摘要
目的探讨醒脑开窍针法结合补阳还五汤治疗气虚血瘀脑梗死的效果。方法选取江门市蓬江区中西医结合医院2022年1月至2024年8月收治的150例气虚血瘀型脑梗死患者,使用随机数字表分为三组。所有患者均进行常规脑梗死对症西医治疗,汤药组50例患者给予补阳还五汤,针刺组50例患者给予醒脑开窍针法,联合组50例患者给予醒脑开窍针法结合补阳还五汤治疗,三组患者均连续治疗4周。比较三组患者治疗效果[偏瘫功能恢复过程Brunnstrom六阶段评分、美国国立卫生研究院卒中量表(NIHSS)]、治疗前后肢体运动功能[Fugl-Meyer运动功能量表(FMA)、改良Ashworth分级量表(MAS)]、凝血指标[D-二聚体(D-D)、纤维蛋白原(Fig)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、血脂指标[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]以及治疗期间不良反应。结果三组患者治疗前各项指标水平相比差异无统计学意义(P>0.05),治疗后三组患者均有好转。治疗期间,汤药组患者不良反应发生率为4%,针刺组为6%,联合组为10%,三组患者治疗期间不良反应发生率差异无统计学意义(P>0.05)。汤药组及针刺组治疗后Brunnstrom阶段评分及NIHSS评分差异无统计学意义(P>0.05),联合组治疗后Brunnstrom阶段评分为(1.53±0.32)分;NIHSS评分(12.57±2.21)分,与汤药组及针刺组相比差异具有统计学意义(P<0.05)。汤药组及针刺组治疗后FMA、MAS评分相比差异无统计学意义(P>0.05),联合组治疗后FMA评分(68.72±3.46)分、MAS评分(1.22±0.36)分,与汤药组及针刺组相比差异具有统计学意义(P<0.05)。汤药组及针刺组治疗后各项凝血指标及血脂指标水平差异无统计学意义(P>0.05),联合组治疗后D-D、Fig、TG、TC、LDL水平较低,PT、APTT、HDL水平较高(P<0.05)。结论气虚血瘀脑梗死患者使用醒脑开窍针法结合补阳还五汤治疗效果良好,可有效恢复患者肢体运动功能及神经功能,改善患者凝血指标及血脂指标,不会增加患者不良反应。
Objective To explore the effect of XingnaoKaiqiao acupuncture combined with Buyang Huanwu decoction on cerebral infarction caused by Qi deficiency and blood stasis.Methods A total of 150 patients with cerebral infarction of Qi deficiency and blood stasis type admitted to Pengjiang District Hospital of Integrated Traditional Chinese and Western Medicine in Jiangmen City from January 2022 to August 2024 were selected and divided into three groups by random number table.All patients received conventional symptomatic Western medicine treatment for cerebral infarction.50 patients in the decoction group were given BuyangHuanwu decoction,50 patients in the acupuncture group were given XingnaoKaiqiao acupuncture,and 50 patients in the combined group were given XingnaoKaiqiao acupuncture combined with BuyangHuanwu decoction.All patients in the three groups were treated continuously for 4 weeks.The three groups were compared in terms of the treatment effects(Brunnstrom six-stage score during hemiplegic function recovery,National Institutes of Health Stroke Scale[NIHSS]),limb motor function before and after treatment(Fugl-Meyer assessment scale for motor function[FMA],Modified Ashworth rating scale[MAS]),and coagulation index(D-dimer[D-D],fibrinogen[Fig],prothrombin time[PT],activated partial thromboplastin time[APTT]),lipid indexes(triglyceride[TG],total cholesterol[TC],low density lipoprotein[LDL],high density lipoprotein[HDL]),and adverse reactions during treatment.Results There was no difference of statistical significance in the level of all indexes among the three groups before treatment(P>0.05),and all the three groups were improved after treatment.During treatment,the incidence of adverse reactions was 4%in the decoction group,6%in the acupuncture group,and 10%in the combined group.There was no difference of statistical significance in the incidence of adverse reactions among the three groups(P>0.05).There was no difference of statistical significance in Brunnstrom stage score and NIHSS score between the decoction group and the acupuncture group after treatment(P>0.05).The Brunnstrom stage score(1.53±0.32)points,and NIHSS score(12.57±2.21)points of the combined group showed difference of statistical significance from those of the decoction group and the acupuncture group(P<0.05).There was no difference of statistical significance in FMA and MAS scores between the decoction group and the acupuncture group after treatment(P>0.05),while FMA scores(68.72±3.46)points and MAS scores(1.22±0.36)points in the combined group after treatment showed difference of statistical significance from those in the decoction group and the acupuncture group(P<0.05).There was no difference of statistical significance in the levels of coagulation indexes and lipid indexes between the decoction group and the acupuncture group after treatment(P>0.05).The levels of D-D,Fig,TG,TC and LDL were lower in the combined group after treatment,while the levels of PT,APTT and HDL were higher(P<0.05).Conclusion The method of XingnaoKaiqiao acupuncture combined with BuyangHuanwu decoction has good therapeutic effect for patients with cerebral infarction with Qi deficiency and blood stasis,which could effectively restore limb motor function and nerve function,improve coagulation index and lipid index of patients,and would not increase adverse reactions of patients.
作者
李建有
陈乐乐
赵振强
LI Jian-you;CHEN Le-le;ZHAO Zhen-qiang
出处
《中国疗养医学》
2025年第5期27-30,共4页
Chinese Journal of Convalescent Medicine
基金
江门市卫生健康局科研立项(24A032)。
关键词
脑梗死
醒脑开窍针法
补阳还五汤
治疗效果
Cerebral infarction
XingnaoKaiqiao acupuncture
BuyangHuanwu decoction
Therapeutic effect
