电芒针透刺联合通络扶正汤治疗气虚血瘀型缺血性脑卒中偏瘫临床研究被引量：11

Clinical Study on Penetrating Needling by Electro-Elongated Needle Combined with Tongluo Fuzheng Decoction(通络扶正汤)in Treatment of Hemiplegia Caused by Ischemic Stroke of Qi Deficiency and Blood Stasis Syndrome

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摘要目的:评价电芒针透刺联合通络扶正汤治疗气虚血瘀型缺血性脑卒中偏瘫的临床疗效,并观察该疗法对患者神经功能缺损程度、肢体运动功能恢复及生活质量的影响。方法:选取气虚血瘀型缺血性脑卒中偏瘫患者94例,按随机数字表法分为观察组和对照组各47例。对照组给予常规治疗,并进行肢体功能恢复训练,观察组在对照组基础上服用通络扶正汤,并给予电芒针透刺治疗,两组均治疗4周。比较两组患者疗效、气虚血瘀证评分、美国国立卫生研究院卒中量表(NIHSS)评分、患侧肢体运动功能评分、脑卒中专用生活质量量表(SS-QOL)评分及血液指标水平。结果:治疗后,观察组总有效率显著高于对照组(P<0.05);两组患者气虚血瘀证评分、NIHSS评分较治疗前均显著降低(P<0.05),且观察组患者气虚血瘀证评分、NIHSS评分均低于对照组(P<0.01);两组患者患侧肢体运动功能评分、SS-QOL评分较治疗前均显著升高(P<0.05),且观察组患侧肢体运动功能评分、SS-QOL评分均高于对照组(P<0.05);两组患者血清碱性成纤维生长因子(bFGF)、血管内皮生长因子(VEGF)、脑源性神经营养因子(BDNF)水平较治疗前均显著升高(P<0.05),肿瘤坏死因子-α(TNF-α)水平较治疗前显著降低(P<0.05),且观察组上述指标水平均优于对照组(P<0.01)。结论:电芒针透刺联合通络扶正汤治疗气虚血瘀型缺血性脑卒中偏瘫可显著缓解患者气虚血瘀症状,提高临床疗效,并可促进患者神经功能和肢体运动功能恢复,提高生活质量;其改善神经功能的机制与促进患者脑血管生成、减轻炎症反应、降低脑缺血所致神经元损伤程度有关。 Objective:To evaluate the clinical curative efficacy of penetrating needling by electro-elongated needle combined with Tongluo Fuzheng Decoction(通络扶正汤)in treatment of hemiplegia caused by ischemic stroke of qi deficiency and blood stasis syndrome,and observe the effect of this therapy on severity of neurological deficit,recovery of limbs motor function and life quality of the patients.Methods:A total of 94 patients with hemiplegia caused by ischemic stroke of qi deficiency and blood stasis syndrome were divided into observation group and control group according to the random number table method,with 47 cases in each group.Patients in the control group were given routine etiological and sympto-matic treatment,and limbs function recovery training.On the basis of the control group,patients in the observation group were given Tongluo Fuzheng Decoction and penetrating needling by electro-elongated needle.The patients in both the two groups were treated for 4 weeks.The curative efficacy,the scores of qi deficiency and blood stasis syndrome,National Institute of Health Stroke Scale(NIHSS),motor function of the affected limbs,and special quality of life scale for stroke(SS-QOL),as well as the levels of blood indexes of the two groups were compared.Results:After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The qi deficiency and blood stasis syndrome score and NIHSS score of the patients in both the two groups were significantly lower than those before treatment(P<0.05),and the qi deficiency and blood stasis syndrome score and NIHSS score of the patients in the observation group were lower than those of the patients in the control group(P<0.01).The motor function scores of the affected limbs and the SS-QOL score of the patients in both the two groups were significantly higher than those before treatment(P<0.05),and the motor function scores of the affected limbs and the SS-QOL score of the patients in the observation group were higher than those of the patients in the control group(P<0.05).The levels of serum basic fibroblast growth factor(bFGF),vascular endothelial growth factor(VEGF)and brain-derived neurotrophic factor(BDNF)of the patients in both the two groups were significantly higher than those before treatment(P<0.05),and the level of tumor necrosis factor-α(TNF-α)of the patients in both the two groups was significantly lower than that before treatment(P<0.05),and the above indexes of the patients in the observation group were better than those of the patients in the control group(P<0.01).Conclusions:In the treatment of hemiplegia caused by ischemic stroke of qi deficiency and blood stasis syndrome,penetrating needling by electro-elongated needle combined with Tongluo Fuzheng Decoction can significantly relieve the symptoms of qi deficiency and blood stasis,improve the clinical curative efficacy,promote the recovery of neurological function and limbs motor function,and improve the life quality of the patients.The mechanism of improving neurological function is related to promoting cerebrovascular formation,reducing inflammatory reaction and reducing the degree of neuronal damage caused by cerebral ischemia.

作者董全勇王园段晓娜王欣 DONG Quanyong;WANG Yuan;DUAN Xiaona;WANG Xin(Rehabilitation Department,Shandong Provincial Third Hospital,Jinan 250031,China;Clinical Laboratory Department,Shandong Provincial Third Hospital,Jinan 250031,China)

机构地区山东省立第三医院康复科山东省立第三医院检验科

出处《山东中医杂志》 2022年第8期869-874,共6页 Shandong Journal of Traditional Chinese Medicine

基金山东省中医药科技项目(编号:Z24)。

关键词缺血性脑卒中偏瘫气虚血瘀电芒针透刺通络扶正汤神经功能肢体运动功能生活质量 ischemic stroke hemiplegia qi deficiency and blood stasis penetrating needling by electro-elongated needle Tongluo Fuzheng Decoction neurological function limbs motor function life quality