加减补阳还五汤联合针刺治疗脑卒中伴吞咽障碍临床观察  

Modified Buyang Huanwu Decoction Combined with Acupuncture in the Treatment of Stroke with Dysphagia

作　　者：丁立 DING Li(Department of Rehabilitation Medicine,Shanxian Central Hospital,Shandong Province,Heze 274300,China)

机构地区：[1]菏泽市单县中心医院康复医学科,山东菏泽274300

出　　处：《中国中医药现代远程教育》2023年第22期80-82,共3页Chinese Medicine Modern Distance Education of China

摘　　要：目的分析补阳还五汤加减联合针刺治疗脑卒中伴吞咽障碍的临床效果以及相关分子机制。方法采用前瞻性临床病例对照的方法,选择2019年8月—2021年8月于菏泽市单县中心医院首次确诊脑卒中伴吞咽障碍患者共124例,用随机数字表法分为对照组和观察组,各62例;对照组采用常规吞咽功能训练,观察组在对照组基础上应用补阳还五汤加减联合针刺治疗。评估2组吞咽功能,及脑源性神经营养因子(BDNF)、血管内皮生长因子(VEGF)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的表达情况。结果治疗8周后,2组吞咽功能均明显改善,且观察组比对照组改善更明显(P<0.05);观察组血清BDNF和VEGF水平显著高于对照组,IL-6和TNF-α明显低于对照组(P<0.05)。结论补阳还五汤加减联合针刺治疗脑卒中伴吞咽障碍,能够明显改善患者吞咽功能、提高BDNF和VEGF水平、降低炎症反应,有较好的临床推广价值。Objective To analyze the clinical efficacy and related molecular mechanism of modified Buyang Huanwu decoction combined with acupuncture in the treatment of stroke with dysphagia.Methods A total of 124 patients with dysphagia after stroke admitted to Shanxian Central Hospital for the first time from August 2019 to August 2021 were prospective selected as the study subjects.They were divided into the control group of 62 cases and the observation group of 62 cases by random number method.The control group received routine dysphagia training,and the observation group received modified Buyang Huanwu decoction combined with acupuncture on the basis of the control group.The swallowing function was evaluated and the levels of brain-derived neurotrophic factor(BDNF),vascular endothelial growth factor(VEGF),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were observed.Results After 8 weeks of treatment,the swallowing function of both groups was significantly improved,and the improvement of observation group was more obvious than that of control group(P<0.05).Serum levels of BDNF and VEGF in observation group were significantly higher than those in control group,IL-6 and TNF-αwere significantly lower than those in control group(P<0.05).Conclusion Buyang Huanwu decoction combined with acupuncture in the treatment of stroke with dysphagia can significantly improve the swallowing function,increase the levels of BDNF and VEGF,and reduce the inflammatory response,which has good clinical promotion value.

关 键 词：脑卒中 吞咽障碍 补阳还五汤 针刺疗法 中医综合疗法 

分 类 号：R277.7[医药卫生—中医学]