摘要
[目的]观察真方白丸子+按摩联合西药治疗缺血性中风疗效。[方法]使用随机平行对照方法,将165例住院患者按病志号抽签方法简单随机分为两组。对照组80例控制水肿、降颅压、营养脑细胞、抗凝、预防感染、抗应激性溃疡、维持水电解质平衡及对症支根据临床反馈予钙离子拮抗剂、阿司匹林和脑复康等。治疗组85例真方白丸子(半夏、白术各15g,天麻、当归个20g,地龙10g,陈皮20g,丹参30g,川牛膝、钩藤各20g,鸡血藤25g,全蝎5g,炙甘草15g),水煎400m L,1剂/d,早晚分服;理疗:医生位于患者瘫痪侧,一手虎口与病人虎口相交叉,拇指指腹按压合谷,食指和中指按压内关,另一手拇指按压曲池,食指或中指按压少海,同时托住肘关节处,在指压各穴位同时,托住肘关节,在肱骨外旋情况下依次使肩关节外展,内收,内旋,外旋,肘关节屈伸,前臂旋前,旋后,指关节等屈伸,内外旋,每动作各做50~100次,操作15min;医生一手拇指、食指分别按压病人双膝眼,另一手食指或中指按压照海,拇指按压昆仑,双手用力抬起下肢,使髋关节内收、外展、内旋、外旋各50~100次,操作15min;一手握住病人小退,另一手拇指或中指按压涌泉,双手用力使病人下肢屈膝,曲髋50~100次;活动踝关节,使其背曲,左右旋转,操作15min;西药治疗同对照组。连续治疗14d为1疗程。观测临床症状、肢体运动功能(FMA)、日常生活活动能力(MBI)、神经功能缺损程度(NIHSS)、不良反应。连续治疗2疗程(28d),判定疗效。[结果]治疗组基本痊愈23例,有效56例,无效6例,总有效率92.94%;对照组基本痊愈19例,有效46例,无效15例,总有效率81.25%;治疗组疗效优于对照组(P<0.05)。FMA评分、MBI评分两组均明显改善(P<0.01),治疗组改善优于对照组(P<0.01),NIHSS评分治疗组改善明显(P<0.01),对照组无显著变化(P>0.05)。[结论]真方白丸子+按摩联合西药治疗缺血性中风,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the true Zhenfang Baizi Wan ＋ massage combined with western medicine in the treatment of ischemic apoplexy. [Methods] 165 patients were randomly divided into two groups according to random parallel control method. The control group of 80 cases of edema and intracranial pressure, brain cells nutrition, anticoagulation, anti infection, prevention of stress ulcer, maintaining water and electrolyte balance and symptomatic support according to clinical feedback to the calcium antagonists, aspirin and piracetam etc. The treatment group of 85 cases of true white balls（Banxia, Baizhu 15 g, Tianma,Danggui20 g, Dilong 10 g, Chenpi 20 g, Danshen 30 g Chuanniuxi,Gouteng 20 g, Jixueteng 25 g, Quanxie 5 g, Zhigancao15 g）, decoction 400 mL, 1 doses of/d, 2 times/d; physiotherapy： doctors in patients paralysis side, hand thumb and patient Hukou cross thumbs pressing Hegu, forefinger and middle finger pressing another hand thumb pressing Neiguan, Quchi, index or middle finger pressing Shaohai, and hold the elbow joint, while massage each acupuncture point, hold the elbow joint, humeral external rotation condition in turn the shoulder abduction, adduction, internal rotation, external rotation, elbow flexion and forearm pronation, supination,finger joint flexion, internal rotation and external rotation, each movement to do 50 to 100 times, 15 min;the doctor hands the thumb and forefinger respectively press patient knees eyes, another Hand forefinger or middle finger pressing the thumb as the sea of Kunlun, both hands lift force of lower limbs, the hip adduction,abduction and internal rotation, external rotation of the 50~100 times, the operation of 15 min; holding a small patient back, another hand thumb or finger pressing springs, hands force the lower limb flexion of knee.Song of hip in 50~100 times; the activity of ankle dorsiflexion, rotation, 15 min operation; western medicine treatment with the control group. Continuous treatment for 1 courses of 14 D. Observation of clinical symptoms,limb motor function（FMA）, activities of daily living（MBI）, the degree of neurological deficits（NIHSS）,adverse reactions. Continuous treatment for 2 course of treatment（28 d）, to determine the efficacy. [Results]the treatment group cured 23 cases, effective 56 cases, invalid 6 cases, the total efficiency of 92.94%;control group 19 cases were cured, 46 cases effective, 15 cases ineffective, the total efficiency of 81.25%;the treatment group than the control group（P0.05）. FMA score, MBI score of two groups were significantly improved（P0.01）, the treatment group was better than the control group（P0.01）, NIHSS score improved significantly（P0.01）, the control group had no significant change（P0.05）. [Conclusion] really white balls＋ massage combined with western medicine in the treatment of ischemic stroke, the curative effect is satisfied,no serious adverse reactions, worthy of promotion.
出处
《实用中医内科杂志》
2018年第1期34-36,共3页
Journal of Practical Traditional Chinese Internal Medicine
