补阳还五汤加减联合针刺与常规疗法治疗气虚血瘀型脑卒中后遗症临床研究  

Clinical Study on Modified Buyang Huanwu Decoction Combined with Acupuncture and Routine Therapy for Post-Stroke Sequela of Qi Deficiency and Blood Stasis Typ

作　　者：朱笛英 ZHU Diying(Medical Community of Longyou County Hospital of Chinese Medicine(Xikou Branch),Longyou Zhejiang 324403,China)

机构地区：[1]龙游县中医医院医共体溪口镇分院,浙江龙游324403

出　　处：《新中医》2024年第24期30-35,共6页New Chinese Medicine

摘　　要：目的:观察在现代医学常规疗法与针刺疗法的基础上加用补阳还五汤加减治疗气虚血瘀型脑卒中后遗症的效果。方法:将纳入研究的82例气虚血瘀型脑卒中后遗症患者随机分为对照组和治疗组各41例。2组均采用常规疗法与针刺疗法治疗,治疗组加予补阳还五汤加减治疗。2组均治疗4个疗程。治疗前、治疗4个疗程后评定中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分、改良Barthel指数评定量表评分、世界卫生组织生存质量测定量表(WHOQOL-BREF)评分,检测血液流变学指标(红细胞聚集指数、血浆黏度、全血高切黏度、全血低切黏度)、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]。治疗4个疗程后评定2组的临床疗效。结果:治疗4个疗程后,治疗组总有效率高于对照组(P<0.05)。2组中医证候积分均较治疗前降低(P<0.05),治疗组中医证候积分低于对照组(P<0.05)。2组红细胞聚集指数、血浆黏度、全血高切黏度、全血低切黏度值均较治疗前降低(P<0.05),治疗组4项指标值均低于对照组(P<0.05)。2组TNF-α、IL-6水平均较治疗前降低(P<0.05),治疗组TNF-α、IL-6水平均低于对照组(P<0.05)。2组NIHSS评分均较治疗前下降,改良Barthel指数评分及WHOQOL-BREF评分均较治疗前升高,差异均有统计学意义(P<0.05)。治疗组NIHSS评分低于对照组,改良Barthel指数评分及WHOQOL-BREF评分均高于对照组,差异均有统计学意义(P<0.05)。结论:在现代医学常规疗法与针刺疗法的基础上加用补阳还五汤加减治疗气虚血瘀型脑卒中后遗症患者疗效显著,不但能有效缓解患者的临床症状,改善血液循环、减轻炎症反应,还能提高患者的日常生活能力和生活质量,安全性较好。Objective:To observe the curative effect of modified Buyang Huanwu Decoction on poststroke sequela of qi deficiency and blood stasis type based on the routine therapy in modern medicine and acupuncture.Methods:A total of 82 cases with post-stroke sequela of qi deficiency and blood stasis type were randomly divided into the control group and the treatment group,with 41 cases in each group.Both groups were treated with routine therapy and acupuncture,and the treatment group was additionally treated with modified Buyang Huanwu Decoction.Both groups were treated for four courses of treatment.Before and after four courses of treatment,the traditional Chinese medicine(TCM)syndrome scores,and the score of National Institutes of Health Stroke Scale(NIHSS),Modified Barthel Index,and World Health Organization Quality of Life Brief Scale(WHOQOL-BREF)were evaluated;the hemorheology indexes(red cell aggregation,plasma viscosity,whole blood high-shear viscosity and whole blood low-shear viscosity),and the inflammatory factors[tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)]were detected.After four courses of treatment,the clinical effects in the two groups were evaluated.Results:After four courses of treatment,the total effective rate in the treatment group was higher than that in the control group(P<0.05).The TCM syndrome scores in the two groups were lower than those before treatment(P<0.05),and the TCM syndrome score in the treatment group was lower than that in the control group(P<0.05).The red cell aggregation index,plasma viscosity,whole blood high-shear viscosity and whole blood low-shear viscosity in the two groups were dwindled when compared with those before treatment(P<0.05),and the above four indexes in the treatment group were lower than those in the control group(P<0.05).The levels of TNF-αand IL-6 in the two groups were reduced when compared with those before treatment(P<0.05),and the levels of TNF-αand IL-6 in the treatment group were lower than those in the control group(P<0.05).The NIHSS scores in t

关 键 词：脑卒中后遗症 气虚血瘀证 补阳还五汤 血液流变学 炎症因子 生活质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]