| 引用本文:张婷1，齐婧2，刘侃2，王玥3.温针灸联合逐瘀活血汤治疗脑梗死恢复期气虚血瘀证临床疗效观察[J].世界中医药,2023,(12):. |
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| 温针灸联合逐瘀活血汤治疗脑梗死恢复期气虚血瘀证临床疗效观察 |
| Clinical Observation of Warming Needle Moxibustion Combined with Zhuyu Huoxue Decoction in Treating Cerebral Infarction Patients in Convalescence |
| 投稿时间：2021-03-11 |
| DOI：10.3969/j.issn.1673-7202.2023.12.016 |
| 中文关键词: 脑梗死 恢复期 中药 活血逐瘀汤 温针灸 血管内皮功能 神经功能 血流动力学 |
| English Keywords:Cerebral infarction Convalescence Chinese medicine Huoxue Zhuyu Decoction Warming needle moxibustion Vascular endothelial function Neurological function Hemodynamics |
| 基金项目:湖南省科卫联合项目（2020JJ8066） |
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| 中文摘要: |
| 目的：观察温针灸联合逐瘀活血汤治疗脑梗死恢复期气虚血瘀证的临床疗效。方法：选取2018年6月至2020年12月湖南中医药大学第一附属医院收治的脑梗死恢复期气虚血瘀证患者96例作为研究对象，按照随机数字表法分为观察组和对照组，每组48例。2组均接受神经内科常规治疗，对照组在常规治疗基础上予以中药逐瘀活血汤口服，每日1剂；观察组在对照组治疗基础上予以温针灸治疗。比较治疗前后2组中医证候评分、美国国立卫生研究院卒中量表评分（NIHSS）、简化Fugl-Meyer运动功能评分（FMA）、计算脑血管储备功能（CVR）、大脑中动脉最大峰值流速（Vs）、血管搏动指数（PI）、阻力指数（RI），并比较2组血清胰岛素样生长因子-1（IGF-1）、脑源性神经生长因子（BDNF）、一氧化氮（NO）、内皮素-1（ET-1）、血管性血友病因子（vWF）水平。结果：治疗后观察组中医证候半身不遂、言语謇涩、少言不语、口舌歪斜、气短乏力评分均低于对照组（P<0.05）；NIHSS评分低于对照组（P<0.05），FMA评分高于对照组（P<0.05）；CVR、Vs高于对照组（P<0.05），PI、RI低于对照组（P<0.05）；血清ET-1、vWF水平低于对照组（P<0.05），IGF-1、BDNF、NO水平高于对照组（P<0.05）。结论：温针灸联合逐瘀活血汤可改善脑梗死恢复期气虚血瘀证患者血管内皮功能障碍，促进神经营养因子的分泌，有效缓解中医证候，改善脑组织血液循环，提高神经功能，治疗脑梗死恢复期效果显著。 |
| English Summary: |
| To observe the clinical effect of warming needle moxibustion combined with Zhuyu Huoxue Decoction in treating cerebral infarction patients in convalescence.Methods:A total of 96 patients with cerebral infarction in convalescence(syndrome of qi deficiency and blood stasis) and treated in the First Hospital of Hunan University of Chinese Medicine from June 2018 to December 2020 were selected and randomized into a control group(n=48) and an observation group(n=48).Both groups received routine treatment in the Department of Neurology.The control group was additionally treated with Zhuyu Huoxue Decoction at one bag per day，and the observation group with warming needle moxibustion on the basis of the therapy in the control group.The TCM symptom score，National Institutes of Health Stroke Scale(NIHSS) score，the simplified Fugl-Meyer Assessment(FMA) score，cerebrovascular reserve(CVR)，peak velocity of middle cerebral artery(Vs)，pulsatility index(PI)，and resistance index(RI) were compared between the two groups before and after treatment.In addition，the serum levels of insulin-like growth factor-1(IGF-1)，brain-derived nerve growth factor(BDNF)，nitric oxide(NO)，endothelin-1(ET-1)，and von Willebrand factor(vWF) were compared between the two groups.Results:After treatment，the scores of hemiplegia，dysphasia，aphasia，tongue deviation，and shortness of breath of the observation group were lower than those of the control group(P<0.05).The observation group had lower NIHSS score，PI，and RI and higher FMA score，CVR，and Vs than the control group(P<0.05).In addition，the observation group had lower levels of ET-1 and vWF and higher levels of IGF-1，BDNF，and NO in the serum than the control group(P<0.05).Conclusion:Warming needle moxibustion combined with Zhuyu Huoxue Decoction can alleviate vascular endothelial dysfunction，promote the secretion of neurotrophic factors，relieve TCM symptoms，activate blood circulation in the brain tissue，and improve neurological function，demonstrating significant effects in treating cerebral infarction patients in convalescence. |
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