督脉十三针联合解语丹加减治疗中风后失语合并失眠症临床研究  

Clinical Study on Thirteen Needles of Governor Vessel Combined with Modified Jieyu Dan on Post-Stroke Aphasia Combined with Insomnia

作　　者：安洁琼 李昊[1] 闫迪[1] AN Jieqiong;LI Hao;YAN Di(Zhoukou Central Hospital,Zhoukou Henan 466000,China)

机构地区：[1]周口市中心医院,河南周口466000

出　　处：《新中医》2024年第19期157-162,共6页New Chinese Medicine

基　　金：河南省中医药科学研究专项课题(20-21ZY2095)。

摘　　要：目的:观察督脉十三针联合解语丹加减对中风后失语合并失眠症患者疗效及对语言功能、大脑皮层功能重组及昼夜节律的影响。方法:选取84例中风后失语合并失眠症患者,按随机数字表法分为西医组及中医组各42例。西医组给予常规西医治疗,中医组给予督脉十三针联合解语丹加减治疗。比较2组临床疗效,比较2组治疗前后中医证候评分、功能性语言沟通能力(CFCP)、睡眠状况自评量表(SRSS)、健侧及患侧各向异性(FA)值、血浆褪黑素(MT)、血清S100钙结合蛋白B(S100B)、5-羟色胺(5-HT)、谷胱甘肽过氧化物酶(GSH-Px)水平的变化。结果:治疗后,经秩和检验,中医组临床疗效优于西医组,差异有统计学意义(P<0.05)。治疗后,2组言语謇涩或不语、头晕目眩、口舌歪斜、痰多而黏、感觉减退或消失、半身不遂中医证候评分均较治疗前下降(P<0.05),中医组上述6项评分均低于西医组(P<0.05)。治疗后,2组CFCP评分均较治疗前升高(P<0.05),SRSS评分均较治疗前下降(P<0.05);中医组CFCP评分高于西医组(P<0.05),SRSS评分低于西医组(P<0.05)。治疗后,2组健侧、患侧FA值均较治疗前升高(P<0.05),中医组健侧FA值高于西医组,差异有统计学意义(P<0.05)。治疗后,2组MT、5-HT、GSH-Px水平均较治疗前上升(P<0.05),S100B水平均较治疗前下降(P<0.05);中医组MT、5-HT、GSH-Px水平均高于西医组(P<0.05),S100B水平低于西医组(P<0.05)。结论:督脉十三针联合解语丹加减治疗中风后失语合并失眠症患者,可减少氧化应激反应及神经元损伤,促进大脑皮层功能重组,改善语言功能、昼夜节律及睡眠质量,缓解病情,提升临床疗效。Objective:To observe the curative effect of thirteen needles of the governor vessel combined with modified Jieyu Dan on post-stroke aphasia combined with insomnia and its effects on language function,cortical reorganization,and circadian rhythm.Methods:A total of 84 cases of patients with post-stroke aphasia combined with insomnia were selected and divided into the western medicine group and the Chinese medicine group according to the random number table method,with 42 cases in each group.The western medicine group was treated with conventional western medicine,and the Chinese medicine group was treated with thirteen needles of the governor vessel and modified Jieyu Dan.Clinical effects were compared between the two groups.Changes in traditional Chinese medicine syndrome scores,the scores of the Chinese Functional Communication Profile(CFCP)and Self-Rating Sleep Scale(SRSS),and the levels of fractional anisotropy(FA)of the healthy side and the affected side,plasma melatonin(MT),serum S100 calcium-binding protein B(S100B),serotonin(5-HT),and glutathione peroxidase(GSH-Px)before and after treatment were compared between the two groups.Results:After treatment,tested by rank sum test,clinical effects in the Chinese medicine group was better than that in the western medicine group,the difference being significant(P<0.05).After treatment,TCM syndrome scores of difficulty or silence in speech,vertigo and dizzy vision,deviation of mouth and tongue,profuse sticky phlegm,decreased or absent sensation,and hemiplegia in the two groups were declined when compared with those before treatment(P<0.05),and the above six scores in the Chinese medicine group were lower than those in the western medicine group(P<0.05).After treatment,CFCP scores in the two groups were increased when compared with those before treatment(P<0.05),and SRSS scores were decreased when compared with those before treatment(P<0.05);CFCP score in the Chinese medicine group was higher than that in the western medicine group(P<0.05),and SRSS score in the Chines

关 键 词：中风后失语 失眠症 督脉十三针 解语丹 氧化应激反应 语言功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R246.6[医药卫生—临床医学]