世界中医药

目的:探讨化瘀通脉汤联合芒针针刺治疗脑卒中后肢体痉挛的临床疗效及其可能作用机制。方法:选取2016年8月至2018年8月安徽中医药大学第二附属医院收治的脑卒中后肢体痉挛患者62例作为研究对象,按入院治疗顺序将其分为对照组和观察组,每组31例。对照组予以脑卒中内科常规治疗和康复训练,观察组在对照组基础上加用化瘀通脉汤联合芒针针刺治疗,2组患者治疗时间均为4周。观察2组患者临床疗效;记录2组患者治疗前后的生命质量、病情严重程度以及中医症候积分;采用酶联免疫吸附法对患者血清中甘氨酸(Gly)、γ-氨基丁酸(GABA)进行检测,并比较两者表达水平的差异。结果:观察组临床疗效(9355%)明显高于对照组(6774%)(χ2=661,P=001);治疗后,2组患者组CSI、改良Ashworth评分等病情严重程度指标均出现降低,且观察组相较于对照组更低(P<001);2组患者偏身麻木、语言蹇涩或不语、口舌歪斜、半身不遂、舌质暗淡苔白腻、脉沉细等中医症候积分均出现降低,且观察组相较于对照组更低(P<001);2组患者Gly、GABA等相关血清指标以及BI、QOL-BREF评分等生命质量指标均出现降低,且观察组相较于对照组水平更低(P<001)。结论:化瘀通脉汤联合芒针针刺可明显者降低脑卒中后肢体痉挛患肢体痉挛程度,促进神经功能恢复并提高生命质量,同时能够调节Gly、GABA表达,值得临床推广应用。

English Summary:

To study the clinical effect of Huayu Tongmai Decoction combined with Awn Needle Acupuncture on limb spasm after stroke and explore its possible mechanism.Methods:A total of 62 patients with post-stroke limb spasm admitted to our hospital from August 2016 to August 2018 were divided into study group(31 cases)and control group(31 cases)according to the order of admission treatment.The control group was given routine treatment and rehabilitation training of stroke medicine,and the research group was treated with Huayu Tongmai Decoction combined with Mangliao needle acupuncture on the basis of this treatment.The treatment time of both groups was 4 weeks.The clinical efficacy of the two groups was observed;the quality of life,the severity of the disease and the scores of TCM symptoms were recorded before and after treatment;the serum glycine(Gly)and gamma-aminobutyric acid(GABA)were detected by enzyme-linked immunosorbent assay(ELISA),and the differences of the expression levels between the two groups were compared.Results:The clinical efficacy of the study group(9355%)was significantly higher than that of the control group(6774%)(χ2=661,P=001).After treatment,the severity indexes of CSI and improved Ashworth score of the two groups decreased,and the study group was lower than that of the control group(P<001).The two groups were paralyzed,language astringency or nonverbal,mouth and tongue deviation,hemiplegia.The scores of TCM symptoms such as dull tongue coating,white greasy tongue and fine pulse were lower in the study group than in the control group(P<001).The serum indexes such as Gly,GABA,BI and QOL-BREF were lower in the two groups,and the level in the study group was lower than that in the control group(P<001).Conclusion:Huayu Tongmai Decoction combined with Awn Needle Acupuncture can significantly reduce the degree of limb spasm after stroke,promote the recovery of nerve function and improve the quality of life,and regulate the expression of Gly and GABA,which is worthy of clinical application.

查看全文查看/发表评论下载PDF阅读器