益气活血方联合针灸对脑梗死下肢偏瘫患者氧化应激指标和肢体功能的影响  

Effects of Yiqi Huoxue recipe combined with acupuncture on indexes of oxidative stress and function of limbs in patients with cerebral infarction lower limb hemiplegia

作　　者：曾德毅 黄楚栓 蔡彦[3] Zeng Deyi;Huang Chushuan;Cai Yan(Department of Rehabilitation,Guangzhou Panyu Sanatorium,Guangzhou 511400,Guangdong,China;Department of Respiratory Medicine,the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510000,Guangdong,China;Department of Respiratory Medicine,Guangdong Traditional Chinese Medicine Hospital,Guangzhou 510000,Guangdong,China)

机构地区：[1]广州市番禹疗养院康复科,广东广州511400 [2]广州中医药大学第一附属医院呼吸内科,广东广州510000 [3]广东省中医院呼吸内科,广东广州510000

出　　处：《中国中西医结合急救杂志》2019年第6期669-673,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广东省广州市科技计划项目(201803010053)。

摘　　要：目的观察益气活血方联合针灸对脑梗死下肢偏瘫患者血中同型半胱氨酸(Hcy)、超氧化物歧化酶(SOD)和肢体功能及生活质量的影响.方法采用前瞻性研究方法,选择2015年12月至2017年12月广州市番禹疗养院康复科治疗的脑梗死下肢偏瘫患者110例,按随机数宇表法将患者分为针灸组与中药联合针灸组,每组55例.两组患者均给予康复治疗,针灸组在康复治疗的同时针刺内关、委中、极泉、尺泽、三阴交等穴,点刺不留针,上星透百会;上午针刺四中穴、双侧颗穴、环跳、血海、足三里、曲池、外关、合谷等穴,快速进针,留针20 min;下午针刺风池、完骨、大柱穴,留针20 min,每3 d 1次,7 d为1个疗程,持续治疗12个疗程.中药联合针灸组在针灸组治疗基础上加用益气活血方(组成:黄蔑30 g、当归15 g、川穹15 g、桑寄生15 g、千年健15 g、续断15 g、赤芍15 g、地龙15 g、桃仁15 g、红花10 g、姜黄10 g、苦杏仁10 g、山英肉10 g、知母10 g、石斜10 g、僵蚕10 g、制大黄10 g),每日1剂,水煎至约300 mL,分早晚2次服用,30 d为1个疗程,持续治疗3个疗程.检测治疗前后两组患者氧化应激指标水平;并观察两组患者肢体功能、神经功能及生活质量的变化.结果随时间延长,两组治疗后中医证候积分均较治疗前降低,治疗90 d达最低水平,巨中药联合针灸组明显低于针灸组(分:10.27±4.12比15.88±3.56,P<0.05).两组治疗后Hcy、Ashworth痉挛等级量表评分、美国国立卫生研究院卒中量表(NIHSS)评分均较治疗前明显降低,SOD、Fugl-Meyer运动功能量表(FMA)评分、功能性步行分级(FAC)、脑卒中专用生活质量量表(SS-QOL)评分均较治疗前明显升高,巨治疗后中药联合针灸组上述指标的变化较针灸组更明显[Hcy(mmol/L):13.18±1.83比14.77±1.83,Ashworth痉挛等级量表评分(分):1.34±0.20比1.51±0.13,NIHSS(分):12.43±4.54比14.76±3.56,SOD(kU/L):74.75±8.95比66.23±9.40,FMA(分):23.Objective To observe the effects of Yiqi Huoxue recipe combined with acupuncture and moxibustion on homocysteine(Hcy),superoxide dismutase(SOD),body function and quality of life in patients with cerebral infarction lower limb hemiplegia.Methods A prospective study was conducted.One hundred and ten patients with cerebral infarction lower limb hemiplegia admitted in the Department of Rehabilitation of Guangzhou Panyu Sanatorium were selected from December 2015 to December 2017.According to the random number table method,the patients were divided into an acupuncture group and a traditional Chinese medicine(TCM)combined with acupuncture group,55 cases in each group.Both groups of patients received rehabilitation treatment;simultaneously,in the acupuncture group,acupunctures without needle retention were performed at acupoints of Neiguan,Weizhong,Jiquan,Chize,Sanyinjiao,etc,while at Shangxing acupoint the needle also penetrated through the location of Baihui for the patients;in the morning,the acupunctures with quick needle insertions at Sizhong,bilateral Nei,Huantiao,Xuehai,Zusanli,Quchi,Waikuan,Hegu,etc acupoints were performed,and in the afternoon acupunctures at Fengchi,Wangu,Tienzhu acupoints were performed with needle retention for 20 min,3 times a day,7 days constituting one therapeutic course and persisting for 12 courses;in the combination of TCM and acupuncture group,on the basis of the treatment of the acupuncture group,additionally a blood-activating and qi-tonifying prescription was used(the ingredients in the prescription:radix astragali 30 g,radix angelicae sinensis 15 g,ligusticum wallichi 15 g,radix dipsaci 15 g,herba taxilli 15 g,rhizoma homalomenae 15 g,radix paeoniae rubra 15 g,lumbricus 15 g,semen persicae 15 g,carthami flos 10 g,rhizoma curcumae longae 10 g,semen armeniacae amarum 10 g,rhizoma anemarrhenae 10 g,pulp of dogwood fruit 10 g,herba dendrobii 10 g,bombyx batryticatus 10 g,radix et rhizoma rhei 10 g,etc),and 1 dose of the prescription was boiled with water to form about 300 mL decoction

关 键 词：益气活血方 针灸 脑梗死 偏瘫 同型半胱氨酸 超氧化物歧化酶 肢体功能 

分 类 号：R24[医药卫生—中医临床基础]