三虫通络化风汤加减联合“标本配穴”针刺治疗缺血性脑卒中后肢体痉挛效果观察
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摘要
目的探讨三虫通络化风汤加减联合"标本配穴"针剌治疗缺血性脑卒中后肢体痉挛的效果。方法选取缺血性脑卒中后肢体痉挛患者160例,根据随机数字表法分为4组,每组40例。对照组采用常规处理,实验1组在对照组基础上加用三虫通络化风汤加减治疗,实验2组在对照组治疗基础上联合"标本配穴"针刺治疗,实验3组在对照组治疗基础上加用三虫通络化风汤加减联合"标本配穴"针刺治疗,比较4组疗效、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分、人体主要运动肌群肌张力评定表(Ashworth)评分及不良反应情况。结果实验3组治疗后临床总有效率明显高于对照组、实验1组及实验2组(P均<0.05);实验3组治疗1个月NIHSS评分、Ashowrth评分均明显低于对照组、实验1组及实验2组(P均<0.05),BI评分明显高于对照组、实验1组及实验2组(P均<0.05)。结论三虫通络化风汤加减联合"标本配穴"针刺治疗缺血性脑卒中后肢体痉挛效果显著,可有效改善患者神经功能、肌张力情况,提高患者日常生活能力,且安全性较好。
Objective It is to investigate the effect of Sanchong Tongluo Huafeng decoction combined with acupuncture based on incidental-fundamental point on spasticity of limbs after ischemic stroke. Methods A total of 160 patients with limb paralysis after ischemic stroke were enrolled and divided into four groups according to the random number table method, 40 cases in each group. The control group was treated with conventional therapy. The experimental group I was treated with Sanchong Tongluo Huafeng decoction on the basis of the control group. The experimental group II was treated with acupuncture based on incidental-fundamental point on the basis of the control group. The experimental group III was treated with Sanchong Tongluo Huafeng decoction combined with acupuncture based on incidental-fundamental point on the basis of the control group. The curative effects, the National Institutes of Health Stroke Scale(NIHSS), Barthel Index(BI) score, the Ashworth score and adverse reactions of the four groups were compared. Results The total effective rate and BI scores of the experimental group III were significantly higher while the NIHSS scores, Ashowrth scores were significantly lower than that of the control group, experimental group I, experimental group II, the differences were statistically significant(P<0.05). Conclusion Sanchong Tongluo Huafeng decoction combined with acupuncture based on incidental-fundamental point is effective in the treatment of spasticity of limbs after ischemic stroke, it can effectively improve the neurological function, muscle tone and the daily living ability of patients with good safety.
Objective It is to investigate the effect of Sanchong Tongluo Huafeng decoction combined with acupuncture based on incidental-fundamental point on spasticity of limbs after ischemic stroke. Methods A total of 160 patients with limb paralysis after ischemic stroke were enrolled and divided into four groups according to the random number table method, 40 cases in each group. The control group was treated with conventional therapy. The experimental group I was treated with Sanchong Tongluo Huafeng decoction on the basis of the control group. The experimental group II was treated with acupuncture based on incidental-fundamental point on the basis of the control group. The experimental group III was treated with Sanchong Tongluo Huafeng decoction combined with acupuncture based on incidental-fundamental point on the basis of the control group. The curative effects, the National Institutes of Health Stroke Scale(NIHSS), Barthel Index(BI) score, the Ashworth score and adverse reactions of the four groups were compared. Results The total effective rate and BI scores of the experimental group III were significantly higher while the NIHSS scores, Ashowrth scores were significantly lower than that of the control group, experimental group I, experimental group II, the differences were statistically significant(P<0.05). Conclusion Sanchong Tongluo Huafeng decoction combined with acupuncture based on incidental-fundamental point is effective in the treatment of spasticity of limbs after ischemic stroke, it can effectively improve the neurological function, muscle tone and the daily living ability of patients with good safety.
引文
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[13] 侯宝国,张志兰,孙金华,等.针刺结合化痰解语汤治疗缺血性脑卒中后失语症的临床疗效[J].检验医学与临床,2017,14(11):1545-1546;1549
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[2] 胡英华,王燕,蒋雪玲,等.电针头穴早期干预对急性缺血性脑卒中(气虚血瘀证)患者炎性因子和血液流变学指标的影响[J].中国中医急症,2017,26(11):2040-2042
[3] 关淑婷,冶尕西,刘秀芬,等.回医烙灸结合常规针刺疗法对缺血性脑卒中患者运动功能恢复的疗效[J].宁夏医科大学学报,2017,39(9):985-988
[4] 中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2015[J].中华神经科杂志,2015,48(4):246-257
[5] 黄如训,郭玉璞.脑卒中的分型分期治疗(建议草案)[J].中国神经精神疾病杂志,2001,27(1):73
[6] 王华,杜元灏.针灸学[M].9版.北京:中国中医药出版社,2012:123-127
[7] 全国第四届脑血管病学术会议.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):381-382
[8] 严婉力.三补三泻针刺法结合康复训练疗法治疗脑卒中后肢体痉挛的疗效评价研究[J].中医临床研究,2013,5(2):51-53
[9] 李威,王玲,杨雄,等.体外反搏结合“醒脑开窍”针法对缺血性脑卒中恢复期下肢痉挛患者的临床疗效和肌电图分析[J].针灸临床杂志,2016,32(10):15-19
[10] 郑德松,董静.针灸通督法联合康复训练对缺血性脑卒中患者平衡功能的影响[J].中国中医急症,2017,26(8):1465-1467
[11] 豆小妮,张兆元.自拟一草二白三虫汤治疗面肌痉挛22例的效果[J].中国医药导报,2014,11(25):91-94;98
[12] 于川,王麟鹏.十二透刺法联合火针法治疗缺血性脑卒中后肌张力增高的疗效观察[J].针灸临床杂志,2014,30(12):51-53
[13] 侯宝国,张志兰,孙金华,等.针刺结合化痰解语汤治疗缺血性脑卒中后失语症的临床疗效[J].检验医学与临床,2017,14(11):1545-1546;1549
[14] 刘树玲,刘梅芳,朱宝亮.中草药成分抗缺血性脑卒中药理作用的研究进展[J].医学综述,2009,15(22):3478-3480