中风Ⅱ号方联合针刺治疗气虚血瘀证脑卒中疗效观察及对短链脂肪酸的影响
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Observation of Stroke Prescription Ⅱ Combined with Acupuncture for Stroke with Qi Deficiency and Blood Stasis Syndrome and Its Effect on Short-Chain Fatty Acids
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    摘要:

    目的:观察中风Ⅱ号方联合针刺治疗对气虚血瘀证脑卒中患者学习记忆功能、脑血流及短链脂肪 酸的影响。方法:选取140 例气虚血瘀证脑卒中患者,按随机数字表法分为联合组及常规组各70 例。常规组 采用中风Ⅱ号方治疗,联合组在常规组基础上联合针刺治疗。比较2 组临床疗效及病残情况,比较2 组治疗前 后中医证候积分、学习记忆功能、日常生活活动能力量表(ADL) 评分、美国国立卫生研究院卒中量 表(NIHSS) 评分、脑血流及短链脂肪酸的变化。结果:联合组临床疗效总有效率为94.29%,常规组为 82.86%,2 组比较,差异有统计学意义(P<0.05)。治疗后,2 组半身不遂、口舌歪斜、言语謇涩、偏身麻木 中医证候积分均较治疗前下降(P<0.05),联合组上述4 项中医证候积分均低于常规组(P<0.05)。治疗后, 2 组最小血流速度、最大血流速度、平均血流速度、平均血流量均较治疗前升高(P<0.05),脑血管阻力均治 疗前下降(P<0.05);联合组最小血流速度、最大血流速度、平均血流速度、平均血流量均高于常规组(P< 0.05),脑血管阻力低于常规组(P<0.05)。治疗后,2 组异丁酸、戊酸、异戊酸、己酸比较,差异无统计学意 义(P>0.05);治疗后,2 组乙酸、丙酸、丁酸及总短链脂肪酸均较治疗前升高(P<0.05);联合组乙酸、丙 酸、丁酸及总短链脂肪酸均高于常规组(P<0.05)。治疗后,2 组临床记忆量表评分、ADL 评分均较治疗前升 高(P<0.05),NIHSS 评分均较治疗前下降(P<0.05);联合组临床记忆量表评分、ADL 评分均高于常规 组(P<0.05),NIHSS 评分低于常规组(P<0.05)。联合组病残程度低于常规组,差异有统计学意义(P< 0.05)。结论:中风Ⅱ号方联合针刺治疗气虚血瘀证脑卒中疗效显著,可促进认知功能的恢复,提高患者学习 记忆功能,缓解临床症状,改善脑血流动力学指标,降低病残程度。

    Abstract:

    Abstract: Objective: To observe the effect of Stroke Prescription Ⅱ combined with acupuncture on stroke with qi deficiency and blood stasis syndrome and its effect on learning and memory function, cerebral blood flow and short- chain fatty acids. Methods: A total of 140 cases of stroke patients with qi deficiency and blood stasis syndrome were selected and divided into the combination group and the routine group according to the random number table method,with 70 cases in each group. The routine group was treated with the Stroke Prescription Ⅱ,and the combination group was treated with acupuncture based on the treatment of the routine group. The clinical effects and disability status were compared in the two groups. The changes in traditional Chinese medicine (TCM) syndrome scores, learning and memory function,Activities of Daily Living (ADL) scores,National Institutes of Health Stroke Scale (NIHSS) scores, cerebral blood flow,and short-chain fatty acids were compared before and after treatment. Results:The total effective rate of clinical effect was 94.29% in the combination group, and 82.86% in the routine group,the difference being significant (P<0.05). After treatment,the scores of TCM syndromes including hemiplegia, tongue and mouth deviation, awkward speech, and numbness in the two groups were decreased when compared with those before treatment (P<0.05),and the above TCM syndrome scores in the combination group were lower than those in the routine group (P<0.05). After treatment,the minimum blood flow velocity,maximum blood flow velocity,average blood flow velocity,and average blood flow in the two groups were increased when compared with those before treatment (P<0.05),and the cerebral vascular resistance was decreased when compared with that before treatment (P<0.05); the minimum blood flow velocity,maximum blood flow velocity,average blood flow velocity,and average blood flow in the combination group were higher than those in the routine group (P<0.05), and the cerebral vascular resistance was lower than that in the routine group (P<0.05). After treatment, there was no significant difference in the comparison of isobutyric acid,valeric acid,isovaleric acid,and caproic acid between the two groups (P>0.05). After treatment, the levels of acetic acid, propionic acid, butyric acid, and total short chain fatty acids in the two groups were increased when compared with those before treatment (P< 0.05); the levels of acetic acid, propionic acid, butyric acid, and total short chain fatty acids in the combination group were higher than those in the routine group (P<0.05). After treatment, the clinical memory scale scores and ADL scores in the two groups were increased when compared with those before treatment (P<0.05),and the NIHSS scores were decreased when compared with those before treatment (P<0.05). The clinical memory scale scores and ADL scores in the combination group were higher than those in the routine group (P<0.05),and the NIHSS score was lower than that in the routine group (P< 0.05). The degree of disability in the combination group was lower than that in the routine group, the difference being significant (P<0.05). Conclusion:Stroke Prescription Ⅱ combined with acupuncture has a significant curative effect for stroke with qi deficiency and blood stasis syndrome,which can promote the recovery of cognitive function, improve the patient's learning and memory function, alleviate clinical symptoms,improve cerebral blood flow indexes,and reduce disability.

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顾华芬,张宴斌,徐杰.中风Ⅱ号方联合针刺治疗气虚血瘀证脑卒中疗效观察及对短链脂肪酸的影响[J].新中医,2024,56(5):49-55

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  • 在线发布日期: 2024-03-14
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