摘要
目的观察自拟"桂枝茯苓加减方"结合"舒筋通络、活血祛瘀"针法预防脑卒中急性期下肢深静脉血栓形成(deep venous thrombus,DVT)的疗效。方法选取200例脑卒中急性期患者,按就诊先后顺序随机分为对照组、针灸组、中药组、针药组四组,每组50例,对照组予常规机械预防治疗,针灸组在对照组的基础上采用"舒筋通络、活血祛瘀"针法,中药组在对照组的基础上采用自拟"桂枝茯苓加减方",针药组在对照组基础上加用自拟"桂枝茯苓加减方"结合"舒筋通络、活血祛瘀"针法,观察脑卒中急性期患者患肢麻木、肿胀、疼痛的发生率,行患肢深静脉彩色多普勒超声检测,观察血栓发生率;观察比较4组治疗后血液流变学指标:红细胞压积HCT(%)、红细胞聚集率(%)、血浆黏度(Pa·s)、纤维蛋白Fib(g/L)、D-二聚体(μg/mL)、全血黏度(Pa·s)等变化情况。结果对照组、针灸组、中药组的麻木、肿胀、疼痛比率均显著高于针药组。对照组、针灸组、中药组的第1个月DVT发生率、第2个月DVT发生率、DVT总发生率均显著高于针药组。治疗后针灸组、中药组、针药组的各血液流变学指标均显著低于对照组;针药组的各血液流变学指标均显著低于中药组、针药组。结论相对于对照组、针灸组、中药组,针药组预防脑卒中急性期DVT效果最显著。针药结合,以自拟"桂枝茯苓丸"活血化瘀为主,针灸舒筋通络、活血祛瘀为辅,有效降低纤维蛋白、血液黏度、抑制红细胞聚集,从而改善血液流变学、降低血液黏度,能有效地预防脑卒中急性期下肢深静脉血栓形成,且降低了出血的可能,方法安全可靠,临床应用价值较高,推广应用前景广阔。
Objective To observe the therapeutic effect of Modified Guizhi Fuling Formula combined with acupuncture method for relaxing tendons and dredging collateral as well as promoting blood circulation and removing blood stasis to prevent deep venous thrombus (DVT) in the acute stage of cerebral apoplexy. Methods Two hundred cases of acute cerebral apoplexy patients,according to the doctor order,were randomly divided into control group,acupuncture group,the Chinese medicine group,the acupuncture and Chinese medicine group,50 cases in each group. The control group used the conventional mechanical prevention treatment. The acupuncture groupon the basis used tendon-relaxing and collateral-dredging as well as blood-activating and stasis-removing acupuncture. The Chinese medicine groupon the basis of the control group used Modified Guizhi Fuling Formula. The acupuncture and Chinese medicine group on the basis of the control group used tendon-relaxing and collateral-dredging as well as blood-activating and stasis-removing acupuncture and Modified Guizhi Fuling Formula. We observed the incidence of limb numbness,swelling,pain at the acute phase of cerebral apoplexy patients. By the limb deep venous color doppler ultrasonic detection,the incidence of thrombosis was observed. The hemorheological indexes,including hematocrit HCT (%),erythrocyte aggregation rate (%),plasma viscosity (pa. s),fibrin Fib (g/L),d-dimer (μg/mL),whole blood viscosity (pa. s) and other changesof the four groups after treatment were observed and compared.Results The incidence of numbness,swelling and pain in the control group,acupuncture group and Chinese medicine group were significantly higher than those in acupuncture and Chinese medicine group. The incidence of DVT in the first and second month and the total incidencein the control group,acupuncture group and Chinese medicine group were significantly higher than those in the acupuncture and Chinese medicine group. After treatment,hemorheology indexes of acupuncture group,Chinese medicine group and acupuncture and Chinese medicine group were significantly lower than those of control group. The hemorheology indexes of acupuncture and Chinese mediicne group were significantly lower than those of Chinese medicine group and acupuncture group. Conclusion Compared with the control group,acupuncture group and Chinese medicine group,acupuncture and Chinese medicine group has the most significant effect on preventing DVT in acute stage of stroke. Combination of acupuncture with medicine mainly uses Modified Guizhi Fuling Formula for activating blood circulation and resolving blood stasis and uses acupuncture to dredge collateral and tendons. The treatment can effectively reduce the fiber protein and blood viscosity,inhibit erythrocyte aggregation,improve blood rheology and reduce blood viscosity,and also can effectively prevent acute lower extremity deep vein thrombosis,and reduce the bleeding. It is a safe and reliable method,with higher clinical value and application prospect.
作者
罗静
杨华
LUO Jing;YANG Hua(Rehabilitation Department,Taizhou Central Hospital,Taizhou 318000,Zhejiang,China)
出处
《实用中医内科杂志》
2020年第4期114-118,共5页
Journal of Practical Traditional Chinese Internal Medicine
关键词
针灸
中医中药
脑卒中后急性期下肢深静脉血栓形成
疗效
acupuncture
traditional Chinese medicine
deep venous thrombosis of lower limbs in acute stage after stroke
efficacy
