温针灸联合栝楼桂枝汤在脑卒中躯干控制能力障碍患者中的应用效果

Application Effect of Warm Acupuncture Combined with Gualou Guizhi Decoction in Patients with Stroke Trunk Control Ability Disorder

目的:探讨脑卒中躯干控制能力障碍患者应用温针灸联合栝楼桂枝汤的效果及对组蛋白去乙酰化酶3(HDAC3)、信号转导分子3(SMAD3)水平的影响。方法:选择2020年9月—2023年9月武夷山市立医院收治的72例脑卒中躯干控制能力障碍患者作为研究对象,按照乱数表法将患者分为观察组(n=36)与对照组(n=36)。对照组给予常规西药治疗,观察组在对照组基础上给予温针灸联合栝楼桂枝汤,比较两组临床疗效、神经炎症因子、神经功能、躯干控制能力及日常生活能力。结果:观察组总有效率为97.22%,明显较对照组的80.56%高,差异有统计学意义(P<0.05)。治疗后,两组HDAC3、SMAD3、白细胞介素-1β(IL-1β)水平及美国国立卫生研究院卒中量表(NIHSS)评分均降低,且观察组较对照组更低,差异有统计学意义(P<0.05)。治疗后,两组简式Fugl-Meyer(FMA)评分、Sheikh躯干控制评分及改良Barthel指数(MBI)评分均升高,且观察组较对照组更高,差异有统计学意义(P<0.05)。结论:脑卒中躯干控制能力障碍患者应用温针灸联合栝楼桂枝汤的临床效果较显著,可有效降低神经炎症反应,改善神经功能及躯干控制能力,并提高日常生活能力。

Objective:To explore the effect of warm acupuncture combined with Gualou Guizhi Decoction in patients with stroke trunk control ability disorders and its influence on the levels of histone deacetylase 3(HDAC3)and signal transduction molecule 3(SMAD3).Method:A total of 72 patients with stroke trunk control ability disorders who admitted to Wuyishan Municipal Hospital from September 2020 to September 2023 were selected as the research objects,the patients were divided into the observation group(n=36)and the control group(n=36)according to the random number table method.The control group was given conventional western medicine treatment,the observation group was given warm acupuncture combined with Gualou Guizhi Decoction on the basis of the control group,the clinical curative effect,neuroinflammatory factors,nerve function,trunk control ability and daily life ability of two groups were compared.Result:The total effective rate of the observation group was 97.22%,which was significantly higher than 80.56%of the control group,and the difference was statistically significant(P<0.05);after treatment,the levels of HDAC3,SMAD3,interleukin-1β(IL-1β)and National Institutes of Health stroke scale(NIHSS)scores in two groups were decreased,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05);after treatment,the simple Fugl-Meyer(FMA)scores,Sheikh trunk control scores and modified Barthel index(MBI)scores of two groups were increased,and those in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The clinical effect of warm acupuncture combined with Gualou Guizhi Decoction in the treatment of patients with stroke trunk control ability disorders is significant,which can effectively reduce the neuroinflammatory response,improve the nerve function and trunk control ability,and improve the daily life ability.