祛瘀涤痰针刺法对急性缺血性脑卒中的影响  

Effects of Acupuncture for Removing Blood Stasis and Phlegm on Acute Ischemic Stroke

作　　者：宋仲涛 黄清苑[1] 曾志威[1] 郭裕霞 宋晓动 SONG Zhongtao;HUANG Qingyuan;ZENG Zhiwei;GUO Yuxia;SONG Xiaodong(Meizhou People’s Hospital,Meizhou 514031,Guangdong,China)

机构地区：[1]梅州市人民医院,广东梅州514031

出　　处：《辽宁中医杂志》2023年第1期155-158,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：广东省中医药局中医药科研项目(20202206);梅州市医药卫生科研项目(2020-B-67)。

摘　　要：目的观察祛瘀涤痰针刺法对急性缺血性脑卒中患者神经功能、凝血功能的影响。方法采用随机数字表法将2019年5月—2021年1月梅州市人民医院收治的72例急性缺血性卒中患者分为观察组和对照组各36例。两组患者均采取脑卒中二级预防及早期康复治疗,在此基础上观察组患者给予祛瘀涤痰针刺法治疗,对照组患者给予传统头针联合体针治疗。治疗1周后,观察两组患者临床疗效,比较治疗前、治疗1周后两组患者中医证候积分(半身不遂、口眼歪斜、言语蹇涩、感觉异常、头晕目眩、痰多而黏)、凝血功能[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)]、神经功能[神经功能缺损程度评分(NIHSS)]及日常生活能力[改良Barthel指数(MBI)]水平变化情况,统计治疗后3个月两组患者改良Rankin评分(mRS)水平。结果治疗期间两组患者均无死亡病例。观察组患者临床总有效率高于对照组(P<0.05)。治疗1周后,两组患者FIB、NIHSS评分均低于治疗前,且观察组低于对照组(P<0.05);两组患者PT、TT、APTT水平及MBI评分均高于治疗前,且观察组高于对照组(P<0.05)。治疗后3个月,观察组患者mRS与对照组差异无统计学意义(P>0.05)。结论祛瘀涤痰针刺法治疗急性缺血性脑卒中患者疗效确切,能有效改善患者中医证候、凝血功能,减轻神经功能缺损程度,提高日常生活能力,在改善预后方面与传统针刺相比无显著性差异。Objective To observe the effects of acupuncture for removing blood stasis and phlegm on neurological function and coagulation function in patients with acute ischemic stroke.Methods Seventy-two patients with acute ischemic stroke treated in the hospital between May 2019 and January 2021 were divided into observation group and control group according to the random number table method,with 36 cases in each group.Both groups were treated with secondary stroke prevention and early rehabilitation.On this basis,patients in the observation group were treated with acupuncture for removing blood stasis and phlegm,and those in the control group were treated with traditional scalp acupuncture combined with body acupuncture.After 1 week of treatment,the clinical efficacy of the two groups was observed.The scores of TCM syndromes(hemiplegia,deviated mouth and eyes,sluggish speech,paresthesia,dizziness,excessive sticky phlegm),coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)],neurological function[National Institutes of Health Stroke Scale(NIHSS)]and ability of daily living[Modified Barthel Index(MBI)]were compared between the two groups before treatment and after 1 week of treatment.Modified Rankin Score(mRS)of patients in both groups was statistically analyzed at 3 months after treatment.Results During treatment,there were no deaths in the two groups.The total clinical effective rate of the observation group was higher than that of the control group(P<0.05).After 1 week of treatment,the FIB and NIHSS score of the two groups were lower than those before treatment,and the above indicators of the observation group were lower than those of the control group(P<0.05).The PT,TT,APTT and MBI score of the two groups were longer or higher than those before treatment,and the indicators of the observation group were longer or higher than those of the control group(P<0.05).At 3 months after treatment,the mRS score of two groups have no statistical difference(P<0.05).C

关 键 词：祛瘀涤痰 针刺 脑卒中 神经功能 凝血功能 

分 类 号：R743[医药卫生—神经病学与精神病学]