目的

观察血糖控制水平对脑梗死患者针刺疗效的影响。

方法

选择2011年7月至2013年5月天津中医院大学第一附属医院针灸科住院中风偏瘫患者349例，依据入院时第1次空腹血糖将患者分为正常组154例、轻度升高组99例和显著升高组96例。所有入组患者均在神经内科常规治疗基础上加用醒脑开窍针刺法治疗。采用重复测量方差分析比较3组患者在治疗前、治疗7d和14 d内3个不同时点的美国国立卫生研究院卒中量表（NIHSS）评分差异。

结果

3组卒中患者NIHSS量表评分中只有轻度升高组在治疗前、治疗7d和治疗14d的3个时点的NIHSS评分［（8.67±3.32），（7.64±2.76），（6.40±2.60）］分比较，差异具有统计学意义（F=3.184，P﹤0.05）。3组卒中患者治疗后的NIHSS评分为显著升高组﹥正常组﹥轻度升高组，显著升高组和轻度升高组在治疗7d和14 d后分别为［（8.58±3.58），（7.64±2.76）］分和［（6.40±2.60），（7.56±3.42）］分，与正常组比较［（7.71±3.10），（6.65±2.90）分］比较，均有统计学意义（t=2.117、2.094，P均﹤0.05；t=2.360、2.718，P均﹤0.05）。

结论

空腹血糖轻度升高的脑梗死患者针刺疗效优于血糖正常患者，显著升高则疗效较差。

Objective

To investigate the effect of blood glucose level on the efficacy of acupuncture treatment for hemiplegia.

Methods

A total of 349 patients with hemiplegia after stroke at Department of Acupuncture，First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from July 2011 to May 2013，were included in this study.According to the 1st time of fasting blood glucose level at admission，patient were divided into normal group（n=154），mildly elevated group（n=99）and significantly elevated group（n=96）.All patients were treated with the neurology conventional therapy and consciousnessrestoring resuscitation acupuncture.The repeated measures ANOVA and non-parametric tests were used for comparison the US National Institutes of Health Stroke Scale（NIHSS）scorebetween groups at different time points.

Results

There were significant differences in NIHSS scores before treatment，7 d and 14 d after treatment only in mildly elevated group［（8.67±3.32），（7.64±2.76），（6.40±2.60），F=3.184，P﹤0.05］.NIHSS scores were significantly increased after treatment in significantly elevated group﹥normal group﹥mildly elevated group.NIHSS scores were［（8.58±3.58），（7.64±2.76）］after 7d treatment and［（6.40±2.60），（7.56±3.42）］after 14d treatment in significantly elevated group and mildly elevated group，which were significantly different compared with those of control group［（7.71±3.10）and（6.65±2.90），t=2.360 and 2.718，P﹤0.05］.

Conclusion

The efficacy of acupuncture treatment in cerebral infarction is better in patients with mildly elevated fasting glucose than that of patients with normal blood glucose，but the significantly higher group showed the worse efficacy.