针灸督脉联合中药治疗缺血性卒中的疗效观察及对脑动脉血流动力学的影响  

Observation on the efficacy of Du meridian acupuncture and combined with Chinese medicines in the treatment of ischemic stroke and its effect on cerebral arterial hemodynamics

作　　者：孟占鹏 郭子华 张丹 刘作印 MENG Zhanpeng;GUO Zihua;ZHANG Dan;LIU Zuoyin(Kaifeng Hospital of Traditional Chinese Medicine,Henan Province,Kaifeng 475000,China)

机构地区：[1]河南省开封市中医院,开封475000

出　　处：《上海针灸杂志》2025年第2期177-182,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河南省中医药科学研究专项课题(2023ZY2170)。

摘　　要：目的观察针灸督脉联合补阳还五汤加减治疗缺血性卒中的临床疗效及对患者脑动脉血流动力学、神经功能和血清相关因子水平的影响。方法选取110例气虚血瘀型缺血性卒中患者,随机分为对照组和观察组,每组55例。两组均接受基础治疗,对照组另予口服补阳还五汤加减治疗,观察组在对照组口服中药基础上联合针灸督脉治疗。比较两组临床疗效及不良反应发生情况,观察两组治疗前后中医证候积分、脑动脉血流动力学指标、神经功能指标和血清相关因子水平的变化。结果观察组总有效率高于对照组(P<0.05)。两组治疗后中医证候积分、美国国家卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分、脑动脉血流动力学指标[大脑中动脉收缩期峰值流速(peak systolic velocity,PSV)、平均血流速度(mean velocity,Vm)和舒张末期血流速度(end-diastolic volume,EDV)]及血清相关因子[陷窝蛋白-1(caveolin-1,Cav-1)、正五聚蛋白3(pentraxin 3,PTX3)和视锥蛋白样蛋白-1(visinin-like protein-1,VILIP-1)]水平均优于同组治疗前(P<0.05),且观察组治疗后上述指标均优于对照组(P<0.05)。两组均未发生明显不良反应。结论在基础治疗基础上,针灸督脉联合补阳还五汤加减治疗缺血性卒中能更有效地改善患者脑动脉血流动力学水平,促进神经功能恢复,临床疗效优于单纯口服补阳还五汤加减,且无明显不良事件发生。Objective To observe the clinical efficacy and effects of the combination of Du meridian acupuncture and modified Bu Yang Huan Wu decoction in the treatment of ischemic stroke and its effect on cerebral arterial hemodynamics,neurological function and serum related factor levels of the patients.Method A total of 110 patients with ischemic stroke of blood stasis due to qi deficiency pattern were selected and randomly divided into a control group and an observation group,with 55 cases in each group.Both groups received basic treatment,the control group was treated with modified Bu Yang Huan Wu decoction orally,and the observation group was treated with Du meridian acupuncture on the basis of oral modified Bu Yang Huan Wu decoction in the control group.The clinical efficacy and the occurrence of adverse reactions were compared between the two groups,and the changes of traditional Chinese medicine(TCM)pattern score,cerebral artery hemodynamic indexes,neurological function indexes and serum related factor levels before and after treatment were observed in the two groups.Result The total effective rate of the observation group was higher than that of the control group(P<0.05).TCM pattern score,National Institutes of Health stroke scale(NIHSS)score,cerebral arterial hemodynamic indexes[peak systolic velocity(PSV),mean velocity(Vm),and end-diastolic volume(EDV)]and serum-related factors[caveolin-1(Cav-1),pentraxin 3(PTX3)and visinin-like protein-1(VILIP-1)]were better than those in the same group before treatment(P<0.05),and the above indexes in the observation group were better than those in the control group after treatment(P<0.05).No significant adverse reactions occurred in both groups.Conclusion On the basis of basic treatment,the combination of Du meridian acupuncture and modified Bu Yang Huan Wu decoction in the treatment of ischemic stroke can more effectively improve the level of cerebral arterial hemodynamics and promote the recovery of neurological function,and the clinical efficacy of this treatment is better

关 键 词：针灸疗法 放血疗法 针药并用 脑梗死 卒中 神经功能 血液流变学 

分 类 号：R246.6[医药卫生—针灸推拿学]