益气活血针法联合重复经颅磁刺激治疗气虚血瘀型缺血性脑卒中后偏瘫临床研究  

Clinical Study on Yiqi Huoxue Acupuncture Combined with Repetitive Transcranial Magnetic Stimulation for Hemiplegia After Ischemic Stroke of Qi Deficiency and Blood Stasis Type

作　　者：岳琳 施赟华 张蓉蓉 乐维 谢存 YUE Lin;SHI Yunhua;ZHANG Rongrong;LE Wei;XIE Cun(Zhoushan City Hospital of Traditional Chinese Medicine,Zhoushan Zhejiang 316000,China)

机构地区：[1]舟山市中医院,浙江舟山316000

出　　处：《新中医》2025年第4期61-66,共6页New Chinese Medicine

摘　　要：目的:观察益气活血针法联合重复经颅磁刺激(rTMS)治疗气虚血瘀型缺血性脑卒中(IS)后偏瘫的临床疗效。方法:选取2022年1月—2024年1月舟山市中医院康复科收治的92例气虚血瘀型IS后偏瘫患者,以随机数字表法分为治疗组与对照组各46例。对照组给予rTMS治疗,治疗组在对照组基础上加用益气活血针刺法治疗。2组均治疗8周。比较2组临床疗效、中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分、Fugl-Meyer运动功能评定量表(FMA)评分及步态参数(步速、步幅、步频、患侧单支撑相、双支撑相)。结果:治疗8周后,总有效率治疗组93.18%(41/44),高于对照组77.27%(34/44),差异有统计学意义(P<0.05)。2组主症、次症积分及中医证候总分均较治疗前降低,治疗组主症、次症积分及中医证候总分均低于对照组,差异均有统计学意义(P<0.05)。2组NIHSS评分均较治疗前降低,Fugl-Meyer上肢运动功能(FMA-UE)、Fugl-Meyer下肢运动功能(FMA-LE)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,FMA-UE、FMA-LE评分均高于对照组,差异均有统计学意义(P<0.05)。2组步速、步频均较治疗前提高,步幅均较治疗前增大,患侧单支撑相、双支撑相均较治疗前降低,差异均有统计学意义(P<0.05);治疗组步速、步频均高于对照组,步幅大于对照组,患侧单支撑相、双支撑相均低于对照组,差异均有统计学意义(P<0.05)。结论:与仅使用rTMS治疗比较,益气活血针法联合rTMS治疗气虚血瘀型IS后偏瘫可提升疗效,进一步缓解临床症状,减轻神经功能缺损程度,改善肢体功能及步态,提升患者的步行能力。Objective:To observe the clinical effect of Yiqi Huoxue acupuncture combined with repetitive transcranial magnetic stimulation(rTMS)on patients with hemiplegia after ischemic stroke(IS)of qi deficiency and blood stasis type.Methods:A total of 92 cases of patients with hemiplegia after IS of qi deficiency and blood stasis type,who were treated at Zhoushan City Hospital of Traditional Chinese Medicine from January 2022 to January 2024 were selected and divided into the treatment group and the control group according to the random number table method,with 46 cases in each group.The control group received rTMS treatment,and the treatment group was additionally treated with Yiqi Huoxue acupuncture based on the treatment of the control group.Both groups were treated for eight weeks.Clinical effects,traditional Chinese medicine(TCM)syndrome scores,National Institutes of Health Stroke Scale(NIHSS)scores,Fugl-Meyer Assessment(FMA)scores,and gait parameters(walking speed,stride length,stride frequency,single support phase on the affected side,and double support phase)were compared between the two groups.Results:After eight weeks of treatment,the total effective rate was 93.18%(41/44)in the treatment group,higher than that of 77.27%(34/44)in the control group,the difference being significant(P<0.05).The primary and secondary symptom scores and the total scores of TCM in the two groups were decreased when compared with those before treatment,and the primary and secondary symptom scores and the total score of TCM in the treatment group were lower than those in the control group,differences being significant(P<0.05).The NIHSS scores in the two groups were decreased when compared with those before treatment,and scores of Fugl-Meyer Assessment of Upper Extremity(FMA-UE)and Fugl-Meyer Assessment of Lower Extremity(FMA-LE)were increased when compared with those before treatment,differences being significant(P<0.05);the treatment group had lower NIHSS scores and higher FMA-UE and FMA-LE scores compared to the control group,differen

关 键 词：缺血性脑卒中 偏瘫 气虚血瘀型 益气活血针法 重复经颅磁刺激 神经功能 肢体功能 步态 

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]