补阳还五汤联合醒脑开窍针刺治疗高血压性基底节区脑出血临床研究  

Clinical study on treatment of hypertensive basal ganglia hemorrhage by Buyang Huanwu decoction combined with Xingnao Kaiqiao acupuncture

作　　者：李莲 田军 张秋媛 李青[1] LI Lian;TIAN Jun;ZHANG Qiuyuan;LI Qing(Shijiazhuang People’s Hospital,Shijiazhuang 050011,China)

机构地区：[1]石家庄市人民医院,河北石家庄050011

出　　处：《陕西中医》2025年第3期403-406,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2024383)。

摘　　要：目的:探讨补阳还五汤联合醒脑开窍针刺治疗高血压性基底节区脑出血(HBGH)疗效。方法:回顾性研究95例HBGH气虚血瘀证患者,按治疗方式不同分成两组。中药汤剂组(n=47)应用补阳还五汤治疗;针药组(n=48)在中药汤剂组基础上联合醒脑开窍针刺治疗,均治疗4周。比较两组患者临床疗效、气虚血瘀证积分、美国国立卫生院卒中量表(NIHSS)、血清基质金属蛋白酶9(MMP-9)、转化生长因子-β1(TGF-β1)水平及患者预后。结果:针药组总有效率93.75%,高于中药汤剂组的74.47%,差异有统计学意义(P<0.05)。治疗后,两组气虚血瘀证积分、NIHSS评分、血清MMP-9水平均低于治疗前,且针药组低于中药汤剂组(均P<0.05)。治疗后,两组血清TGF-β1水平均高于治疗前,且针药组高于中药汤剂组(均P<0.05)。针药组预后良好率72.92%高于中药汤剂组的48.94%(P<0.05)。结论:对HBGH患者应用补阳还五汤联合醒脑开窍针刺治疗疗效较好,可有效调节患者血清MMP-9、TGF-β1水平,改善神经功能及相关症状,提高预后良好率。Objective:To explore effects of Buyang Huanwu decoction combined with Xingnao Kaiqiao acupuncture on hypertensive basal ganglia hemorrhage(HBGH).Methods:Retrospective analysis was conducted on 95 HBGH patients with Qixu Xueyu syndrome.According to different treatment methods,the patients were separated into two groups.The traditional Chinese medicine decoction group(n=47)were treated with Buyang Huanwu decoction,and the acupuncture medication group(n=48)were treated on the basis of the traditional Chinese medicine decoction group combined with Xingnaokai acupuncture treatment,both treated for 4 weeks.The two groups were compared in terms of efficacy,Qixu Xueyu syndrome score,neurological function NIHSS,MMP-9,TGF-β1 levels,and prognosis.Results:The total effective rate of the acupuncture medication group was higher than that in the traditional Chinese medicine decoction group(93.75%vs 74.47%),difference statistically significant(P<0.05).After treatment,the scores of Qixu Xueyu syndrome,NIHSS scores,and serum MMP-9 level in both groups were lower than before treatment,and the acupuncture medication group were lower than those in the traditional Chinese medicine decoction group(all P<0.05).After treatment,the serum TGF-β1 level in both groups were higher than before treatment,and the acupuncture medication group was higher than that in the traditional Chinese medicine decoction group(all P<0.05).The good prognosis rate of the acupuncture medication group was higher than that in the traditional Chinese medicine decoction group(72.92%vs 48.94%),difference statistically significant(P<0.05).Conclusion:Application of Buyang Huanwu decoction combined with Xingnao Kaiqiao acupuncture in treating HBGH patients had better effect.It can effectively regulate serum MMP-9 and TGF-β1 levels,obviously improve neurological function and related symptoms and obviously increase good prognosis rate.

关 键 词：高血压性基底节区脑出血 补阳还五汤 醒脑开窍针刺 气虚血瘀证 神经功能 预后 

分 类 号：R255.2[医药卫生—中医内科学]