针刺联合养阴熄风通络汤对老年脑梗死恢复期患者神经功能、颅内血运的影响
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Effect of Acupuncture Combined with Yangyin Xifeng Tongluo Decoction on Neurolog⁃ ical Function and Intracranial Blood Circulation of Senile Patients with Cerebral Infarc⁃ tion in Convalescence
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    摘要:

    目的:观察针刺联合养阴熄风通络汤治疗老年脑梗死恢复期患者的临床疗效。方法:选取86 例老 年脑梗死恢复期患者为研究对象,按照随机数字表法分为观察组44 例和对照组42 例。对照组给予降压、降 脂、调节血糖、抗血小板及平衡电解质等基础治疗,并根据患者恢复情况开展康复训练;观察组在对照组基础 上加用针刺及养阴熄风通络汤治疗。比较2 组临床疗效,以及治疗前后中医证候评分、神经功能[神经功能缺 损评分(CSS)、美国国立卫生研究院卒中量表(NIHSS)]、认知功能[简易精神状态检查量表(MMSE)]、 颅内血运[收缩期最大血流速度(Vs)、平均血流速度(Vm)、阻力指数(RI)]、超敏C-反应蛋白(hs-CRP)、 神经元特异性烯醇化酶(NSE) 水平。结果:观察组总有效率为93.18%,对照组为76.19%,2 组比较,差异 有统计学意义(P<0.05)。治疗后,2 组肢体麻木、半身不遂、口眼歪斜、头晕目眩、面红目赤、咽干口燥等 中医证候评分均较治疗前降低(P<0.05),且观察组各项中医证候评分均低于对照组(P<0.05)。治疗后, 2 组CSS、NIHSS 评分均较治疗前降低(P<0.05),MMSE 评分均较治疗前升高(P<0.05);且观察组上述各 项指标改善较对照组更显著(P<0.05)。治疗后,2 组Vs、Vm 水平均较治疗前升高(P<0.05),RI 水平均较 治疗前降低(P<0.05);且观察组上述各项指标改善均较对照组更显著(P<0.05)。治疗后,2 组血清 hs-CRP、NSE 水平均较治疗前降低(P<0.05),且观察组hs-CRP、NSE 水平均低于对照组(P<0.05)。结 论:针刺联合中药养阴熄风通络汤治疗老年脑梗死恢复期患者可有效缓解临床症状,显著改善神经功能、认知 功能和脑血流状态。

    Abstract:

    Abstract: Objective: To observe the clinical effect of the therapy of acupuncture combined with Yangyin Xifeng Tongluo Decoction on senile patients with cerebral infarction in convalescence. Methods:A total of 86 senile patients with cerebral infarction in convalescence were selected as the study objects and divided into an observation group of 44 cases and a control group of 42 cases according to the random number table method. The control group was given western medicine for lowering blood pressure and lipid, regulating blood sugar, anti- platelet aggregation and electrolyte balance as the basic treatment and rehabilitation training according to the recovery of patients;the observation group was additionally treated with acupuncture combined with Yangyin Xifeng Tongluo Decoction based on the treatment of the control group. The clinical effects and traditional Chinese medicine (TCM) syndrome scores,neurological function, including scores of China Stroke Scale (CSS) and National Institute of Health Stroke Scale (NIHSS),Mini- Mental State Examination (MMSE) for cognitive function, intracranial blood circulation including peak systolie velocity (Vs) and meam velocity (Vm) and resistance index (RI),hyper-sensitive C-reactive protein (hs-CRP) and levels of neuron-specific enolase (NSE) were compared before and after treatment between the two groups. Results:The total effective rate was 93.18% in the observation group and 76.19% in the control group, the difference being significant (P<0.05). After treatment, the TCM syndrome scores of numbness of the limbs,hemi-paralysis,deviated mouth and eyes,dizziness,red complexion and eyes, and dry throat and mouth in the two groups were decreased when compared with those before treatment (P<0.05),and the above six scores in the treatment group were lower than those in the control group (P< 0.05). After treatment,the scores of CSS and NIHSS in both groups were decreased when compared with those before treatment (P<0.05), and the MMSE scores were increased when compared with those before treatment (P<0.05); the improvement of above three scores in the observation group was more significant than that in the control group (P<0.05). After treatment, the levels of Vs and Vm in the two groups were increased when compared with those before treatment (P<0.05), and the RI levels were decreased when compared with those before treatment (P<0.05);the improvement of above three levels in the observation group was more significant than that in the control group (P<0.05). After treatment,the levels of serum hs- CRP and NSE in both groups were decreased when compared with those before treatment (P<0.05), and the above two levels in the observation group were lower than those in the control group (P<0.05). Conclusion: The therapy of acupuncture combined with Yangyin Xifeng Tongluo Decoction can effectively mitigate the clinical symptoms and significantly improve the neurological function, cognitive function and cerebral blood circulation of senile patients with cerebral infarction in convalescence.

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胡沙欧,王明,宋丽静.针刺联合养阴熄风通络汤对老年脑梗死恢复期患者神经功能、颅内血运的影响[J].新中医,2023,55(12):121-125

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  • 在线发布日期: 2023-06-27
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