中药结合“醒脑开窍”针法治疗中风后痉挛性瘫痪
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摘要
目的探讨自拟中药方配合"醒脑开窍"针刺法治疗中风后痉挛性瘫痪的临床疗效及安全性。方法选取我院2016年7月-2017年8月期间收治的120例中风后痉挛性瘫痪患者作为研究对象,按照随机的方法分为观察组和对照组,各60例。对照组给予单纯康复治疗,观察组患者运用自拟中药方配合"醒脑开窍"针刺法治疗。评价2组患者的临床疗效、不良反应、运动功能(Fugl-Meyer)、改良Barthel指数评分(MBI)改善情况。结果观察组患者临床总有效率为95.00%,优于对照组的76.67%(P <0.05);观察组患者仅1例出现恶心,对照组患者共出现5例不良反应,差异有统计学意义(P <0.05);观察组治疗后的MBI评分和FMA显著优于对照组和治疗前,差异有统计学意义(P <0.05)。结论自拟中药方配合"醒脑开窍"针刺法治疗中风后痉挛性瘫痪,可醒脑开窍,活血化瘀,促进静脉张力,改善脑循环,保护脑细胞,进而改善患者的运动功能,提高预后生活质量。
Objective To explore the clinical efficacy and safety of self made Traditional Chinese medicine prescription combined with Xingnao Kaiqiao acupuncture in treating spastic paralysis after stroke. Methods 120 patients with spastic paralysis after the stroke from July 2016 to August 2017 were selected as the research subjects and divided into the observation group(n = 60) and the control group(n = 60) according to the random methods. The control group was given the simple rehabilitation treatment. The patients in the observation group were treated with the traditional Chinese medicine prescription and the Xingnao Kaiqiao acupuncture. The clinical efficacy, adverse reactions, motor function(Fugl-Meyer) and modified Barthel index(MBI) were compared between the two groups.Results The total clinical effective rate of the patients in the observation group was 95.00%, which was better than that of the control group(76.67%)(P < 0.05). There was only one case of nausea in the observation group and five cases in the control group, the dif ference was statistically significant(P < 0.05). The MBI score and FMA in the observation group were significantly better than those in the control group and before the treatment, the dif ference was statistically significant(P < 0.05). Conclusion The traditional Chinese medicine prescription combined with Xingnao Kaiqiao acupuncture method in the treatment of spastic paralysis after apoplexy can awaken the brain and open the orifices,invigorate blood circulation, remove blood stasis, promote venous tension, improve cerebral circulation, protect brain cells, and then improve the patients' motor function, improve the quality of life of prognosis.
Objective To explore the clinical efficacy and safety of self made Traditional Chinese medicine prescription combined with Xingnao Kaiqiao acupuncture in treating spastic paralysis after stroke. Methods 120 patients with spastic paralysis after the stroke from July 2016 to August 2017 were selected as the research subjects and divided into the observation group(n = 60) and the control group(n = 60) according to the random methods. The control group was given the simple rehabilitation treatment. The patients in the observation group were treated with the traditional Chinese medicine prescription and the Xingnao Kaiqiao acupuncture. The clinical efficacy, adverse reactions, motor function(Fugl-Meyer) and modified Barthel index(MBI) were compared between the two groups.Results The total clinical effective rate of the patients in the observation group was 95.00%, which was better than that of the control group(76.67%)(P < 0.05). There was only one case of nausea in the observation group and five cases in the control group, the dif ference was statistically significant(P < 0.05). The MBI score and FMA in the observation group were significantly better than those in the control group and before the treatment, the dif ference was statistically significant(P < 0.05). Conclusion The traditional Chinese medicine prescription combined with Xingnao Kaiqiao acupuncture method in the treatment of spastic paralysis after apoplexy can awaken the brain and open the orifices,invigorate blood circulation, remove blood stasis, promote venous tension, improve cerebral circulation, protect brain cells, and then improve the patients' motor function, improve the quality of life of prognosis.
引文
[1]付露,潘文宇.中风后痉挛性瘫痪的针灸推拿及康复治疗现状[J].现代中西医结合杂志,2016,25(10):1137-1140.
[2]廖穆熙,潘海华,庄礼兴,等.以挛三针为主穴治疗中风后痉挛性瘫痪[J].长春中医药大学学报,2016,32(3):544-547.
[3]NEU E,TRAUB M,MICHAILOV M,et al.On neurovascular factors of idiopathic hypertension including cerebral apoplexy[J].Journal of the Neurological Sciences,2015(357):e206.
[4]CHRISTENSEN M S,BRODERSEN P,OLESEN J,et al.Cerebral apoplexy(stroke)treated with or without prolonged artificial hyperventilation:1.cerebral circulation,clinical course,and cause of death[J].Stroke,1973,4(4):568-631.
[5]贺君,庄礼兴,林涵.靳三针疗法治疗中风后痉挛性瘫痪的多因素分析研究[J].针灸临床杂志,2016,32(2):6-9.
[6]黄日龙,夏青,朱宗俊,等.针刺结合康复训练治疗中风偏瘫痉挛状态临床观察[J].安徽中医药大学学报,2016,35(4):59-62.
[7]胡菱,赵冬琰.中风后痉挛性偏瘫中西医研究进展[J].中西医结合心脑血管病杂志,2016,14(7):729-733.
