益气养阴祛瘀汤配合针刺对脑梗死恢复期患者血清同型半胱氨酸水平与凝血功能的影响  

Effect of Yiqi-Yangyin-Quyu decoction combined with acupuncture on serum homocystine level and blood coagulation function of patients with cerebral infarction in convalescent period

作　　者：刘万里[1] 冯艳 张杰[1] Liu Wanli;Feng Yan;Zhang Jie(Department of Traditional Chinese Medicine,the First Hospital of China Medical University,Shenyang 110001, China;Department of Internal Medicine,the 4th People's Hospital of ShenYang,Shenyang 110035,China)

机构地区：[1]中国医科大学附属第一医院中医科,沈阳110001 [2]辽宁省沈阳市第四人民医院北院内科,110035

出　　处：《国际中医中药杂志》2019年第2期115-119,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的观察益气养阴祛瘀汤配合针刺对脑梗死恢复期患者血清同型半胱氨酸(homocystine,HCY)水平与凝血功能的影响。方法将符合入选标准的80例脑梗死恢复期患者按随机数字表法分为2组,每组40例。对照组给予西医常规对症治疗,观察组在对照组基础上给予益气养阴祛瘀汤配合针刺治疗。2组均治疗4周。采用Barthel指数(Barthel Index,BI)评价日常生活能力,采用美国国立卫生院神经功能缺损评分量表(National Institutes of Health Stroke Scale,NIHSS)评价患者神经功能缺损情况;采用免疫比浊法检测血清CRP水平,采用电化学发光法检测血清HCY水平,采用全自动凝血仪检测血浆凝血酶原时间(prothrombin time,PT)、凝血酶时间(thrombintime,TT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)及纤维蛋白原(fibrinogen,FIB),评价临床疗效。结果观察组总有效率为90.0%(36/40)、对照组为70.0%(28/40),2组比较差异有统计学意义(Z=-3.184,P=0.004)。治疗后,观察组NIHSS评分低于对照组、BI评分高于对照组(t值分别为4.528、4.337,P值均<0.05);观察组CRP[(9.25±1.21)mg/L比(15.24±1.74)mg/L,t=4.905]、HCY[(12.59±2.05)μmol/L比(16.52±2.05)μmol/L,t=4.821]水平均低于对照组(P<0.05);治疗后,观察组PT[(15.20±1.17)s比(12.95±1.02)s,t=4.891]、APTT[(36.72±1.98)s比(33.02±1.68)s,t=4.553]、TT[(14.67±0.95)s比(12.21±1.10)s,t=4.210]均高于对照组(P<0.05),FIB[(2.55±0.25)g/L比(3.03±0.51)g/L,t=4.027]水平低于对照组(P<0.05)。结论益气养阴祛瘀汤配合针刺可有效改善脑梗死恢复期患者的凝血功能,降低脑组织损伤,促进脑神经功能恢复,提高患者生活质量。Objective To observe the effect of Yiqi-Yangyin-Quyu decoction combined with acupuncture on serum homocystine level and blood coagulation function of patients with cerebral infarction in convalescent period. Methods A total of 80 patients with cerebral infarction convalescence were divided into the observation group and the control group according to the random number table method, with 40 cases in each group. The control group was given routine treatment of western medicine. Based on this, the observation group was treated with Yiqi-Yangyin-Quyu decoction combined with acupuncture. After 4 weeks of treatment, the Barthel index (BI), neurological impairment National Institutes of Health Stroke Scale (NIHSS), C-reactive protein (CRP), and the level of homocystine (HCY) and blood coagulation function index of plasma prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen (FIB)] of the two groups were compared and analyzed. Results The total effective rate of the observation group was 90.0% (36/40), while the total effective rate of the control group was 70.0% (28/40). The total effective rate of the 2 groups was statistically significant (Z=-3.184, P=0.004). After treatment, the NIHSS score of the observation group were lower than those of the control group, and the BI score of the observation group were higher than those of the control group(t value were 4.528, 4.337, P<0.05). After treatment, the content of CRP (9.25 ± 1.21 mg/L vs. 15.24 ± 1.74 mg/L, t=4.905) and HCY (12.59 ± 2.05 μmol/L vs. 16.52 ± 2.05 μmol/L, t=4.821) of the observation group were significantly lower than those of the control group (P<0.05). After treatment, the level of PT (15.20 ± 1.17 s vs. 12.95 ± 1.02 s, t=4.891), APTT (36.72 ± 1.98 s vs. 33.02 ± 1.68 s, t=4.553), and TT (14.67 ± 0.95 s vs. 12.21 ± 1.10 s, t=4.210) of the observation group were significantly higher than those of the control group (P<0.05), while the level of FIB (2.55 ± 0.25 g/L vs. 3.03 ± 0.51 g/L, t=4.027) of th

关 键 词：脑梗塞 恢复期 针刺疗法 穴位 头针刺激区 益气养阴祛瘀汤 同型半胱氨酸 血液流变学 

分 类 号：R277.7[医药卫生—中医学]