益气活血化浊解毒方联合针灸治疗脑卒中后失语临床研究  

Clinical Study on the Treatment of Aphasia After Stroke with Qi-Supplementing and Blood-Activating and Turbidity-Resolving and Detoxifying Formula Combined with Acupuncture Therapy

作　　者：陶录岭 周先炎 牛耕 TAO Luling;ZHOU Xianyan;NIU Geng(Nanyang Second General Hospital,Nanyang,Henan,China,473000)

机构地区：[1]南阳市第二人民医院,河南南阳473000

出　　处：《河南中医》2025年第5期755-760,共6页Henan Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项项目(2022ZY2071)。

摘　　要：目的:观察益气活血化浊解毒方联合针灸治疗脑卒中后失语的临床疗效。方法:选取2022年7月至2024年4月南阳市第二人民医院收治的脑卒中后失语患者96例,依据随机数字表法分为对照组和试验组,每组各48例。对照组给予语言康复训练配合常规药物治疗,试验组在对照组基础上给予益气活血化浊解毒方联合针灸治疗,两组均连续治疗4周。比较两组患者的临床疗效及治疗前后波士顿诊断性失语评级(Boston diagnostic aphasia examination,BDAE)、美国国立卫生研究院卒中评分(National Institutes of Health Stroke Scale,NIHSS)、语言功能评分变化情况,检测两组患者治疗前后脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、白细胞介素(interleukin,IL)-6、IL-1β、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)水平,同时比较血清内肠道菌群代谢产物短链脂肪酸(short-chain fatty acids,SCFAs)、谷氨酸(glutamic acid,GLU)、γ-氨基丁酸(gGamma-aminobutyric acid,GABA)水平。结果:试验组有效率为87.50%,高于对照组的68.75%,差异具有统计学意义(P<0.05)。两组患者治疗后BDAE分级中0级、Ⅰ级、Ⅱ级例数低于本组治疗前,且治疗后试验组低于对照组(P<0.05)。两组患者治疗后NIHSS评分低于本组治疗前,且治疗后试验组低于对照组(P<0.05)。两组患者治疗后自发谈话、听理解、复述、命名、阅读、书写各项评分均高于治疗前,且治疗后试验组各项语言功能评分高于对照组(P<0.05)。两组患者治疗后IL-6、IL-1β、TNF-α低于本组治疗前,BDNF水平高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后SCFAs、GLU、GABA水平高于本组治疗前,且治疗后试验组高于对照组(P<0.05)。试验组不良反应发生率为12.50%,高于对照组的8.33%,但差异无统计学意义(P>0.05)。结论:益气活血化浊解毒方联合针灸治疗脑卒中后失语,可通过改善患者�Objective:To observe the clinical efficacy of Qi-Supplementing and Blood-Activating and Turbidity-Resolving and Detoxifying Formula combined with acupuncture therapy on aphasia after stroke.Methods:A total of 96 patients with aphasia after stroke admitted to Nanyang Second General Hospital from July 2022 to April 2024 were selected and randomly divided into the control group and the experimental group,with 48 cases in each group.The control group was treated with language rehabilitation training combined with conventional drug therapy,while the experimental group was treated with Qi-Supplementing and Blood-Activating and Turbidity-Resolving and Detoxifying Formula on the basis of the control group.Both groups were treated for 4 consecutive weeks.The clinical efficacy,changes in Boston Diagnostic Aphasia Examination(BDAE),National Institutes of Health Stroke Scale(NIHSS),and language function scores before and after treatment were compared between the two groups.The levels of brain-derived neurotrophic factor(BDNF),interleukin(IL)-6,IL-1β,and tumor necrosis factor-α(TNF-α)before and after treatment were detected in both groups.The levels of short-chain fatty acids(SCFAs),glutamic acid(GLU),andγ-aminobutyric acid(GABA)in the serum were also compared before and after treatment.Results:The effective rate of the experimental group was 87.50%,which was higher than that of the control group(68.75%),and the difference was statistically significant(P<0.05).After treatment,the number of cases with grades 0,I,and II in the BDAE classification was fewer than that before treatment in both groups,and the experimental group′s was lower than that of the control group(P<0.05).The NIHSS scores were lower than those before treatment in both groups,and the experimental group′s score was lower than that of the control group(P<0.05).The scores of spontaneous speech,auditory comprehension,repetition,naming,reading,and writing in both groups improved compared with those before treatment,and the language function scores of the ex

关 键 词：脑卒中后失语 益气活血化浊解毒方 针灸疗法 语言康复训练 多奈哌齐片 

分 类 号：R277.743.3[医药卫生—中医学]