世界中医药

目的：观察中西医结合疗法在脑卒中后疲劳康复中的治疗效果。方法：选取2010年6月至2013年7月于我院就诊的91例脑卒中后疲劳患者为研究对象，随机分为对照组45例和治疗组46例。对照组给予进氧支持、控制血糖、血压、抗凝、合理饮食、纠正机体水电解质平衡、抗感染、防并发症等西医常规基础性治疗，并指导患者进行科学的康复锻炼；治疗组患者在对照组治疗的基础上给予“艾灸、电脑中频穴位电按摩”治疗，15 d为1个疗程。治疗2个疗程后，比较2组患者的临床症状改善情况及证候积分变化情况，用疲劳严重程度量表(FSS)和脑卒中专用生活质量量表(SS-QOL)对脑卒中后疲劳患者进行评估。比较2组的有效率。结果：对照组有效率为73.3%，治疗组有效率为91.3%，对照组有效率高于治疗组，2组有效率比较，差异有统计学意义（P<0.05）。2组患者倦怠乏力、关节痛、筋肉酸痛、多汗、纳差、眠差、头痛、情志不舒等临床症状及证候积分较治疗前均有所改善，治疗组临床症状的改善更为明显，差异有统计学意义（P<0.05）。2组患者治疗前疲劳严重程度量表(FSS)和脑卒中专用生活质量量表(SS-QOL)的积分比较，差异无统计学意义（P>0.05），治疗后患者的疲劳严重程度量表(FSS)积分较治疗前有所降低，脑卒中专用生活质量量表(SS-QOL)的积分治疗前有所增加，治疗组患者的评分变化程度更为明显，差异有统计学意义（P<0.05）。结论：运用艾灸和电脑中频穴位电按摩联合西医常规基础治疗脑卒中后疲劳是临床上以中西医结合治疗为方向治疗神经科疾病的一种有效可行的治疗方案，作者临床经验是，运用艾灸和电脑中频穴位电按摩能达到培元固本、理中益气，活血舒筋的效果，临床应用能有效缓解患者以疲劳乏力为主的临床症状，改善患者的生活质量，达到标本兼治的效果，且不良反应少，具有良好的临床疗效，值得进行临床推广。

English Summary:

To observe the effect of TCM therapy in fatigue rehabilitation after stroke.Methods：Ninety one patients with stroke fatigue treated in our hospital from June 2010 to July 2013 was selected and randomly divided into control group (n=45) and treatment group (n=46).Patients in the control group received conventional western medicine treatment including oxygen support，blood glucose control，blood pressure，anticoagulation，proper diet，correct body water and electrolyte balance，anti-infective，anti-complications as well as scientific rehabilitation guidance to patients.Patients in the treatment group received extra “moxibustion，intermediate frequency electric acupoint massage” therapy treatment apart from the same therapies as the control group applied.Fifteen days was one treatment course.After 2 courses of treatment，the patient’s clinical symptoms were compared，and the syndrome score improvement and changes with fatigue severity scale (FSS) and the Quality of Life Scale dedicated stroke (SS-QOL) of patients with post-stroke fatigue were evaluated.The therapeutic effects of the two groups were compared.Results：The response rate of the control group was 73.3%，and that of the treatment group was 91.3%，and the difference between the groups was statistically significant (P<0.05).Clinical symptoms of patients in both groups were improved after treatment，including fatigue，joint pain，muscle aches，sweating，anorexia，poor sleep，headaches，and other emotional discomfort and symptom scores，and the treatment group improved more obviously (P<0.05).Before treatment，Fatigue Severity Scale (FSS) and stroke special quality of life scale (SS-QOL) points showed no significant difference between the two groups (P>0.05); after treatment，fatigue severity scale (FSS) of patients of the both groups were decreased，and quality of life scale before special stroke (SS-QOL) increased，and patients in treatment group got better outcomes (P<0.05).Conclusion：The application of moxibustion and intermediate frequency electrical acupoint massage combined with western medicine treating post stroke fatigue is a feasible and effective treatment option.It can nourish the yuan qi and consolidate the root，sooth and benefit qi，activate blood so as to effectively relieve clinical symptoms mainly manifested with fatigue，improve quality of life and hence treat both the tip and root of the disease.The therapy shall good therapeutic effect with few side effects，which is worthy of generalization.

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