摘要
目的探讨化瘀通络方联合芒针针刺治疗脑卒中痉挛性瘫痪患者的临床疗效。方法采用前瞻性研究,选取2019年7月—2020年12月期间开封市中医院收治的脑卒中后肢体痉挛患者126例,采用随机数字表法将其分为研究组和对照组,每组各63例。对照组给予芒针针刺法治疗4周,研究组在对照组基础上给予化瘀通络方加减治疗30 d。观察比较两组患者临床疗效,治疗前后的中医证候(偏身麻木、舌僵语蹇、口舌歪斜、半身不遂、肢体水肿、脉沉细)积分、肢体痉挛程度(MAS评分)、肢体运动功能(FMA评分)和日常生活能力(Barthel指数),并检测两组患者治疗前后的血清谷氨酸(Glutamic acid,Glu)、γ-氨基丁酸(γ-aminobutyric acid,GABA)、Glu/GABA比值和血清神经元特异性醇化酶(Neurone specific enolase,NSE)、同型半胱氨酸(Homocysteine,Hcy)水平。结果治疗后研究组总有效率90.48%(57/63)明显高于对照组76.19%(48/63),差异有统计学意义(P<0.05)。治疗后两组患者各项中医证候评分均较治疗前明显降低,差异有统计学意义(P<0.05),且研究组各项中医证候评分均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者MAS评分均较治疗前明显降低,Barthel和FMA上下肢评分均较治疗前明显升高,差异有统计学意义(P<0.05);且研究组MAS评分较对照组明显节点,Barthel和FMA上下肢评分均较对照组明显升高,差异有统计学意义(P<0.05)。治疗后两组患者Glu、Glu/GABA比值均较治疗前明显降低,GABA比值均较治疗前明显升高,差异有统计学意义(P<0.05);且研究组Glu、Glu/GABA比值均较对照组明显降低,GABA比值较对照组明显升高,差异有统计学意义(P<0.05)。治疗后两组患者NSE、Hcy水平均较治疗前明显降低,差异有统计学意义(P<0.05);且研究组NSE、Hcy水平均较对照组明显降低,差异有统计学意义(P<0.05)。结论化瘀通络方联合芒针针刺治疗可显著提高脑�
Objective To explore the clinical effect of Huayu Tongluo Decoction combined with elongated needle acupuncture in the treatment of stroke patients with spastic paralysis.Methods A prospective study was used to select 126 patients with post-stroke limb spasticity who were admitted to Kaifeng Hospital of Traditional Chinese Medicine from July 2019 to December 2020.They were divided into two groups using a random number table.The 63 cases in the control group were treated with elongated needle acupuncture for 4 weeks,while on this basis,the 63 cases in the study group received modified Huayu Tongluo Decoction for 30 days.The clinical efficacy of the two groups were compared.In addition,the TCM syndrome(hemianesthesia,stiff tongue,deviated tongue,hemiplegia,limb edema,and deep and thready pulse)score,the degree of limb spasm[Modified Ashworth Scale(MAS)score],limb motor function[limb motor function(FMA score)score]and ability of daily living(Barthel index)before and after treatment were compared.Moreover,the serum glutamic acid(Glu),γ-aminobutyric acid(GABA),Glu/GABA ratio and serum neuron specific enolase(NSE)and homocysteine(Hcy)levels before and after treatment were detected in the two groups.Results The total effective rate[90.48%,(57/63)]of treatment in the study group was higher than that[76.19%(48/63)]in the control group(P<0.05).After treatment,the TCM syndrome score,MAS score,Glu,Glu/GABA ratio,and serum NSE and Hcy levels of the two groups were lower than those before treatment(P<0.05),and the study group had more significant reduction than the control group(P<0.05).The Barthel index,FMA upper and lower limb scores,and GABA of the two groups were higher than those before treatment(P<0.05),and the study group had more significant increase than the control group(P<0.05).Conclusion Huayu Tongluo Decoction combined with elongated needle acupuncture could significantly improve the comprehensive treatment effect of stroke patients with spastic paralysis.It could effectively regulate the serum Glu and GABA expres
作者
周国锐
秦小永
ZHOU Guo-rui;QIN Xiao-yong(Kaifeng Hospital of Traditional Chinese Medicine,Kaifeng Henan 475000)
出处
《世界中西医结合杂志》
2022年第8期1580-1584,1588,共6页
World Journal of Integrated Traditional and Western Medicine
基金
国家中医药管理局河南邵氏针灸流派传承工作室开封市中医院工作站项目(LP0116036-Z3)。
关键词
化瘀通络方
针刺治疗
脑卒中
痉挛性瘫痪
肢体运动功能
神经递质
Huayu Tongluo Decoction
Elongated acupuncture treatment
Stroke
Spastic paralysis
Limb motor function
Neurotransmitter
