醒脑开窍针刺法合并补肾化痰活血方治疗急性脑梗死风痰瘀阻证的临床研究  

Clinical Study of the Xingnao Kaiqiao Acupuncture Method Combined with Bushen Huatan Huoxue Formula in Treating Acute Cerebral Infarction with Wind-Phlegm Stasis Syndrome

作　　者：付飞 樊飞 FU Fei;FAN Fei(Department of Brain Disease,Sun Simiao Hospital of Beijing University of Chinese Medicine,Tongchuan 727000,China)

机构地区：[1]北京中医药大学孙思邈医院脑病科,陕西铜川727000

出　　处：《中医药学报》2025年第1期83-87,共5页Acta Chinese Medicine and Pharmacology

基　　金：陕西省重点研发计划项目(2020SF-139);铜川市2021年卫生健康领域科技计划资助项目(TCKJ-2021-027)。

摘　　要：目的:探究醒脑开窍针刺法合并补肾化痰活血方治疗急性脑梗死风痰瘀阻证的临床效果。方法:选择北京中医药大学孙思邈医院2021年1月-2023年12月收治的急性脑梗死风痰瘀阻证患者106例,采用随机数字表法分为针刺组和联合组,每组53例。两组均给予抗凝、改善微循环、控制血压、神经保护、吸氧、心脏监测等常规西医治疗,针刺组给予醒脑开窍针刺法治疗,联合组在针刺组基础上给予补肾化痰活血方口服治疗。观察两组患者的中医证候积分、神经功能指标、血流动力学指标、神经功能与运动功能及日常生活能力评分、临床疗效、不良反应发生情况。结果:治疗后,两组中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分、神经胶质纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S100β)、血流峰值时间(TTP)与阻力指数(RI)水平均较治疗前降低(P<0.05),且联合组低于针刺组(P<0.01);治疗后,两组血清神经生长因子(NGF)、脑血容量(CBV)、平均血流量(Qmean)水平、简式Fugl-Meyer评分(FMA)与Barthel指数(BI)评分均较治疗前升高(P<0.05),且联合组高于针刺组(P<0.01);联合组治疗总有效率高于针刺组(P<0.05);两组不良反应总发生率差异无统计学意义(P>0.05)。结论:醒脑开窍针刺法合并补肾化痰活血方治疗急性脑梗死风痰瘀阻证可降低中医证候积分,缓解临床症状,增加脑血流量,改善神经功能,提高临床疗效,且安全性较高。Objective:To investigate the clinical efficacy of the Xingnao Kaiqiao acupuncture method combined with the Bushen Huatan Huoxue formula in treating acute cerebral infarction with wind-phlegm stasis syndrome.Methods:A total of 106 patients who had acute cerebral infarction with wind-phlegm stasis syndrome treated at Sun Simiao Hospital of Beijing University of Chinese Medicine from January 2021 to December 2023 were selected.The patients were randomly divided into the acupuncture group and the combined group,with 53 cases in each group.Both groups received conventional Western medical treatments,including anticoagulation,microcirculation improvement,blood pressure control,neuroprotection,oxygen therapy,and cardiac monitoring.The acupuncture group received the Xingnao Kaiqiao acupuncture treatment,while the combined group received the Bushen Huatan Huoxue formula orally in addition to the acupuncture treatment.The TCM syndrome scores,neurological function indicators,hemodynamic parameters,neurological and motor function,daily living ability scores,clinical efficacy,and adverse reactions were observed in both groups.Results:After treatment,the TCM syndrome scores,NIH Stroke Scale(NIHSS)scores,glial fibrillary acidic protein(GFAP),neuron-specific enolase(NSE),S100βprotein,time-to-peak(TTP),and resistance index(RI)levels in both groups were significantly lower than before treatment(P<0.05),with the combined group showing lower levels than the acupuncture group(P<0.05).After treatment,the levels of serum nerve growth factor(NGF),cerebral blood volume(CBV),mean blood flow(Qmean),simplified Fugl-Meyer assessment(FMA)scores,and Barthel Index(BI)scores in both groups were significantly higher than before treatment(P<0.05),with the combined group showing higher levels than the acupuncture group(P<0.05).The overall effective rate in the combined group was higher than that in the acupuncture group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.

关 键 词：醒脑开窍针刺法 补肾化痰活血方 急性脑梗死 风痰瘀阻证 

分 类 号：R255.2[医药卫生—中医内科学]