培元通腑法联合西药治疗痰热腑实型缺血性脑卒中临床研究  

Clinical Study on Method of Cultivating the Vital Essence and Unblocking the Bowels Combined with Western Medicine for Ischemic Stroke of Phlegm-Heat and Bowel Excess Type

作　　者：陈赛亚 蒋玉燕[1] 王环芬 周依纯 CHEN Saiya;JIANG Yuyan;WANG Huanfen;ZHOU Yichun(Department of Geriatric Medicine,Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University,Wenzhou Zhejiang 325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院老年医学科,浙江温州325000

出　　处：《新中医》2023年第23期60-64,共5页New Chinese Medicine

基　　金：2021年温州市科技局项目(Y20210898)。

摘　　要：目的:观察培元通腑法联合西药治疗缺血性脑卒中的疗效及对动脉粥样硬化的影响。方法:选取98例痰热腑实型缺血性脑卒中患者,按随机数字表法分为联合组及对照组各49例,对照组接受阿托伐他汀钙片及阿司匹林肠溶片治疗,联合组在对照组基础上给予培元通腑法(化痰通腑汤联合培元固本法针刺)治疗,2组均连续治疗4周。观察2组临床疗效及不良反应发生率,比较2组治疗前后中医证候积分、神经功能[美国国立卫生研究院卒中(NIHSS)]、日常生活活动能力(Barthel指数)、斑块参数[斑块面积、斑块总积分、颈动脉内中膜厚度(IMT)]指标值的变化。结果:联合组临床疗效总有效率91.84%,对照组为75.51%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组言语謇涩、口眼歪斜、偏身麻木、半身不遂、痰多而黏中医证候积分均较治疗前下降(P<0.05),联合组上述5项中医证候积分均低于对照组(P<0.05)。治疗后,2组NIHSS评分均较治疗前下降(P<0.05),Barthel指数均较治疗前升高(P<0.05);联合组NIHSS评分低于对照组(P<0.05);Barthel指数高于对照组(P<0.05)。治疗后,2组斑块面积、斑块总积分、IMT指标值均较治疗下降(P<0.05),联合组上述3项指标值均低于对照组(P<0.05)。对照组不良反应发生率为8.16%,联合组不良反应发生率为10.20%,2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:培元通腑法联合西药治疗痰热腑实型缺血性脑卒中疗效较好,可改善神经功能及日常生活活动能力,延缓颈动脉斑块进展,且安全性良好。Objective:To observe the curative effect of the method of cultivating the vital essence and unblocking the bowels combined with western medicine on ischemic stroke and its effects on atherosclerosis.Methods:A total of 98 cases of patients with ischemic stroke of phlegm-heat and bowel excess type were selected and divided into the combination group and the control group according to the random number table method,with 49 cases in each group.The control group was treated with Atorvastatin Calcium Tablets and Aspirin Enteric-Coated Tablets,the combination group was additionally treated with the method of cultivating the vital essence and unblocking the bowels(Huatan Tongfu Decoction combined with acupuncture with the method of cultivating the vital essence and unblocking the bowels)based on the treatment of the control group.Both groups were continuously treated for 4 weeks.Clinical effects and the incidence of adverse reactions were observed in the two groups.Changes in traditional Chinese medicine(TCM)syndrome scores,neurological function[National Institutes of Health Stroke Scale(NIHSS)],activity of daily living(Barthel Index),and plaque parameters[plaque area,total plaque score,and carotid intima-media thickness(IMT)]were compared between the two groups before and after treatment.Results:The total clinical effective rate was 91.84%in the combination group and 75.51%in the control group,the difference being significant(P<0.05).After treatment,TCM syndrome scores including sluggish speech,facial palsy,half-body numbness,hemiplegia,and profuse and sticky sputum in the two groups were decreased when compared with those before treatment(P<0.05),and the above five scores in the combination group were lower than those in the control group(P<0.05).After treatment,NIHSS scores in the two groups were decreased when compared with those before treatment(P<0.05),and Barthel Indexes were increased when compared with those before treatment(P<0.05);NIHSS score in the combination group was lower than that in the control group(P<

关 键 词：缺血性脑卒中 痰热腑实型 化痰通腑汤 针刺 神经功能 动脉粥样硬化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]