偏瘫通络汤联合针刺治疗缺血性中风偏瘫(气虚血瘀)随机平行对照研究
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摘要
[目的]观察偏瘫通络汤联合针刺治疗缺血性中风偏瘫(气虚血瘀)疗效。[方法]使用随机平行对照方法,将120例住院患者按病志号抽签随机分两组。对照组30例抗血小板聚集,调脂、稳定斑块,营养神经,调控血压等对症处理。治疗组30例针刺(风池、灵骨),30min/次,1次/d;偏瘫通络汤(黄芪、当归、桃仁、红花、赤芍、地龙炒、川芎、水蛭烫、土鳖虫、白花蛇、乌梢蛇),1剂/d,水煎400m L,分两次服,200m L/次。连续治疗28d为1疗程。观测临床症状、日常生活功能评分、运动功能评分、神经功能缺损评分、全血高切黏度、全血低切黏度、血浆黏度、不良反应。治疗1疗程,判定疗效。[结果]治疗组临床治愈13例,显效27例,有效18例,无效2例,总有效率96.70%;对照组临床治愈8例,显效20例,有效12例,无效20例,总有效率66.70%;治疗组疗效优于对照组(P<0.05)。日常生活功能评分、运动功能评分、神经功能缺损评分两组均有明显改善(P<0.05),治疗组改善优于对照组(P<0.05);全血高切黏度、全血低切黏度、血浆黏度两组均有明显降低(P<0.05),治疗组降低优于对照组(P<0.05)。[结论]偏瘫通络汤联合针刺治疗缺血性中风偏瘫(气虚血瘀),疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of hemiplegia Tongluo decoction combined with acupuncture on ischemic apoplexy hemiplegia(Qi deficiency and blood stasis). [Methods] 60 inpatients were randomly divided into two groups by random parallel control method. 30 patients in the control group were treated with anti-platelet aggregation, lipid regulation, plaque stabilization, nutritional nerve and blood pressure control. In the treatment group, 30 cases were treated with acupuncture(Fengchi, Linggujiao 30 mins/d) and Buyang Huanwu decoction(Astragalus, Angelica sinensis, peach kernel, safflower, Radix Paeoniae rubra, fried Dilong, Chuanxiong, scalding leeches, hillbilly worm, white flower snake, Wutiao serpent, 1/d, decoction 400 ml, twice, respectively). 200 m L/times. Continuous treatment for 28 days as a course of treatment. Clinical symptoms, ADL score, motor function score, neurological deficit score, whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity, adverse reactions were observed. After 1 course of treatment, the curative effect was evaluated. [Results] In the treatment group, 13 cases were clinically cured, 27 cases were effective, 18 cases were effective, 2 cases were ineffective, and the total effective rate was 96.700. In the control group, 8 cases were clinically cured, 20 cases were effective, 12 cases were effective, 20 cases were ineffective, and the total effective rate was 66.70. The curative effect of the treatment group was better than that of the control group(P<0.05). Daily life function score, motor work The score and neurological deficit scores improved significantly(P<0.05), and the improvement of treatment group was better than that of the control group(P<0.05). The whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity decreased significantly(P<0.05), the decrease of treatment group was superior to the control group(P<0.05). [Conclusion] The combination of Tongluo decoction combined with acupuncture in treatment of ischemic stroke hemiplegia(Qi deficiency and blood stasis), satisfactorycurative effect, no serious adverse reaction, deserve popularization.
