针刺配合穴位贴敷分期辨证治疗缺血性卒中500例  

Clinical observation of acupuncture combined with acupoint application on the treatment of ischemic stroke based on syndrome differentiation of clinical stages

作　　者：周志峰[1] 薛新琴[1] 王玥[1] 赵立峰[2] 周志怀[3] 王瑞杰[4] 

机构地区：[1]河北省石家庄市第三医院针灸科,河北石家庄050011 [2]河北省石家庄市社区卫生服务管理中心,河北石家庄050021 [3]河北省石家庄市第四医院影像科,河北石家庄050011 [4]河北省邯郸市第四医院针灸科,河北邯郸056000

出　　处：《河北中医》2016年第12期1852-1857,1864,共7页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2015年度中医药类科研计划课题(编号:2015204)

摘　　要：目的观察针刺配合穴位贴敷分期辨证治疗缺血性卒中的疗效。方法将600例缺血性卒中患者随机分为2组,对照组100例进行针刺分期辨证治疗,治疗组500例在对照组治疗基础上加穴位贴敷治疗。检测2组痉挛期患者治疗前后血清中谷氨酸(Glu)、γ-氨基丁酸(GABA)的含量,采用卒中残损评价表(SIAS)评估2组患者治疗前后整体功能状况,比较2组治疗前后中医症状评分变化及临床疗效。结果治疗组总有效率98.20%,对照组84.00%,2组总有效率比较差异有统计学意义(P<0.05),治疗组临床疗效优于对照组。2组痉挛期患者治疗后血清Glu含量均较本组治疗前降低(P<0.05),GABA含量增加(P<0.05),Glu/GABA值下降(P<0.05),且2组组间比较差异亦均有统计学意义(P<0.05)。2组治疗后SIAS积分均较本组治疗前提高(P<0.05),中医症状评分降低(P<0.05),且2组组间比较及2组SIAS积分治疗前后差值比较差异均有统计学意义(P<0.05)。结论针刺配合穴位贴敷分期辨证治疗缺血性卒中疗效显著。Objective To observe the curative effects of acupuncture combined with acupoint application on the treatment of ischemic stroke based on syndrome differentiation of clinical stages. Methods 600 patients with ischemic stroke were randomly divided into two groups. 100 cases in control group were treated by acupuncture based on syndrome differentiation of clinical stages, and 500 cases in treatment group were treated by acupoint application on the basis of control group treatment. The serum glutamic acid （Glu）, γ -aminobutyric acid （GABA） before and after treatment were measured in patients during convulsion stage. The whole condition was evaluated by Stroke Im- pairment Assessment Set （SIAS） before and after treatment. The traditional Chinese medicine （ TCM ） syndrome score and clinical effects before and after treatment were evaluated in two groups. Results The total effective rate in treatment group （98.20%） was superior to control group （ 84.00%, P 〈 0.05 ）. The serum Glu after treatment in patients during convulsion stage was decreased as compared with before treatment （ P 〈 0.05 ）, the GABA was in- creased （P 〈 0.05） and the Glu/GABA was decreased （ P 〈 0.05 ） , and there were statistical differences between two groups （P 〈 0.05）. The score of SIAS after treatment was increased in two groups （ P 〈 0.05 ）, the TCM syndrome score was decreased as compared with those in before treatment （P 〈 0.05）, and there were statistical differences on SIAS after treatment between two groups （ P 〈 0. 05 ）. Conclusion Acupuncture combined with acupoint application has exact effects on the treatment of ischemicstroke.

关 键 词：卒中 针刺疗法 穴位贴敷法 辨证论治 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R245.31[医药卫生—临床医学]