针刺阳明经配合补阳还五汤加减治疗气虚血瘀型脑梗死的效果分析  

Efficacy of acupuncture at Yangming meridian combined with modified Buyang Huanwu Decoction in treating cerebral infarction differentiated as type of Qi deficiency and blood stasis

作　　者：燕炼钢[1] 周婷[1] 贾泽坤[1] 杨娅[1] 江娜[1] 何彦蓉[1] 王储蓄 殷红彪 YAN Liangang;ZHOU Ting;JIA Zekun;YANG Ya;JIANG Na;HE Yanrong;WANG Chuxu;YIN Hongbiao(the Tenth Ward,the Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui,230061)

机构地区：[1]安徽中医药大学第二附属医院十病区,安徽合肥230061

出　　处：《实用临床医药杂志》2023年第22期105-109,共5页Journal of Clinical Medicine in Practice

基　　金：安徽中医药大学科研基金项目(2022ZJPT04);安徽省高等学校科学研究项目自然科学类(2022AHO50497);安徽中医药大学科研基金项目(2021zjzx005)。

摘　　要：目的探讨针刺阳明经配合补阳还五汤加减对气虚血瘀型脑梗死患者肢体偏瘫及血液流变学、神经营养因子的影响。方法选取2018年3月—2023年6月住院治疗的84例气虚血瘀型脑梗死患者为研究对象,随机分为观察组和对照组,每组42例。对照组接受针刺及常规治疗,观察组在对照组基础上配合补阳还五汤加减治疗。比较2组治疗2周后的临床疗效以及治疗前后主要症状积分、神经功能、肢体功能、血液流变学指标及神经营养因子水平。结果治疗2周后,观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);2组治疗后半身不遂、口角歪斜、言语謇涩症状积分均较治疗前下降,且观察组低于对照组,差异有统计学意义(P<0.05)。2组治疗后美国国立卫生研究院卒中量表(NIHSS)评分均较治疗前下降,且观察组低于对照组,差异有统计学意义(P<0.05);2组治疗后运动功能评定量表(Fugl-Meyer)评分均较治疗前提高,且观察组高于对照组,差异有统计学意义(P<0.05)。2组治疗后血浆黏度、红细胞聚集指数、全血高切黏度、全血低切黏度均较治疗前下降,且观察组低于对照组,差异有统计学意义(P<0.05)。2组治疗后血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)、胶质细胞源性神经营养因子(GDNF)水平均较治疗前提高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论针刺阳明经配合补阳还五汤加减可提高对气虚血瘀型脑梗死肢体偏瘫的治疗效果,改善临床症状,修复神经损伤,促进肢体功能恢复。Objective To investigate the effect of acupuncture at Yangming meridian combined with modified Buyang Huanwu Decoction on hemiplegia,hemorheology and neurotrophic factors in patients with cerebral infarction differentiated as type of Qi deficiency and blood stasis.Methods A total of 84 hospitalized patients with cerebral infarction differentiated as type of Qi deficiency and blood stasis from March 2018 to June 2023 were selected as research objects,and they were randomly divided into observation group and control group,with 42 cases in each group.The control group was conducted with acupuncture and routine treatment,while the observation group was conducted with modified Buyang Huanwu Decoction on the basis of the control group.Clinical efficacy after 2 weeks of treatment as well as the scores of main symptoms,neurological function,limb function,hemorheological indicators and levels of neurotrophic factors before and after treatment were compared between two groups.Results After 2 weeks of treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);after treatment,the scores of symptoms such as hemiplegia,deviated mouth and awkward speech in both groups decreased significantly when compared to those before treatment,and these scores in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the score of the National Institutes of Health Stroke Scale(NIHSS)in both groups decreased significantly when compared to that before treatment,and the score in the observation group was significantly lower than that in the control group(P<0.05);the score of the Motor Function Assessment Scale(Fugl-Meyer)after treatment in both groups was significantly higher than that before treatment,and the observation group was significantly higher than that in the control group(P<0.05).After treatment,the plasma viscosity,red blood cell aggregation index,whole blood high shear viscosity and whole blood low shear viscosity in bot

关 键 词：针灸 阳明经 补阳还五汤加减 气虚血瘀证 脑梗死 肢体偏瘫 血液流变学 神经营养因子 

分 类 号：R454[医药卫生—治疗学] R743.3[医药卫生—临床医学] R277.7