督脉灸调补脾肾阳虚型肌萎缩侧索硬化患者22例临床观察  

Governer Vessel(督脉)Moxibustion for Regulating and Replenishing Spleen and Kidney Yang Deficiency in Patients with Amyotrophic Lateral Sclerosis:22 Cases Observation

作　　者：徐慧[1] 秦兰芳 裘涛[1] 秋超[1] XU Hui;QIN Lanfang;QIU Tao;QIU Chao(The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine),Hangzhou,310006)

机构地区：[1]浙江中医药大学附属第一医院(浙江省中医院),浙江省杭州市310006

出　　处：《中医杂志》2024年第17期1802-1807,共6页Journal of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划(2022ZA071)。

摘　　要：目的 观察督脉灸对脾肾阳虚型肌萎缩侧索硬化(ALS)患者的临床效果及安全性。方法 纳入脾肾阳虚型ALS患者44例,按照随机数字表法分为治疗组和对照组各22例,对照组采用利鲁唑片口服+依达拉奉注射液静脉滴注+中药裘氏温肾止痿汤口服+常规康复护理的治疗方案,治疗组在对照组的基础上进行督脉灸治疗,每周施灸1次,2周为1个疗程。两组均治疗3个月。观察两组患者治疗前及治疗1、2、3个月后的ALS中医疗效评价量表(ALS-SSIT)及修订版ALS功能评分量表(ALSFRS-R)评分,观察并记录治疗过程中两组不良反应发生情况。结果 与本组治疗前比较,治疗组治疗1、2、3个月后口咽部功能、肌肉功能、非运动症状评分均降低,ALSFRS-R评分升高(P<0.05);对照组治疗1、2、3个月后口咽部功能、肌肉功能评分升高,ALSFRS-R评分降低,非运动症状评分治疗2、3个月后降低(P<0.05)。治疗组治疗1个月后肌肉功能、非运动症状评分低于对照组;治疗2、3个月后口咽部功能、肌肉功能、非运动症状评分均低于对照组,ALSFRS-R评分高于对照组(P<0.05)。治疗组出现便秘、皮肤瘙痒、皮肤红疹、口干舌燥各3、2、1、1例,对照组各出现2、1、2、2例,两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 在中西医药物结合治疗联合常规康复护理的基础上施加督脉灸外治疗法,有助于改善脾肾阳虚型ALS患者的部分临床症状,且安全性良好。Objective To observe the clinical effect and safety of Governer Vessel(督脉) moxibustion on amyotrophic lateral sclerosis(ALS) patients with spleen and kidney yang deficiency. Methods Forty-four ALS patients with spleen and kidney yang deficiency were finally enrolled, and they were divided into 22 cases each in the treatment group and the control group. The control group was treated with oral riluzole tablets, intravenous drip of edaravone injection, oral Qiu's Wenshen Zhiwei Decoction(裘氏温肾止痿汤), and conventional rehabilitation nursing, while the treatment group was additionally given Governer Vessel moxibustion based on the control group. The moxi-bustion treatment was applied once a week for a course of 2 weeks. Both groups were treated for 3 months. The scores of amyotrophic lateral sclerosis symptom score in integrative treatments(ALS-SSIT) for evaluating therapeutic effect of traditional Chinese medicine and amyotrophic lateral sclerosis functional rating scale-revised(ALSFRS-R) were assessed before treatment and after 1 month, 2 months and 3 months treatment, and the occurrence of adverse reac-tions in both groups was observed. Results The treatment group showed a significant decrease in oropharyngeal function score, muscle function score, and non-motor symptom score, and an increase in ALSFRS-R scale scores after 1, 2, and 3 months of treatment(P<0. 05). The scores of oropharyngeal function and muscle function in the control group increased, while the ALSFRS-R score decreased after 1, 2 and 3 months of treatment, and the nonmotor symptom score decreased after 2 and 3 months of treatment(P<0. 05). The scores of muscle function and nonmotor symptoms in the treatment group were lower than those in the control group after 1 month of treatment;the scores of oropharyngeal function, muscle function and non-motor symptoms were lower than those in the control group, while the ALSFRS-R score was higher after 2 months and 3 months of treatment(P<0. 05). Constipation(3 cases), skin itching(2 cases), sk

关 键 词：肌萎缩侧索硬化 督脉灸 脾肾阳虚 肌萎缩侧索硬化中医疗效评价量表 肌萎缩侧索硬化功能评分量表 

分 类 号：R246.6[医药卫生—针灸推拿学]