针药结合治疗急性脑梗死痰热腑实型便秘临床研究

Clinical Effects of Acupuncture Combined with Herbal Medicine in Treating Constipation of Phlegm-Heat and Bowel-repletion in Patients with Acute Cerebral Infarction

目的观察针药结合治疗急性脑梗死痰热腑实型便秘的临床效果。方法将我院收治的急性脑梗死痰热腑实型便秘160例随机分为针药组、中药组、针刺组、西药组,每组40例。针药组予针刺少商、商阳(双)、丰隆(双)、天枢(双)、支沟(双侧)、归来(左)、水道(左)、中脘穴方,及中药双花、连翘、黄芩、栀子、胆南星、全瓜萎、当归、生大黄、白术、云苓组方;中药组采用同针药组的中药组方;针刺组采取同针药组的针刺穴方;西药组使用开塞露治疗。比较治疗7 d及21 d的效果及神经功能评分。结果治疗7 d和21 d时,针药组总有效率显著高于其他3组,差异具有统计学意义(P<0.01)。4组神经功能评分与治疗初始比较差异均有统计学意义(P<0.05)。治疗后针药组神经功能评分低于其他3组,差异亦均有统计学意义(P<0.01,P<0.05)。结论针药结合治疗急性脑梗死痰热腑实型便秘可达到作用互补、增强效果的目的,是提高中医药临床疗效的可行途径,值得推广应用。

Objective To observe the clinical effect of acupuncture combined with herbal medicine in treating constipation of Phlegm-heat and Bowel-repletion in patients with acute cerebral infarction.Methods 160 patients were randomly divided into four groups： acupuncture combined with herbal medicine group,herbal medicine group,acupuncture group,and western medicine group（40 in each）.The herbal medicine group was treated with Honeysuckle bud and flower,Weeping forsythia capsule,Scutellaria baicalensis,Cape jasmine fruit,Arisaema Cum Bile,Fructus Trichosanthis,Chinese angelica,Rhubarb root and rhizome,Largehead atractylodes rhizome and Poria cocos;the acupuncture group was treated with Shaoshang（two-sided）,Shangyang bloodletting（two-sided）,Fenglong（two-sided）,Tianshu（two-sided）,Zhigou（two-sided）,Guilai（left）,Shuidao（left）and Zhongwan.The acupuncture combined with herbal medicine group was treated with the combination of treatments applied in both groups.The western medicine group was treated with diluted glycerol.All four groups were observed and compared before treatment and 7 and 21 days after treatment in terms of clinical improvement of constipation and scores of neurological impairment.Results 7 and 21 days after treatment,the acupuncture combined with herbal medicine group was found to have the best clinical outcome among all the four groups（P0.01）.There were significant differences on the scores of neurological impairment for all four groups before and after treatment（P0.05）,with the scores of neurological impairment of the acupuncture combined with herbal medicine group lower than that of the other three groups after treatment（P0.01,P0.05）.Conclusion Combination of acupuncture and herbal medicine has been proven to be an effective therapeutic method in treating constipation of phlegm-heat and bowel-repletion in patients with acute cerebral infarction.It can also improve clinical effectiveness of treatment for acute cerebral infraction,which indicates that acupuncture plays a supporting but important role in Chinese herbal medicine.