摘要
目的探讨“培元通腑法”针药结合治疗痰热腑实型卒中的临床疗效及对脑肠肽、肠道菌群的影响。方法研究纳入痰热腑实型中风病患者94例,采用随机数字表的分组方法分为观察组与对照组各47例。对照组给予卒中的常规支持治疗,观察组在对照组治疗的基础上,给予培元通腑汤口服联合培元通腑针法治疗,均连续治疗4周后判定疗效。比较两组患者治疗前后的“痰热腑实证”中医症状积分、NIHSS和SS-QOL量表评分。检测并比较两组患者治疗前后的血清脑肠肽水平和粪便中的肠道菌群计数。结果观察组治疗后的燥屎不行、脘腹胀满、口气臭秽等中医症状积分及总积分较对照组均显著降低,观察组治疗后的有效率(93.62%,44/47)显著高于对照组(78.72%,31/47),组间比较差异有统计学意义(χ2=4.374,P<0.05)。NIHSS评分、血清血管活性肠肽(vasoactive intestinal peptide,VIP)水平和粪便中的大肠杆菌、肠球菌计数,观察组均显著低于对照组(P<0.05);SS-QOL评分、血清胃动素(motilin,MTL)、胃泌素(gastrin,GAS)、P物质(substance P,SP)水平和粪便中的双歧杆菌、乳酸杆菌计数,观察组均显著高于对照组(P<0.05)。结论“培元通腑法”针药结合治疗痰热腑实型卒中,能够明显改善卒中患者痰热腑实的临床表现,促进患者神经功能和生活质量的恢复,该治疗作用与机体脑肠肽分泌紊乱和肠道菌群失调相关。
Objective To investigate the curative effect of acupuncture combined with medicine of tonifying vital Qi and dred⁃ging fu-organs method in treatment of phlegm-heat in Fu-organs type of apoplexy and its effect on brain-gut peptide and in⁃testinal flora.Methods A total of 94 patients with phlegm-heat in Fu-organs type of apoplexy were included in this study and divided into observation group and control group by random number table,47 patients in each group.The control group was given conventional supportive treatment and the observation group was given peiyuan Tongfu Decoction(培元通腑汤)combined with acupuncture on the basis of control group.The efficacy was determined after continuous treatment for 4 weeks.The scores of TCM symptoms,National Institute of Health stroke scale(NIHSS)and stroke specific quality of life scale(SS-QOL)scales,ser⁃um brain-gut peptide levels and count of intestinal flora in feces in two groups were compared before and after treatment.Results Compared with those of the control group,the scores of TCM symptoms such as dry constipation,abdominal fullness,distention,smelly breath and the total score were significantly lower in the observation group after treatment(P<0.05).The effective rate of the observation group(93.62%,44/47)was significantly higher than that of the control group(78.72%,37/47),and the differ⁃ence was statistically significant(χ2=4.374,P<0.05).NIHSS score,serum vasoactive intestinal peptide(VIP)level and counts of Escherichia coli and enterococcus in water and faeces in the observation group were significantly lower than those in the control group(P<0.05).SS-QOL score,serum levels of motilin(MTL),gastrin(GAS)and substance P(SP)and counts of bifidobacteria and lactobacillus in water and feces in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Acupuncture combined with medicine of tonifying vital Qi and dredging fu-organs method in the treatment of phlegm-heat in Fu-organs type of apoplexy can significantly improve the clinical manifestations,and promote the recovery of patients'neurological function and quality of life.The therapeutic effect is related to the disorder of brain intestinal peptide secretion and intestinal microflora.
作者
唐祎周
许文婷
关莹
张翀
唐一鹤
朱路文
TANG Yizhou;XU Wenting;GUAN Ying;ZHANG Chong;TANG Yihe;ZHU Luwen(Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,Heilongjiang,China)
出处
《中华中医药学刊》
CAS
北大核心
2023年第2期144-148,共5页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(82174477)
全国名老中医药专家师承项目(2022)
黑龙江省中医药科研项目(ZHY2020-141)
黑龙江中医药大学科研基金面上项目(2019MS24)。
关键词
培元通腑法
痰热腑实证
卒中
临床疗效
脑肠肽
肠道菌群
phlegm-heat in Fu-organs type of apoplexy
phlegm-heat in Fu-organs type
apoplexy
clinical curative effect
brain-gut peptide
intestinal flora
