CAJ | 학술논문

目的：观察头部针刺透穴治疗颈动脉粥样硬化的临床疗效，并探讨其作用机制。方法将90例颈动脉粥样硬化患者随机分为3组。针刺透穴组30例，予头部针刺透穴治疗；针刺对照组30例，予常规针刺疗法治疗；药物对照组30例，予常规药物治疗。治疗2个月后比较3组治疗前后血液流变学指标[全血黏度（低切、高切）、血浆黏度、红细胞比容及纤维蛋白原]、血脂指标[甘油三酯（ TG）、总胆固醇（ TC）、高密度脂蛋白胆固醇（ HDL-C）及低密度脂蛋白胆固醇（ LDL-C）]及颈动脉粥样硬化斑块厚度的变化，并统计疗效。结果针刺透穴组控显率均优于针刺对照组及药物对照组（ P＜0．05）；3组治疗后全血黏度（高切、低切）、血浆黏度、红细胞压积及纤维蛋白原水平变化与本组治疗前比较均有明显降低，且针刺透穴组治疗后分别与针刺对照组及药物对照组比较差异均有统计学意义（P＜0．05）；3组治疗后TG、TC、HDL-C及LDL-C水平变化与本组治疗前比较，TG、TC、LDL-C均有明显降低，HDL-C升高，且针刺透穴组治疗后分别与针刺对照组及药物对照组比较差异均有统计学意义（P＜0．05）；3组治疗后颈动脉粥样硬化斑块厚度变化与本组治疗前比较均有明显减少，且针刺透穴组治疗后分别与针刺对照组及药物对照组比较差异均有统计学意义（P＜0．05）。结论头部针刺透穴疗法可以降低血脂水平，改善血液流变学性质，降低血细胞的聚集性和血液的黏滞性，降低动脉硬化斑块厚度，进而改善微循环状况，增加脑血流量，改善脑组织血氧供应，使病损脑细胞功能得以修复，以上作用相互结合，有助于减轻和防止颈动脉粥样硬化的发生和发展。
목적：관찰두부침자투혈치료경동맥죽양경화적림상료효，병탐토기작용궤제。방법장90례경동맥죽양경화환자수궤분위3조。침자투혈조30례，여두부침자투혈치료；침자대조조30례，여상규침자요법치료；약물대조조30례，여상규약물치료。치료2개월후비교3조치료전후혈액류변학지표[전혈점도（저절、고절）、혈장점도、홍세포비용급섬유단백원]、혈지지표[감유삼지（ TG）、총담고순（ TC）、고밀도지단백담고순（ HDL-C）급저밀도지단백담고순（ LDL-C）]급경동맥죽양경화반괴후도적변화，병통계료효。결과침자투혈조공현솔균우우침자대조조급약물대조조（ P＜0．05）；3조치료후전혈점도（고절、저절）、혈장점도、홍세포압적급섬유단백원수평변화여본조치료전비교균유명현강저，차침자투혈조치료후분별여침자대조조급약물대조조비교차이균유통계학의의（P＜0．05）；3조치료후TG、TC、HDL-C급LDL-C수평변화여본조치료전비교，TG、TC、LDL-C균유명현강저，HDL-C승고，차침자투혈조치료후분별여침자대조조급약물대조조비교차이균유통계학의의（P＜0．05）；3조치료후경동맥죽양경화반괴후도변화여본조치료전비교균유명현감소，차침자투혈조치료후분별여침자대조조급약물대조조비교차이균유통계학의의（P＜0．05）。결론두부침자투혈요법가이강저혈지수평，개선혈액류변학성질，강저혈세포적취집성화혈액적점체성，강저동맥경화반괴후도，진이개선미순배상황，증가뇌혈류량，개선뇌조직혈양공응，사병손뇌세포공능득이수복，이상작용상호결합，유조우감경화방지경동맥죽양경화적발생화발전。
Objective To observe the effect of the head acupuncture through hole on the treatment of carot -id artery atherosclerosis .Methods 90 cases of carotid artery atherosclerosis were randomly divided into three groups.Three groups received separately the head acupuncture through hole , conventional acupuncture therapy and conventional medical treatment .After two months of treatment the hemorheology indexes ( whole blood viscosity ( low cut and high cut),plasma viscosity,erythrocyte hematocrit and fibrinogen ),blood lipid indexes (TG,TC,HDL-C and LDL-C) and carotid atherosclerosis plaque thickness changes were compared .Results The levels of whole blood viscosity ( low cut and high cut ) , plasma viscosity , erythrocyte hematocrit and fibrinogen after treatment were significantly decreased as compared with those before treatment in three groups ,there was significant difference be-tween three groups on the hemorheology indexes (P<0.05).The levels of TG,TC,LDL-C after treatment were de-creased in three groups ,the level of HDL-C after treatment was increased ,there was significant difference between three groups on the blood lipid indexes (P<0.05).Carotid atherosclerosis plaque thickness after treatment was de-creased in three groups ,acupuncture through hole group after treatment ,respectively compared with acupuncture con-trol group and drug control group differences were statistically significant (P<0.05).Conclusion The head acu-puncture through hole can reduce blood lipid levels ,improve blood properties ,lower blood cell aggregation and blood viscosity,reduce the atherosclerotic plaque thickness ,thereby improving microcirculation conditions ,increase cerebral blood flow,improve brain tissue oxygen supply ,so function of brain cells to repair lesions ,combined with each other o-ver the role,helping to reduce and prevent the occurrence and development of carotid atherosclerosis .