通督调神针刺联合补阳还五汤合二陈汤加减治疗缺血性脑卒中后偏瘫的临床观察  

Clinical Observation of Tongdu Tiaoshen Acupuncture Combined with the Modified Prescription of Buyang Huanwu Decoction and Erchen Decoction in the Treatment of Patients with Hemiplegia after Ischemic Stroke

作　　者：杨九三 YANG Jiusan(Department of Rehabilitation,Shanxian Hospital of Traditional Chinese Medicine,Heze 274000,China)

机构地区：[1]山东省单县中医院康复科,山东菏泽274000

出　　处：《中国伤残医学》2025年第5期95-99,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:观察通督调神针刺联合补阳还五汤合二陈汤加减治疗缺血性脑卒中后偏瘫患者的效果。方法:选取2022年1月—2023年12月单县中医院收治的70例缺血性脑卒中后偏瘫患者为研究对象,以随机数字表法将其分为对照组和研究组,各35例。对照组采用西医常规疗法治疗,研究组在对照组基础上采用通督调神针刺联合补阳还五汤合二陈汤加减治疗。两组均治疗8周。比较两组临床疗效、中医证候积分、肢体运动功能、平衡能力、自理能力、神经功能及脑血流动力学参数。结果:研究组治疗总有效率为94.29%,高于对照组的77.14%,差异有统计学意义(P<0.05)。治疗后,两组Fugl-Meyer运动功能评分、脑卒中患者姿势控制量表、日常生活活动能力评分均较治疗前升高,且研究组均高于对照组,两组美国国立卫生研究院卒中量表评分、中医证候积分均较治疗前降低,且研究组均低于对照组,差异均有统计学意义(P<0.05)。治疗后,研究组颈总动脉平均血流量为(9.62±1.23)cm3/s、平均血流速度为(18.79±3.24)cm/s,高于对照组的(8.45±1.58)cm3/s、(15.32±2.73)cm/s,研究组颈总动脉外周阻力为(83.87±14.25)kPa·s/m、动态阻力为(31.67±8.24)kPa·s/m,低于对照组的(96.45±17.46)kPa·s/m、(40.75±9.06)kPa·s/m,差异均有统计学意义(P<0.05)。结论:通督调神针刺联合补阳还五汤合二陈汤加减治疗缺血性脑卒中后偏瘫患者的效果显著,可改善患者脑供血状态,减轻神经功能缺损程度,缓解临床症状,增强肢体运动功能及平衡功能,提升生活自理能力。Objective:To observe the effect of Tongdu Tiaoshen Acupuncture combined with modified prescription Buyang Huanwu Decoction and Erchen Decoction on patients with hemiplegia after ischemic stroke.Methods:A total of 70 patients with hemiplegia after ischemic stroke treated in Shanxian Hospital of Traditional Chinese Medicine from January 2022 to December 2023 were selected as the study objects,and were divided into a control group and a study group by random number table method,with 35 cases in each group.The control group was treated with conventional Western medicine,and the study group was treated with Tongdu Tiaoshen acupuncture combined with modified prescription Buyang Huanwu Decoction and Erchen Decoction on the basis of the control group.Both groups were treated for 8 weeks.The clinical efficacy,TCM syndrome score,limb motor function,balance ability,self-care ability,nerve function and cerebral hemodynamic parameters were compared between the two groups.Results:The total effective rate of the study group was 94.29%,which was higher than 77.14%of the control group,the difference was statistically significant(P<0.05).After treatment,Fugl-Meyer Assessment,Postural Assessment Scale for Stroke Patients and Activity of Daily Living scores in both groups were higher than before treatment,and the study group were higher than the control group,while the National Institutes of Health Stroke Scale score and TCM syndrome score in both groups were lower than before treatment,and the study group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,the average blood flow of the common carotid artery in the study group was(9.62±1.23)cm3/s,the average blood flow velocity was(18.79±3.24)cm/s,which were higher than(8.45±1.58)cm3/s and(15.32±2.73)cm/s of the control group,the peripheral resistance of common carotid artery in the study group was(83.87±14.25)kPa·s/m,the dynamic resistance was(31.67±8.24)kPa·s/m,which were lower than(96.45±17.46)kPa·s/m and(40.75±9.06)k

关 键 词：缺血性脑卒中后偏瘫 通督调神针刺 补阳还五汤合二陈汤加减 脑血流动力学 平衡功能 神经功能 

分 类 号：R246[医药卫生—针灸推拿学]