台灣中風會診針刺的療效評估

The Study on the Assessment of Chinese Medicine Therapeutic Effect in Stroke Patients with Acupuncture Co-management in Taiwan

目的：為了瞭解針刺對中風患者療效評估。方法：選擇符合International Classification of Disease, Ninth Revision ICD-9（430-438）的中風住院患者，包含出血型及梗塞型兩種，患者皆經西醫診斷確定與常規治療，並會診針灸科治療，可合併中藥及復健治療。選擇兩年以上訓練良好的針灸科醫師，一週進行3次針刺治療，每次20-30分鐘，針刺穴位大致固定，並隨病人症狀增減穴位，針刺過程不使用動針療法。以巴氏量表及美國國家衛生研究院腦中風評估量表作療效評估，包含日常生活能力、肌力、語言及意識等項目，在治療前及治療後1-8天及9-16天做評估。不同於針刺醫師，選擇另一位經良好訓練者進行評估。結果：研究顯示收入符合條件的患者共157位，平均年齡為61.71歲，由6位針灸專科醫師進行針刺，在針刺後1-8天及9-16天的巴氏量表及美國國家衛生研究院腦中風評估量表，皆有明顯進步，全部p<0.05，特別是在四肢活動及大小便、飲食等項目進步最顯著。觀察除了少數有針刺流血外，針刺並無造成明顯副作用。結論：在西醫住院常規治療下，中風會診針刺治療，可明顯改善病患生活能力及神經功能。

The aim of this study is to assess acupuncture therapeutic effect in stroke patients. Method: The subjects were hospital in-patients who meet the International Classification of Disease, Ninth Revision ICD-9 (430-438) with the diagnoses of ischemic (infarct) stroke or hemorrhagic stroke. All of them received routine western medical treatment with acupuncture co-management as well as herbal medicines and rehabilitation treatment. The patients were treated by the acupuncture physicians who have been well trained for over two years. Every subject received three times 20-30 minutes acupuncture treatment per week. Some fixed needling points were selected depending on the syndromes of the patients. Moving needle type is forbidden during the acupuncture process. With the Barthel Index (BI) and the National Institutes of Health Stroke Scale (NIHSS), the efficacy evaluations in QOL, muscle strength, language and awareness were made before treatment and in 1-8 days and 9-16 days after treatment. A well-trained person who is not an acupuncture physician was selected to do these evaluations. Results: We had six acupuncture physicians treat 157 appropriate candidates with the average age of 61.71 year old. In the 1-8 days and 9-16 days after acupuncture treatment, the BI and NIHSS scores were significantly increased (p<0.05). These courses showed that it is especially effective in improving eating, drinking, defecating, urinating, moving and walking. According to our observation, acupuncture therapy didn't cause significant side effects except light bleeding in few cases. In conclusion, acupuncture co-management is beneficial to the hospital inpatients. It can make good improvements in patients' nervous functions and ability of daily life.