血栓通脉汤联合针刺治疗脑梗死及对神经、血管功能的影响
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摘要
目的:分析血栓通脉汤联合针刺对脑梗死的疗效及对神经、血管功能的影响。方法:115例急性脑梗死患者,按照随机数字表法分成两组。对照组患者给予西医常规治疗,观察组患者在此基础上给予血栓通脉汤联合针刺治疗。连续治疗12周,对比两组治疗效果、治疗前后神经功能、血管功能及不良反应的差异。结果:治疗后观察组总有效率明显高于对照组,组间有显著的统计学差异(P<0.05)。治疗前两组患者NIHSS评分、GCS评分无统计学差异(P>0.05);治疗后观察组NIHSS评分低于对照组,GCS评分高于对照组,组间有显著的统计学差异(P<0.05)。治疗前两组患者血清ET-1、NO水平无统计学差异(P>0.05);治疗后观察组血清ET-1水平低于对照组,NO水平高于对照组,组间有显著的统计学差异(P<0.05)。治疗期间两组间未见明显的不良反应。结论:血栓通脉汤联合针刺治疗急性脑梗死疗效确切,可较好的改善患者神经功能缺损和血管内皮功能损伤程度。
Objective:To analyze the effect of Xueshuan Tongmai Decoction combined with acupuncture on cerebral infarction and its effect on nerve and vascular function. Methods:A total of 115 patients with acute cerebral infarction were selected and divided into two groups according to the random digital table method. The patients in the control group were given conventional treatment with western medicine. On this basis, the patients in the observation group were treated with Xueshuan Tongmai Decoction to assist the acupuncture. After 12 weeks of continuous treatment, the effects of treatment, nerve function, vascular function and adverse reaction before and after treatment were compared between the two groups. Results:After treatment, the total effective rate of the observation group was significantly higher than that of the control group, and there was significant difference between the groups(P<0.05). Before treatment, there was no significant difference in NIHSS score or GCS score between the two groups(P>0.05). After treatment, the NIHSS score of the observation group was lower than that of the control group, and the GCS score was higher than that of the control group. There was a significant difference between the two groups(P<0.05). Before treatment, there was no significant difference in serum ET-1 or NO levels between the two groups(P>0.05). After treatment, the serum ET-1 level in the observation group was lower than that in the control group, and the level of NO was higher than that in the control group. There was a significant difference between the two groups(P<0.05). There was no obvious adverse reaction between the two groups during the treatment. Conclusion: Xueshuan Tongmai Decoction combined with acupuncture at Tongli(HT5) is effective in treating acute cerebral infarction, which can better improve neurological impairment and vascular endothelial dysfunction.
Objective:To analyze the effect of Xueshuan Tongmai Decoction combined with acupuncture on cerebral infarction and its effect on nerve and vascular function. Methods:A total of 115 patients with acute cerebral infarction were selected and divided into two groups according to the random digital table method. The patients in the control group were given conventional treatment with western medicine. On this basis, the patients in the observation group were treated with Xueshuan Tongmai Decoction to assist the acupuncture. After 12 weeks of continuous treatment, the effects of treatment, nerve function, vascular function and adverse reaction before and after treatment were compared between the two groups. Results:After treatment, the total effective rate of the observation group was significantly higher than that of the control group, and there was significant difference between the groups(P<0.05). Before treatment, there was no significant difference in NIHSS score or GCS score between the two groups(P>0.05). After treatment, the NIHSS score of the observation group was lower than that of the control group, and the GCS score was higher than that of the control group. There was a significant difference between the two groups(P<0.05). Before treatment, there was no significant difference in serum ET-1 or NO levels between the two groups(P>0.05). After treatment, the serum ET-1 level in the observation group was lower than that in the control group, and the level of NO was higher than that in the control group. There was a significant difference between the two groups(P<0.05). There was no obvious adverse reaction between the two groups during the treatment. Conclusion: Xueshuan Tongmai Decoction combined with acupuncture at Tongli(HT5) is effective in treating acute cerebral infarction, which can better improve neurological impairment and vascular endothelial dysfunction.
引文
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[2] 宇传华,罗丽莎,李梅,等.从全球视角看中国脑卒中疾病负担的严峻性[J].公共卫生与预防医学,2016,27(1):1-5.
[3] 袁修银,任俊翠,刘畅,等.医院-社区-家庭整体护理在脑卒中康复中的应用[J].中华全科医学,2016,14(3):491-493,514.
[4] 陆银艳,刘泰.活血化瘀法治疗脑卒中后抑郁症的研究进展[J].中西医结合心脑血管病杂志,2016,14(2):155-157.
[5] 熊杰,刘佳,刘凯,等.针刺结合康复治疗脑卒中后肩手综合征的系统评价[J].中国康复医学杂志,2016,31(8):903-907,916.
[6] 葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:612.
[7] 王永炎,鲁兆麟.中医内科学[M].2版.北京:人民卫生出版社,1999:533.
[8] 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[J].中华神经科杂志,1996,12(6):381-383.
[9] Zhang PL,Wang YX,Chen Y,et al.Use of Intravenous Thrombolytic Therapy in Acute Ischemic Stroke Patients: Evaluation of Clinical Outcomes[J].Cell biochemistry and biophysics,2015,72(1):11-17.
[10] 王艾,曾广民,张福秋,等.高血压合并脑卒中二级预防降压药物的选择[J].中西医结合心脑血管病杂志,2016,14(11):1212-1215.
[11] 陈汉水,童绥君,马祺琳,等.药物联合心理治疗老年脑卒中后睡眠障碍的疗效[J].中国老年学杂志,2016,36(23):5856-5857.
[12] 郑丽玲,臧向博.活血化瘀方在急性缺血性脑卒中治疗中的疗效及预后分析[J].陕西中医,2016,37(7):814-815.
[13] 高鹤,李会娟.活血化瘀化痰通络法对缺血性脑卒中患者神经功能及血小板功能的影响[J].现代中西医结合杂志,2017,26(4):386-388.
[14] 贾春燕,池礼捷,牛瑞芳,等.自拟活血化瘀方对缺血性脑卒中患者生活质量的影响[J].现代生物医学进展,2016,16(36):7176-7178,7193.
[15] 冯声旺,曹淑华,杜淑佳,等.针刺配合吞咽训练治疗脑卒中后吞咽障碍:随机对照研究[J].中国针灸,2016,36(4):347-350.
[16] 徐基民,刘兰群,李艳丽,等.针刺在中西医结合脑卒中康复中的应用体会[J].中国康复理论与实践,2016(2):245-248.
[17] 刘亚玮.针刺结合康复训练治疗老年脑卒中后上肢功能障碍的疗效[J].中国老年学杂志,2016,36(9):2154-2156.
[18] Strbian D,Mustanoja S,Pekkola J,et al.Intravenous alteplase versus rescue endovascular procedure in patients with proximal middle cerebral artery occlusion[J].International journal of stroke: official journal of the International Stroke Society,2015,10(2):188-193.
[19] 周国强,黄宗青,张志,等.增强型体外反搏对缺血性脑卒中患者超敏C反应蛋白和内皮素1的影响[J].中国神经精神疾病杂志,2016,42(3):129-133.
[20] 王德泉.丹参川芎嗪联合厄贝沙坦对高血压患者血管内皮功能的影响[J].中国实用医刊,2017,44(17):45-47.