中药针剂联合中医特色疗法治疗脑梗死急性期瘀血阻络证疗效回顾性分析  

Retrospective Analysis of Curative Effects of Traditional Chinese Medicine Injection in Combination with TCM-featured Therapy in the Treatment of Acute Cerebral Infarction of Blood Stasis Obstructing Collaterals Pattern

作　　者：高晓峰[1] 程慧娟 刘利娟[1] 郭纯[1] 杨仁义[2] 陈瑶[1] 周德生[1,2] GAO Xiaofeng;CHENG Huijuan;LIU Lijuan;GUO Chun;YANG Renyi;CHEN Yao;ZHOU Desheng(Department of Neurology,the First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Hunan University of Chinese Medicine)

机构地区：[1]湖南中医药大学第一附属医院神经内科,湖南长沙410007 [2]湖南中医药大学

出　　处：《西部中医药》2022年第9期115-118,共4页Western Journal of Traditional Chinese Medicine

基　　金：湖南省科技厅科技创新平台与人才计划-中医脑病临床研究中心项目(2017SK4005);湖南省中医药管理局资助项目(201824,202046,202037);湖南中医药大学中西医结合一流学科开放基金项目(2019ZXYJH08)。

摘　　要：目的:回顾性分析中药针剂联合不同的中医特色疗法治疗脑梗死急性期瘀血阻络证的临床疗效。方法:回顾性分析480例脑梗死急性期瘀血阻络证患者的病历资料,将病例分为甲组(西医基础治疗+活血化瘀类针剂)、乙组(西医基础治疗+活血化瘀类针剂+针刺治疗)、丙组(西医基础治疗+活血化瘀类针剂+中药汤剂)、丁组(西医基础治疗+活血化瘀类针剂+中医外治法),记录并比较4组患者总有效率积分及治疗前后中医证候、神经功能缺损美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)、日常生活能力量表(activities of daily living,ADL)评分。结果:甲、乙、丙、丁组总有效率分别为85.83%、96.67%、91.67%、95.83%,疗效均显著;与甲组相比,乙、丙、丁组总有效率提高明显(P<0.05),其中乙组疗效最显著。4组中医证候积分、NIHSS评分、ADL评分均较治疗前改善(P<0.05)。中医证候积分、ADL评分治疗后乙、丁组较甲组下降明显(P<0.01),丙组与甲组比较评分差异无统计学意义(P>0.05);与甲组相比,乙组、丙组、丁组治疗后NIHSS评分均降低(P<0.05),乙组降低最显著。结论:中药针剂联合不同中医特色疗法如针刺、汤剂、外治法均能有效改善脑梗死急性期瘀血阻络证患者的神经功能缺损症状、中医证候评分,提高患者日常生活能力,以针剂联合针刺疗效最明显。Objective:To retrospectively analyze clinical effects of TCM injection joined with different TCM-featured therapies in treating acute cerebral infarction of blood stasis obstructing collateral pattern.Methods:After retrospective analysis of clinical data of 480 patients with acute cerebral infarction of blood stasis obstructing collateral pattern,all the patieats were divided into A group(basic therapy of Western medicine+the injection of activating blood and resolving stasis),B group(basic therapy of Western medicine+the injection of activating blood and resolving stasis+acupuncture therapy)and C group(basic therapy of Western medicine+the injection of activating blood and resolving stasis+herbal decoction),as well as D group(basic therapy of Western medicine+the injection of activating blood and resolving stasis+TCM external therapy),to record and compare the scores of total clinical effects,TCM syndrome,NIHSS and ADL before and after the treatment between four groups.Results:Total effective rates of A,B,C and D groups were 85.83%,96.67%,91.67%and 95.83%respectively,and clinical effects were remarkable;compared with A group,total effective rates of B,C and D groups were increased distinctly(P<0.05),among them,clinical effects of B group were significant.TCM syndrome integrals,NIHSS scores and ADL scores of four groups were improved compared with these before the treatment(P<0.05).The decrease of TCM syndrome integrals and ADL scores in B and C groups were more noticeable than these of A group(P<0.01),the difference had no statistical meaning when C group was compared with A group(P>0.05);compared with A group,NIHSS scores of B,C and D groups were lowered after the treatment(P<0.05),the decrease of B group was the most remarkable.Conclusion:TCM injections combined with different TCM-featured therapies including acupuncture,decoction,external therapy could effectively improve the symptoms of neurological deficits and TCM syndrome integrals,raise the patients’ability of daily living,clinical effects are the most

关 键 词：脑梗死急性期 瘀血阻络证 中药针剂 中医特色疗法 回顾性研究 

分 类 号：R283.6[医药卫生—中药学]