健脾化痰法在针刺治疗中风(风痰阻络型)中的作用及其机理研究

Study on the Effect of Acupuncture in Strengthening the Spleen to Resolve Phlegm in the Treatment of Stroke and Its Mechanism

目的:观察健脾化痰法在针刺治疗中风风痰阻络型中的作用,并初步探讨其机理。方法:将中风风痰阻络型患者随机分为观察组和对照组各30例,观察组以健脾化痰合祛风通络法、对照组仅以祛风通络法针刺治疗,各30次后观察疗效及检测血脂情况。结果:治疗后观察组总有效率为86.67%,对照组为73.33%;痰证辨证积分观察组比对照组显著减低;血脂分析,观察组总胆固醇、载脂蛋白B水平比对照组显著减低,高密度脂蛋白比对照组显著升高。结论:健脾化痰法能有效提高针刺治疗中风风痰阻络型的临床疗效,其机理可能与调节脂代谢有关。

Objective: To observe the effect of acupuncture in strengthening the spleen to resolve phlegm and to study its possible mechanism in the treatment of stroke. Methods: 60 stroke(wind-phlegm blocking collateral type)patients were randomly and equally divided into control group and treatment group. Patients in treatment group were treated with principle of strengthening the spleen to resolve phlegm combined with needling methods for dispelling wind and dredging collaterals. Patients in control group were treated with principles of dispelling wind and dredging collaterals only. Main acupoits used were Baihui(GV 20), Shenting (GV 24), Fengchi (GB 20), Fenglong (ST 40), etc. The treatment was conducted once daily except Saturdays and Sundays,30 times altogether. Serum total cholesterol (TCh), triglyceride (TG), high density lipoprotein (HDL-Ch), apolipoprotein (Apo)-A and -B contents were detected according to the instructions of reagent kits. Results: After treatment, the total effective rates of treatment and control groups were 86.67% and 73.33% respectively, and the therapeutic effect of treatment group was significantly higher than that of control group (P<0.05). The score for wind-phlegm syndrome of treatment group was significantly lowered than that of control group (P<0.05). After treatment,serum TCh and Apo-B of treatment group decreased considerably, which was significantly lower than those of control group(P< 0.05); while HDL-Ch and Apo-A levels increased significantly after treatment which were obviously higher than those of control group(P< 0.05). Conclusion: The acupuncture method of strengthening the spleen to resolve phlegm can significantly raise clinical therapeutic effect in the treatment of wind-phlegm obstructing collateral type stroke, which may be related to its functions in regulating blood lipid metabolism.