| Objective:The clinical efficacy of using magnetic resonance arterial spin labeling perfusion imaging observed light Scalp treatment of ischemic stroke, and explore the feasibility of scalp for secondary prevention of stroke.Method:60 cases of ischemic stroke patients who were included in the standard light will meet randomly divided into two groups, 30 cases for treatment group and 30 cases for the control group. The control group uses oral aspirin therapy with100 mg 1 day,treatment for 4 weeks. The treatment group received treatment scalp once a day for 4weeks. Observed in patients before treatment, after treatment, six months after the stroke aura symptom score, the US National Institutes of Health Stroke Scale(NIHSS)score, ASL cerebral blood flow changes in r CBF values and clinical endpoints(disabling stroke, death) the incidence of clinical efficacy evaluation lightweight scalp treatment of ischemic stroke.Result:(1)NIHSS scale score:After 4 weeks of treatment, two groups of score values were decreased, compared with that before treatment were significantly different(p< 0.05).After 4 weeks of treatment, the twogroups had significant difference(p <0.01), the treatment group was decreased obviously.Acupuncture group in improving the neurological dysfunction in patients with better than western medicine group.(2)The stroke omen symptom score:After 4 weeks treatment, scalp acupuncture treatment group score decreased significantlythan before treatment, the difference was statistically significant(p<0.01), western medicinegroup compared with the group before treatment score decreased significantly, the difference was statistically significant(p<0.01). Scalp acupuncture group and the western medicinecomparison group two,scalp acupuncture treatment group score decreased more obviously,the difference was statistically significant(p<0.01). Acupuncture group can significantly improve the symptoms of patients with apoplexy aura, curative effect is better than that ofcontrol group.After 6 months of follow-up, scalp acupuncture treatment group score significantly higher thanafter 4 weeks of treatment, the two groups had significant difference(p<0.01). Western medicine score higher than the control group, the score of group after 4 weeks of treatment,the two groups had significant difference(p<0.01),scalp acupuncture group and the western medicine comparison group two groups, no significant difference(p>0.05). Tip due to the cessation of follow-up treatment, the therapeutic effect of two groups of variation.(3)ASL cerebral blood flow and r CBF value:After 4 weeks of treatment of scalp acupuncture group compared with before treatment, r CBF value increased significantly,the difference was statistically significant(p<0.01). Western medicine control group 4weeks after treatment than before treatment and r CBF value increased, the difference was statistically significant difference(p<0.01), suggesting that the two treatments can improve cerebral blood hypoperfusion, increase blood flow. After 4 weeks of treatment of scalp acupuncture group and Western medicine control group were significant difference(p<0.01), suggesting that scalp acupuncture group increased cerebral blood flowin patients with side effects than the control group, can significantly improve the cerebral blood hypoperfusion.After the end of treatment group two cases were followed up for 6 months after treatment, two groups of patients with r CBF values after 4 weeks of treatment compared, there were significant differences(p<0.01), the baseline level of each group were compared with before treatment, no significant difference(p>0.05).The difference between the two groups had no statistical significance(p>0.05),suggesting that two groups of blood perfusion and 4 weeks after treatment were significantly reduced compared with group two cases, cerebral blood flow perfusion was improved regional recovery low perfusion.(4)The clinical curative effect of threatened apoplexy:The treatment group after treatment, 14 cases were cured, 9 cases markedly effective,effective 5 cases, invalid 2cases, the total efficiency of 93.33%; control group after treatment4 cases were cured,10 cases markedly effective, effective 8 cases, invalid 8 cases, the total efficiency of73.33%. The total efficiency of two groups of comparison, the difference was statistically significant(p<0.05), acupuncture treatment group after 4 weeks of treatment,symptoms improved obviously, the clinical efficacy is better than western medicine control group.(5)The incidence of end events:Patients were followed up for 6 months, scalp acupuncture treatment group 5 cases progress to disabling stroke, 0 cases of death, the end event rate 16.67%; control group after treatment were followed up for 6 months in 6cases progress to disabling stroke, 0 cases of death, the end event occurrence rate is20%, after statistics processing two groups of end events, no statistically significant difference(p>0.05). Scalp acupuncture treatment group and the western medicine control group in reducing the incidence of equivalent efficacy endpoint events.(6)Safety assessment:In 60 patients before and after treatment, no adverse reactions of acupuncture adverse reactions and obvious medicine, laboratory indexs in the before treatment and after treatmenthad no obvious abnormalities. Two kinds of treatment methods used in this study were safe.Conclusion:(1)Scalp and aspirin therapy in two patients with ischemic stroke were significantly light of clinical efficacy, but the scalp therapy in reducing neurological function in patients, improve clinical symptoms, increase cerebral blood flow, reduce cerebral hypoperfusion area more significant role in other aspects of the clinical efficacy of scalptherapy is superior to aspirin.(2)Scalp effect of aspirin intervention endpoint occurred fairly, scalp therapy can be used for secondary prevention of stroke.(3)During treatment, the clinical efficacy of scalp acupuncture is superior to aspirin,during follow-up, both treatments had no significant effect, and scalp therapy with aspirin efficacy differences disappear, so the scalp and prevention of ischemic stroke,aspirin should be long-term treatment to achieve more good clinical efficacy.(4)International standardization norms scalp treatment, acupoints simple, no adverse reactions and side effects, patient compliance is good, is safe and effective treatment for prevention of ischemic stroke, worthy of promotion. |
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