,suggesting a favorable safety profile.(Chinese Clinical Trial Registry No.ChiCTR2100051971)