针药结合治疗脑梗死恢复期气虚血瘀证患者临床观察  

Clinical Observation of Combination of Acupuncture and Medicine in Treatment of Patients with Qi Deficiency and Blood Stasis Syndrome in Convalescent Period of Cerebral Infarction

作　　者：吴海洋[1] 王颖[1] 王海涛[1] 计海生 WU Haiyang;WANG Ying;WANG Haitao;JI Haisheng(The Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230061,China)

机构地区：[1]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《山东中医杂志》2025年第4期410-415,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81973933);安徽省高等学校科学研究项目(编号:2022AH050503);安徽省卫生健康科研项目(编号:AHWJ2023A20030);安徽中医药大学临床科研项目(编号:2021efylc11);2024年安徽省教育厅青年教师国内访学项目(编号:JNFX2024024)。

摘　　要：目的:探究针药结合治疗脑梗死恢复期气虚血瘀证患者的疗效及对血脂代谢、血清同型半胱氨酸(Hcy)的影响。方法:将60例脑梗死恢复期气虚血瘀证患者按随机数字表法分为对照组和观察组,每组各30例。对照组接受通督调神针刺结合抗血小板聚集、稳定斑块、活血化瘀和营养脑神经等对症处理及二级预防治疗;观察组在对照组基础上加服小续命汤加减。两组均连续治疗2周。观察比较两组临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数评分、中医证候评分和Hcy、血脂[低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)]水平。结果:治疗后观察组总有效率90.00%,对照组80.00%,两组疗效比较,差异有统计学意义(P<0.05);治疗后两组NIHSS评分、中医证候评分均较治疗前降低,且观察组低于对照组(P<0.05);两组Barthel指数评分均较治疗前升高,且观察组高于对照组(P<0.05);两组LDL-C、TG、TC、Hcy水平均较治疗前降低,且观察组低于对照组(P<0.05);两组HDL-C水平均较治疗前升高,且观察组高于对照组(P<0.05)。结论:针药结合能改善脑梗死恢复期气虚血瘀证患者肢体功能障碍,提高患者生活质量,降低血脂和Hcy水平。Objective:To investigate the clinical efficacy of the combination of acupuncture and medicine in the treatment of patients with qi deficiency and blood stasis syndrome in convalescent period of cerebral infarction and its effect on blood lipid metabolism and serum homocysteine(Hcy).Methods:A total of 60 patients with qi deficiency and blood stasis syndrome in convalescent period of cerebral infarction were divided into the control group and the observation group according to random number table method,with 30 cases in each group.The control group received Tongdu Tiaoshen acupuncture combined with the symptomatic treatment and secondary prevention treatment of anti-platelet aggregation,stabilizing plaque,promoting blood circulation and removing blood stasis and nourishing cerebral nerves.The observation group was supplemented with modified Xiaoxuming Decoction(小续命汤)on the basis of the treatment of the control group.Both groups were treated continuously for 2 weeks.The clinical efficacy,National Institutes of Health Stroke Scale(NIHSS)score,Barthel index score,traditional Chinese medicine(TCM)syndrome score,Hcy,blood lipid[low density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)]levels of the two groups were observed and compared.Results:After treatment,the total effective rate was 90.00%in the observation group and 80.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,NIHSS score and TCM syndrome score of both groups were lower than those before treatment,and the observation group was lower than the control group(P<0.05).The Barthel index score in both groups was higher than that before treatment,and the observation group was higher than the control group(P<0.05).LDL-C,TG,TC and Hcy levels in both groups were lower than those before treatment,and the observation group was lower than the control group(P<0.05).HDL-C level in both groups was higher than that before treatment,and the observation g

关 键 词：脑梗死恢复期 气虚血瘀证 通督调神针 小续命汤 针药结合 血脂 同型半胱氨酸 

分 类 号：R277.733[医药卫生—中医学] R246.1