[Objective] To observe the curative effect of hemiplegia Tongluo decoction combined with acupuncture on ischemic apoplexy hemiplegia(Qi deficiency and blood stasis). [Methods] 60 inpatients were randomly divided into two groups by random parallel control method. 30 patients in the control group were treated with anti-platelet aggregation, lipid regulation, plaque stabilization, nutritional nerve and blood pressure control. In the treatment group, 30 cases were treated with acupuncture(Fengchi, Linggujiao 30 mins/d) and Buyang Huanwu decoction(Astragalus, Angelica sinensis, peach kernel, safflower, Radix Paeoniae rubra, fried Dilong, Chuanxiong, scalding leeches, hillbilly worm, white flower snake, Wutiao serpent, 1/d, decoction 400 ml, twice, respectively). 200 m L/times. Continuous treatment for 28 days as a course of treatment. Clinical symptoms, ADL score, motor function score, neurological deficit score, whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity, adverse reactions were observed. After 1 course of treatment, the curative effect was evaluated. [Results] In the treatment group, 13 cases were clinically cured, 27 cases were effective, 18 cases were effective, 2 cases were ineffective, and the total effective rate was 96.700. In the control group, 8 cases were clinically cured, 20 cases were effective, 12 cases were effective, 20 cases were ineffective, and the total effective rate was 66.70. The curative effect of the treatment group was better than that of the control group(P<0.05). Daily life function score, motor work The score and neurological deficit scores improved significantly(P<0.05), and the improvement of treatment group was better than that of the control group(P<0.05). The whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity decreased significantly(P<0.05), the decrease of treatment group was superior to the control group(P<0.05). [Conclusion] The combination of Tongluo decoction combined with acupuncture in treatment of ischemic stroke hemiplegia(Qi deficiency and blood stasis), satisfactorycurative effect, no serious adverse reaction, deserve popularization.
引文
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[7]吴粮葶,李瑛,任玉兰.基于数据挖掘技术探析针灸治疗中风后遗症的经穴特点[J].中国针灸,2013,32(2):125-130.
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[10]毕胜,纪树荣,顾越.Fugl-Meyer上肢运动功能评分与上肢运动功能状态评分的响应性研究[J].中国康复医学杂志,2006,21 (2):118-120.
[11]王新,王拥军,颜振瀛.脑卒中患者临床神经功能缺损评分标准的信度和效度研究[J].卒中与神经疾病,1999,6(3):148-150.
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[13]高潮,张毅.全血黏度样本测定的质量控制[J].中国血液流变学杂志,2002,12(4):356-357.
[2]中医药管理局脑病急症协作组.中风病诊断与疗效判定标准[J].北京中医药大学学报,1996,19(1):55-56.
[3]中华人民共和国卫生部.涉及人的生物医学研究伦理审查办法(试行)[S].(2007-03-26)[2015-02-05].http://www.moh.gov.cn/qjjys/s3581/200804/b9f1bfee4ab344ec892e68097296e2a8.shtml.
[4]杨明锦.通脉舒络汤结合张力平衡针法治疗缺血性中风(气虚血瘀型)痉挛性瘫痪的疗效观察[J].世界最新医学信息文摘,2016, 16(4):9-10.
[5]王清任.医林改错[M].北京:人民卫生出版社,2005.
[6]王宇,沈毅,李德岩,等.张力平衡针法结合牵张训练治疗脑卒中后肌痉挛疗效观察[J].山西中医,2016,32(8):30-31.
[7]吴粮葶,李瑛,任玉兰.基于数据挖掘技术探析针灸治疗中风后遗症的经穴特点[J].中国针灸,2013,32(2):125-130.
[8]盛莉.脑卒中患者临床神经功能缺损程度评分标准[J].中国乡村医药,1995,2(1):45.
[9]盛嘉玲,丁关元,孙忠,等.住院精神病患者日常生活能力评定量表的信度及效度检验[J].中国组织工程研究,2004,8(12):2201-2203.
[10]毕胜,纪树荣,顾越.Fugl-Meyer上肢运动功能评分与上肢运动功能状态评分的响应性研究[J].中国康复医学杂志,2006,21 (2):118-120.
[11]王新,王拥军,颜振瀛.脑卒中患者临床神经功能缺损评分标准的信度和效度研究[J].卒中与神经疾病,1999,6(3):148-150.
[12]宗疆,张雷.代谢综合征与全血高切粘度相关性研究[J].中国老年保健医学,2009,7(2):12-14.
[13]高潮,张毅.全血黏度样本测定的质量控制[J].中国血液流变学杂志,2002,12(4):356-357.