开窍醒神补虚通络针刺治疗卒中后偏瘫疗效及对患者肢体运动功能的影响  

Effect of Kaiqiao Xingshen Buxu Tongluo Acupuncture on poststroke hemiplegia and its impact on limb motor function

作　　者：胡桢 李晴 HU Zhen;LI Qing(Department of Rehabilitation Medicine,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi 710068)

机构地区：[1]陕西省人民医院康复医学科,陕西西安710068

出　　处：《河北中医》2025年第4期632-636,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察开窍醒神补虚通络针刺治疗卒中后偏瘫的临床疗效及对患者肢体运动功能的影响。方法选取2021年1月至2023年1月收治的106例卒中后偏瘫患者为研究对象,按照随机数字表法分为对照组、观察组,各53例,对照组予卒中后偏瘫常规治疗,观察组在对照组的基础上联合开窍醒神补虚通络针刺治疗。2组均以1个月为1个疗程,治疗3个疗程后评估疗效,并比较2组治疗前后中医证候(包括半身不遂、口角㖞斜、言语謇涩、面色白)评分、脑损伤标志物[包括磷脂转移蛋白因子(PLTP)、微管相关蛋白(Tau)、神经纤维丝蛋白轻链(NF-L)]、肢体运动功能[采用Fugl-Meyer运动功能量表(FMA)评价]水平变化情况,比较2组治疗期间不良反应发生情况。结果观察组总有效率92.45%(49/53),对照组总有效率75.47%(40/53),观察组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医证候半身不遂、口角㖞斜、言语謇涩、面色白评分均降低(P<0.05),且治疗组治疗后中医证候半身不遂、口角㖞斜、言语謇涩、面色白评分水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后脑损伤标志物PLTP、Tau、NF-L水平均降低(P<0.05),且治疗组治疗后脑损伤标志物PLTP、Tau、NF-L水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后肢体运动功能FMA上肢、下肢评分及总分均增加(P<0.05),且治疗组治疗后肢体运动功能FMA上肢、下肢评分及总分均高于对照组(P<0.05)。观察组不良反应总发生率13.21%(7/53),对照组不良反应总发生率7.55%(4/53),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论开窍醒神补虚通络针刺治疗卒中后偏瘫疗效显著,可降低患者主要中医证候,抑制脑损伤标志物表达水平,改善患者肢体运动功能,治疗安全性良好。Objective To study and explore the therapeutic effect of Kaiqiao Xingshen Buxu Tongluo Acupuncture on poststroke hemiplegia and its impact on limb motor function.Methods Totally 106 patients with poststroke hemiplegia admitted to our hospital from January 2021 to January 2023 were randomized 1:1 to Kaiqiao Xingshen Buxu Tongluo Acupuncture with routine treatment(the observation group)or routine treatment alone(the control group).After 3 courses of treatment(1 month as 1 course),the key observation was clinical efficacy,traditional Chinese medicine(TCM)symptom scores including hemiplegia,crooked mouth,unsmooth speech,pale complexion,brain injury marker levels including phospholipid transfer protein(PLTP),microtubule-associated protein Tau(MAPT),neurofilament light chain(NF-L),limb motor function scores including Fugl-Meyer Motor Assessment(FMA),and treatment-emergent adverse events(TEAEs).Results The total effective rate in the observation group was significantly higher than the control group(92.45%[49/53]vs 75.47%[40/53],P<0.05).After treatment,the TCM symptom scores,PLTP,MAPT,NF-L in the both groups were significantly decreased than those before treatment(P<0.05),the decreases were more common in the observation group than the control group(P<0.05).After treatment,the dimension score(upper limb and lower limb)and total score of FMA in the both groups significantly increased than those before treatment(P<0.05),the increases were more pronounced in the observation group than the control group(P<0.05).The TEAEs in observation group were comparable to the control group(13.21%[7/53]vs 7.55%[4/53],P>0.05).Conclusion Kaiqiao Xingshen Buxu Tongluo Acupuncture has a significant therapeutic effect for poststroke hemiplegia,which can reduce the main TCM symptoms scores,inhibit the expression level of brain injury markers,improve limb motor function,and with a good treatment safety.

关 键 词：卒中 偏瘫 卒中并发症 针刺疗法 

分 类 号：R743.2[医药卫生—神经病学与精神病学]