针药结合排毒通腑法治疗脑梗死急性期痰热腑实型便秘

Effects of acupuncture combined with herbal medicine on detoxication and purging fu-organ for treatment of patients with constipation of Phlegm-heat and Bowel-repletion in acute cerebral infraction

目的探讨针药结合排毒通腑法对脑梗死急性期痰热腑实型便秘患者神经功能和日常生活能力的影响。方法将患者随机分为2组,治疗组采用针药结合排毒通腑法,对照组采用开塞露,2组患者均给予神经内科常规处理及石氏醒脑开窍针刺法。比较治疗后7 d和21 d的便秘疗效、神经功能评分和Barthel指数评分。结果治疗后7 d及21 d治疗组便秘总有效率明显优于对照组(P<0.01)。治疗组治疗后7 d2、1 d的神经功能评分下降值均明显高于对照组(P均<0.01);治疗组治疗后21 d神经功能评分明显低于对照组(P<0.01),日常生活活动能力明显高于对照组(P<0.01)。结论针药结合排毒通腑法对脑梗死急性期痰热腑实型便秘疗效显著,能够提高患者的神经功能和日常生活能力。

Objective It is to approach the influence of neurological function and ability of daily life （ADL） of acupuncture combined with herbal medicine on detoxication and purging fu-organ for treatment of patients with constipation of Phlegm- heat and Bowel-repletion in acute cerebral infarction. Methods The enrolled cases were randomly assigned to an observation group of 35 cases and a control group of 35 cases, the observation group was treated by acupuncture combined with herbal medicine on detoxication and purging fu-organ and the control group was treated by Dilute Glycerol. The both groups were all treated with routine treatment in neurological department and Brain-activating and Resuscitative Acupuncture Method. Then the indexes of patients in both groups including clinical effect of constipation, scores of neurological impairment, Barthel index in activity of daily living were observed before treatment and after treatment for 7 days and 21 days. Results There were significant differences in the effective rate of constipation after treatment for 7 days and 21 days between the two groups （P 〈 0.05 or 0.01 ）. The descending scores of neurological impairment of the observation group were higher than that of the control group （P〈 0.01 ） after treatment for 7 days and 21 days, and the scores of neurological impairment of the observation group were lower than that of the control group （P〈 0.01） after treatment for 21 days. The Barthel index in ADL of the observation group were higher than that of the control group （P 〈 0.01 ） after treatment for 21 days. Conclusion The method of acupuncture combined with herbal medicine on detoxication, and purging fu-organ has a definite therapeutic effect on treating constipation of phlegm-heat and bowel-repletion in acute cerebral infarction. It can also improve neurological function and ADL of these patients.