靳三针对卒中后遗症患者中医证候积分及脑血管阻力、颈动脉IMT值的影响  

Effects of Jin's Three-needle Therapy on Traditional Chinese Medicine Syndrome Score,Cerebral Vascular Resistance and Carotid IMT in Patients with Apoplexy Sequelae

作　　者：张萌芮 梁超 张燕珍 林明慧 陈少萍 ZHANG Mengrui;LIANG Chao;ZHANG Yanzhen;LIN Minghui;CHEN Shaoping(Haikou Hospital of Traditional Chinese Medicine,Haikou 570206,Hainan,China)

机构地区：[1]海口市中医医院,海南海口570206

出　　处：《中华中医药学刊》2023年第2期93-96,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82060898);海南省自然科学基金项目(821QN1007);海南省临床医学中心建设项目(琼卫医函[2021]276号);海南省医药卫生科研项目(21A200016)。

摘　　要：目的研究靳三针对卒中后遗症患者中医证候积分及脑血管阻力、颈动脉内膜中层厚度(intimamedia thickness,IMT)值的影响。方法将医院2019年6月—2021年6月收治的122例卒中后偏瘫患者纳为研究对象,采用信封法将其均分为观察组与对照组,对照组进行常规康复训练,观察组在此基础上进行靳三针治疗,比较两组治疗前后中医证候积分、日常生活活动能力(Barthel)、神经功能缺损程度[神经功能缺损评分标准(China stroke scale,CSS)量表]以及痉挛程度(ashworth痉挛量表),并采用颈动脉超声检查患者IMT,脑循环动力学检测仪检测患者脑循环动力学(cerebral vascular hymodynamic analyzer,CVA)相关指标。结果两组治疗后,半身不遂、偏身感觉障碍、口舌歪斜、气短乏力、舌质舌苔、面色白、言语謇涩积分及中医证候总积分均较同组治疗前显著下降(P<0.05),且观察组各项目积分及总积分均显著低于对照组(P<0.05)。两组治疗后,Barthel指数均较同组治疗前显著上升(P<0.05),CSS量表及Ashworth评分均较同组治疗前显著下降(P<0.05),且观察组治疗后Barthel量表得分显著高于对照组(P<0.05),CSS量表得分及Ashworth评分显著低于对照组(P<0.05)。两组治疗后,脑循环动力学参数平均血流速度(Vmean)、平均血流量(Qmean)均较同组治疗前显著上升(P<0.05),血管外周阻力(R)、脑血管床特性阻抗(Zc)均较同组治疗前显著下降(P<0.05),且观察组治疗后Vmean及Qmean均显著高于对照组(P<0.05),R、Zc均显著低于对照组(P<0.05)。对照组治疗前后IMT差异无显著统计学意义(P>0.05),观察组治疗后IMT较其治疗前显著下降,且显著低于对照组(P<0.05)。观察组综合疗效及中医证候疗效治疗有效率均显著高于对照组(P<0.05)。结论在常规康复训练的基础上加用靳三针能有效改善卒中后痉挛性偏瘫患者临床症状,同时增强患者脑部血液循环动力学,减轻机体全身动脉粥Objective To investigate the effects of Jin's three-needle therapy on Traditional Chinese Medicine syndrome score,cerebral vascular resistance and carotid intima-media thickness(IMT)in patients with apoplexy sequelae.Methods A to⁃tal of 122 patients with apoplexy sequelae in the hospital from June 2019 to June 2021 were enrolled and divided into two groups by envelope methods.The control group received routine rehabilitation training,while the observation group received routine reha⁃bilitation combined with Jin’s three-needle therapy.The Traditional Chinese Medicine syndrome scores,Barthel Activities of Daily Living(ADL)index,Chinese stroke scale(CSS criteria)and Ashworth Scales of spasticity were compared between the two groups before and after treatment.Carotid IMT was measured using carotid ultrasound,and the cerebral circulatory dynamics(CVA)related indexes were detected by CMT.Cerebral hemodynamic indices were measured using cerebrovascular activity(CVA).Results After treatment,the scores of symptoms including hemiplegia,hemisensory impairment,deviation of eye and mouth,shortness of breath,lassitude,tongue proper and coating,pale appearance,and inarticulate speech and the total score of Traditional Chinese Medicine syndromes were decreased significantly in both groups(P<0.05),and the above score was signifi⁃cantly lower in the observation group than that in the control group(P<0.05).An increase in Barthel index,and a decrease in CSS and Ashworth scale were observed in both groups after treatment(P<0.05).Compared with the control group,the observa⁃tion group had significantly higher Barthel score and lower scores of CSS and Ashworth(P<0.05).The velocity(Vmean)and quantity(Qmean)of mean blood flow were increased in both groups after treatment,and the cerebrovascular peripheral resistance(R)and characteristic impedance(Zc)were decreased in both groups(P<0.05).The observation group had significantly high⁃er Vmean and Qmean as well as lower R and Zc than those of the control group(P<0.05).IMT had no s

关 键 词：靳三针 卒中后遗症 偏瘫 气虚血瘀型 中医证候积分 脑循环动力学 颈动脉超声 

分 类 号：R245.31[医药卫生—针灸推拿学] R277.74.3[医药卫生—中医临床基础]