针刺联合益气活血通络汤对卒中患者神经功能的影响  

Effect of Acupuncture Combined with Yi Qi Huo Xue Tong Luo Decoction on the Neurological Function in Stroke Patients

作　　者：陈莹 黄东勉 谭辉[3] CHEN Ying;HUANG Dong-mian;TAN Hui(Haikou Hospital of Traditional Chinese Medicine,Haikou 570216,China;Hainan Medical Academic Exchange Management Center,Haikou 570216,China;Anhui University of Chinese Medicine,Hefei 230038,China)

机构地区：[1]海口市中医医院,海口570216 [2]海南省医学学术交流管理中心,海口570216 [3]安徽中医药大学,合肥230038

出　　处：《上海针灸杂志》2021年第9期1081-1086,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金青年项目(81603523)。

摘　　要：目的观察针刺联合益气活血通络汤对卒中患者神经功能的影响。方法将86例卒中患者随机分为对照组和联合组,每组43例。先给予基础治疗,对照组给予益气活血通络汤加减方治疗,联合组在益气活血通络汤加减方治疗基础上给予针刺治疗。观察美国国立卫生研究院卒中量表(NIHSS)评分,Fugl-Meyer运动功能评估(FMA)、日常生活活动能力(ADL)、蒙特利尔认知评估量表(MoCA)评分变化,检测血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)、半胱氨酸蛋白酶-3(caspase-3)、半胱氨酸蛋白酶-9(caspase-9)水平,评估中医证候积分,并比较临床疗效。结果与治疗前比较,两组治疗后NIHSS、中医证候积分及血清caspase-3和caspase-9水平降低;FMA、ADL、MoCA评分及血清BDNF和NGF水平升高,差异有统计学意义(P<0.05)。与对照组比较,联合组治疗后NIHSS、中医证候积分及血清caspase-3和caspase-9水平降低;FMA、ADL、MoCA评分及血清BDNF和NGF水平升高,差异有统计学意义(P<0.05)。联合组总有效率高于对照组,差异有统计学意义(P<0.05)。结论在基础治疗的基础上,针刺联合益气活血通络汤加减治疗卒中效果显著,可提高患者认知功能、生活质量和运动功能,改善患者神经功能。Objective To observe the effect of acupuncture plus Yi Qi Huo Xue Tong Luo(supplementing qi,activating blood flow and unblocking collaterals)decoction on the neurological function in stroke patients.Method Eighty-six stroke patients were randomized into a control group and a joint group,with 43 cases in each group.In addition to the basic treatment,the control group was given modified Yi Qi Huo Xue Tong Luo decoction,and the joint group was given modified Yi Qi Huo Xue Tong Luo decoction and acupuncture treatment.Changes in the scores of National Institute of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),activities of daily living(ADL)and Montreal Cognitive Assessment(MoCA)were observed;the levels of serum brain-derived neutrophic factor(BDNF),nerve growth factor(NGF),caspase-3 and caspase-9 were detected;the Traditional Chinese Medicine(TCM)symptoms were scored and clinical efficacy was compared.Result The scores of NIHSS and TCM symptoms and the levels of serum caspase-3 and caspase-9 declined after treatment in both groups,and the scores of FMA,ADL and MoCA and the levels of BDNF and NGF increased,all showing significant differences(P<0.05).Compared with the control group,the scores of NIHSS and TCM symptoms and the levels of caspase-3 and caspase-9 declined in the joint group after treatment,and the scores of FMA,ADL and MoCA and the levels of serum BDNF and NGF increased,all showing significant differences(P<0.05).The total effective rate was higher in the joint group than in the control group,and the difference was statistically significant(P<0.05).Conclusion Based on the conventional treatment,acupuncture plus modified Yi Qi Huo Xue Tong Luo decoction can produce significant efficacy in treating stroke;it can improve the cognitive function,quality of life,motor function and neurological function in the patients.

关 键 词：针刺疗法 益气活血通络汤 针药并用 中风后遗症 偏瘫 美国国立卫生研究院卒中量表(NIHSS) 

分 类 号：R246.6[医药卫生—针灸推拿学]