针药联合水罐治疗中风病急性期风痰阻络证疗效研究  

Joint administration of acupuncture, western and herbal medicines and bamboo-jar-cupping for stroke patients of wind-phlegm obstructing collateral type in acute stage

作　　者：袁玉娇 任大为 关雅素 陈纪仲 姚慧娟 赵颖 李仰敏 王席玲 YUAN Yu-jiao;REN Da-wei;GUAN Ya-su;CHEN Ji-zhong;YAO Hui-juan;ZHAO Ying;LI Yang-min;Wang Xi-ling(Department of Encephalopathy,the First People’s Hospital of Dongcheng District of Beijing,Beijing 100075,China;Department of Encephalopathy,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Department of Traditional Chinese Medicine,Beijing Water Resources Hospital,Beijing 100036)

机构地区：[1]北京市东城区第一人民医院脑病科,北京100075 [2]北京中医药大学东直门医院脑病科,北京100700 [3]北京水利医院中医科,北京100036

出　　处：《针刺研究》2021年第5期416-420,共5页Acupuncture Research

基　　金：北京中医药科技发展资金项目(No.JJ2018-15)。

摘　　要：目的:观察针药联合水罐治疗中风病急性期风痰阻络证患者运动功能障碍疗效。方法:选择中风病急性期风痰阻络证患者100例,按照随机数字表法分为试验组与对照组各50例。对照组予标准方案,含西医常规治疗、半夏白术天麻汤联合桃红四物汤加减方及针刺治疗。试验组在对照组基础上,选用水罐拔罐内关、尺泽、臂臑、足三里、三阴交,留罐10 min,每日1次,治疗2周。治疗后,比较两组的美国国立卫生研究院卒中量表(NIHSS)、简式Fugl-Meyer运动功能评分(FMA)、日常生活能力评分(Barthel)、中医证候积分、C反应蛋白(CRP)、D-二聚体及血同型半胱氨酸变化情况。结果:本组治疗前后比较,两组NIHSS评分均降低(P<0.01),FMA、Barthel评分均升高(P<0.01);试验组NIHSS评分低于对照组(P<0.01),FMA、Barthel评分均高于对照组(P<0.05)。本组治疗前后比较,两组中医证候积分均降低(P<0.01);试验组中医证候积分低于对照组(P<0.05)。本组治疗前后比较,试验组CRP水平降低(P<0.05);试验组CRP水平低于对照组(P<0.05)。结论:针药联合水罐治疗中风病急性期风痰阻络证患者能够促进缺损神经功能的恢复,有效改善运动功能及日常生活能力,降低部分炎性因子,进一步提高其生活质量。Objective To observe the curative effect of joint administration of acupuncture, western and herbal medicines and bamboo-jar-cupping in the treatment of locomotor dysfunction in patients with apoplexy(acute phase) of wind-phlegm blocking meridian-collateral type in acute stroke patients, and its influence on some relevant laboratory indexes.Methods A total of 100 cases of acute stroke patients of wind-phlegm blocking meridian-collateral type were recruited, and equally and randomly divided into control group and treatment group according to the random number table. The patients of both groups received treatment of conventional western medicines(for anti-platelet aggregation, blood-lipid regulation, arterial plaque-stabilization, cerebral cell protection and blood pressure-lowering), Chinese herbal medicines(for promoting blood circulation to dredge the meridian-collaterals), and acupuncture of Neiguan(PC6), Chize(LU5), Zusanli(ST36), Binao(LI14) and Sanyinjiao(SP6);and in addition, the patients of the treatment group also treated by cupping with bamboo-jar(kept for 10 min). The treatment was conducted once a day for 2 weeks. After the treatment, the National Institute of Health Stroke Scale(NIHSS), Fugl-Meyer assessment(FMA), Barthel Index(BI), and traditional Chinese medicine(TCM) syndrome score were used to assess the state of neurofunction, locomotor function, daily living ability, and TCM symptoms. The contents of serum C-reactive protein, D-dimer and blood homocysteine were detected using radical immunodiffusion, immunoturbidimetry, and enzymic methods, respectively.Results After the treatment, of the 50 and 50 cases in the control and treatment groups, 5 and 6 were cured, 7 and 18 experienced marked improvement, 23 and 20 were effective, and 15 and 6 ineffective, with the effective rate being significantly higher in the treatment group(88.0%) than in the control group(70.0%, P<0.05). Self-comparison showed that the FMA and BI scores were significantly increased(P<0.01), and the NIHSS score and TCM syndrome

关 键 词：针刺 水罐 急性缺血性中风 风痰阻络证 神经功能 

分 类 号：R245.99[医药卫生—针灸推拿学]