針灸輔助治療重度腦外傷：隨機對照試驗

Adjuvant Acupuncture Therapy in Patients with Severe Head Injury: A Randomized Controlled Trial

探討針刺或雷射針灸輔助治療重度腦外傷後意識及肌力恢復的效果。於2013年1月至2015年7月收案重度腦外傷（Glasgow Coma Scale, GCS≦8分）患者24例，依序隨機分為3組，在西醫常規治療下，給予針刺、雷射針灸或偽針灸（雷射針灸但無雷射輸出）。每週治療3次（最多18次），於住院期間觀察治療前後GCS及肌力變化。三組病患治療後的GCS及肌力均有改善，惟對照組肌力改善無顯著差異。治療前後的GCS在針刺組為6.00 ± 1.41和9.14 ± 1.95 (p = 0.017)，雷射針灸組為5.78 ± 1.30和9.00 ± 4.00 (p = 0.027)，對照組為6.00 ± 1.41和10.83± 2.79 (p = 0.027)。治療前後的肌力在針刺組為7.29 ±3.82和11.57 ± 3.69 (p = 0.043)，雷射針灸組為5.33 ± 4.06和9.67 ± 4.30 (p = 0.012)，對照組為8.33 ± 2.88和11.17 ± 4.54 (p = 0.109)。受試者無不良反應發生。重度腦外傷患者在西醫常規治療下輔以針刺、雷射針灸或偽針灸均有助於意識及肌力的恢復。各組間的治療效果無顯著差異，可能與收案病患的數量、統計的誤差、針灸治療介入的起始時間、接受治療的次數，或病患的腦損傷嚴重程度或其他合併症有關，未來更多的收案數來做進一步研究是有必要的。

To investigate the effect of adjuvant acupuncture therapy on restoration of consciousness and muscle power (MP) recovery in patients with severe traumatic brain injury. Twenty-four patients with severe traumatic brain injury (Glasgow Coma Scale, GCS ≤ 8) were enrolled and randomly divided into three groups sequentially. They were treated with conventional treatment in addition to needle acupuncture, laser acupuncture, or sham acupuncture (laser acupuncture without laser output). They were treated 3 times a week (maximum 18 sessions). The GCS and MP were measured before and after treatment during hospitalization. The GCS and MP of the three groups improved after treatment. There is no significant difference in MP recovery in control group after treatment. The GCS score before and after treatment were 6.00 ± 1.41 and 9.14 ± 1.95, respectively, in the needle acupuncture group; 5.78 ± 1.30 and 9.00 ± 4.00, respectively, in the laser acupuncture group; and 6.00 ± 1.41 and 10.83± 2.79, respectively, in the control group. The MP before and after treatment were 7.29 ± 3.82 and 11.57 ± 3.69, respectively, in the needle acupuncture group; 5.33 ± 4.06 and 9.67 ± 4.30, respectively, in the laser acupuncture group; and 8.33 ± 2.88 and 11.17 ± 4.54, respectively, in the control group. No adverse effect was reported. We found that conventional Western medicine combined with traditional acupuncture, laser acupuncture, or sham acupuncture, all contributed to the restoration of awareness and MP recovery in patients with severe traumatic brain injury. There were no significant differences in the therapeutic effect between the groups. This result may be related to the small number of subjects, statistical error, time for initial acupuncture intervention, therapeutic sessions, severity of the patients brain injury, or other complications. Further trial and investigation with a larger number of subjects is warranted.