[8]陈迎,刘蓓.足底穴位按摩联合活血通络汤治疗中风恢复期下肢功能障碍患者的效果观察[J].护理学报,2016,23(12):65-66.
[9]王熙,牛红月.针刺四渎穴、合谷穴治疗中风后手指拘挛的疗效观察[J].针灸临床杂志,2016,32(3):26-28.
[10]刘道龙,姜德友,褚雪菲.阴阳经穴透刺治疗中风后遗症痉挛性瘫痪的疗效观察[J].陕西中医,2016,37(8):1068-1069.
[11]范江华,黄永,王开龙,等.从循证医学角度分析推拿治疗中风后痉挛性偏瘫的疗效[J].中国中医基础医学杂志,2016,22(2):242-248,260.
[12]邓妍,刘悦.基于调节气血温阳通气治则毫火针治疗中风后痉挛性偏瘫临床疗效观察[J].四川中医,2017,35(1):186-189.
[13]马健芸,纪哲.经筋疗法联合神经功能重建系统治疗脑梗死后痉挛性瘫痪的临床观察[J].天津中医药,2014,31(9):542-544.
[14]庄朝安,叶晓倩,江一静,等.中风后痉挛性瘫痪的中医临床治疗研究综述[J].世界中医药,2016,11(12):2817-2820.
[15]李超,时国臣.滞针法配合运动针刺经筋结点治疗中风后痉挛性瘫痪的临床研究[J].山东中医杂志,2016,35(7):623-625.
[16]刘嘉林,朱普贤,韩雪娟,等.泻阴补阳针刺法联合化痰通络解痉汤治疗脑卒中痉挛性瘫痪[J].吉林中医药,2017,37(12):1275-1279.
[17]王迅.醒脑开窍针法联合扶正消栓汤对缺血性中风急性期患者hs-CRP的影响[J].针灸临床杂志,2016,32(4):17-19.
[18]石学敏.“醒脑开窍”针刺法治疗中风病9005例临床研究[J].中医药导报,2005,11(1):3-5.
[2]廖穆熙,潘海华,庄礼兴,等.以挛三针为主穴治疗中风后痉挛性瘫痪[J].长春中医药大学学报,2016,32(3):544-547.
[3]NEU E,TRAUB M,MICHAILOV M,et al.On neurovascular factors of idiopathic hypertension including cerebral apoplexy[J].Journal of the Neurological Sciences,2015(357):e206.
[4]CHRISTENSEN M S,BRODERSEN P,OLESEN J,et al.Cerebral apoplexy(stroke)treated with or without prolonged artificial hyperventilation:1.cerebral circulation,clinical course,and cause of death[J].Stroke,1973,4(4):568-631.
[5]贺君,庄礼兴,林涵.靳三针疗法治疗中风后痉挛性瘫痪的多因素分析研究[J].针灸临床杂志,2016,32(2):6-9.
[6]黄日龙,夏青,朱宗俊,等.针刺结合康复训练治疗中风偏瘫痉挛状态临床观察[J].安徽中医药大学学报,2016,35(4):59-62.
[7]胡菱,赵冬琰.中风后痉挛性偏瘫中西医研究进展[J].中西医结合心脑血管病杂志,2016,14(7):729-733.
[8]陈迎,刘蓓.足底穴位按摩联合活血通络汤治疗中风恢复期下肢功能障碍患者的效果观察[J].护理学报,2016,23(12):65-66.
[9]王熙,牛红月.针刺四渎穴、合谷穴治疗中风后手指拘挛的疗效观察[J].针灸临床杂志,2016,32(3):26-28.
[10]刘道龙,姜德友,褚雪菲.阴阳经穴透刺治疗中风后遗症痉挛性瘫痪的疗效观察[J].陕西中医,2016,37(8):1068-1069.
[11]范江华,黄永,王开龙,等.从循证医学角度分析推拿治疗中风后痉挛性偏瘫的疗效[J].中国中医基础医学杂志,2016,22(2):242-248,260.
[12]邓妍,刘悦.基于调节气血温阳通气治则毫火针治疗中风后痉挛性偏瘫临床疗效观察[J].四川中医,2017,35(1):186-189.
[13]马健芸,纪哲.经筋疗法联合神经功能重建系统治疗脑梗死后痉挛性瘫痪的临床观察[J].天津中医药,2014,31(9):542-544.
[14]庄朝安,叶晓倩,江一静,等.中风后痉挛性瘫痪的中医临床治疗研究综述[J].世界中医药,2016,11(12):2817-2820.
[15]李超,时国臣.滞针法配合运动针刺经筋结点治疗中风后痉挛性瘫痪的临床研究[J].山东中医杂志,2016,35(7):623-625.
[16]刘嘉林,朱普贤,韩雪娟,等.泻阴补阳针刺法联合化痰通络解痉汤治疗脑卒中痉挛性瘫痪[J].吉林中医药,2017,37(12):1275-1279.
[17]王迅.醒脑开窍针法联合扶正消栓汤对缺血性中风急性期患者hs-CRP的影响[J].针灸临床杂志,2016,32(4):17-19.
[18]石学敏.“醒脑开窍”针刺法治疗中风病9005例临床研究[J].中医药导报,2005,11(1):3-5.