中成药、针刺、推拿、康复训练、药物熏洗联合西药治疗急性脑出血随机平行对照研究

Chinese Medicine, Acupuncture, Massage, Rehabilitation, Drug Fumigation Combined with Western Treatment of Acute Cerebral Hemorrhage Randomized Controlled Study

[目的]观察中成药、针刺、推拿、康复训练、药物熏洗联合西药治疗急性脑出血疗效。[方法]使用随机平行对照方法，将80例住院患者按抛硬币法简单随机分为两组。对照圣且40例血糖控制、调整血压、降低颅内压、抗脑水肿、预防并发症，按出血量、出血部位、意识状态结合全身状况、年龄、发病时间选择微创手术治疗。治疗组40例中成药：痰热腑实证，20mL醒脑静＋250mL生理盐水，1次／d，静滴；其他类型予20mL丹参注射液＋250mL生理盐水，1次／d，静滴；针刺：石氏醒脑开窍针刺法，主穴为双侧内关、人中及患侧三阴交，副穴为患侧尺泽、极泉水、委中；眩晕加双侧天柱穴，吞咽障碍加双侧凤池、完骨、翳风穴；先刺双侧内关穴，刺入0．5～1寸，提插捻转泻法，持续1min，后刺人中，鼻中隔方向斜刺入O．3～0．5寸，雀啄手法，以眼球湿润或流泪为宜，后刺三阴交，沿胫骨内侧缘和皮肤保持45。斜刺，刺入0．5～1寸，提插补法进行；30min／次，1次／d；推拿，急性期改良陆氏推拿，以拇指按摩头部，5次；手揉拿上肢，5次；手指于肌腱部做弹指法，1～2次；按揉、活动关节；拇指按摩足背面趾间数次；30min／次，1次／d；药物熏洗，偏瘫活络方（桑枝、牛膝、两面针、红花、伸筋草、透骨草各12g），水煎3000mL，熏洗患处．1剂／次，30rain／次，1次／d；西药治疗同对照组。连续治疗28d为1疗程。观测临床症状、FMA评分、NFD评分、不良反应。连续治疗3疗程，判定疗效。[结果]治疗组痊愈21例，显效14侧，有效3例，无效2例，总有效率95．00％。对照组痊愈17例，显效10例，有效5例，无效8例，总有效率80．00％。治疗组疗效优于对照组（P〈0．05）。评分指标两组均有改善俨〈O．01），治疗组改善优于对照组（P〈0．01）。[结论]中成药、针刺、推拿、康复训练、药物熏洗联合西药治疗急性脑出血疗效满意，无严重不良反应，值得推广。

[Objective] To observe Chinese medicine, acupuncture, massage, rehabilitation, drug fumigation combined with Western medicine treatment of acute cerebral hemorrhage. [Methods] randomized, parallel controlled method, 80 patients were hospitalized method is simple coin toss randomized into two groups. The control group of 40 patients glycemic control, adjust blood pressure, increased intracranial pressure, anticerebral edema, prevention of complications, according to the amount of bleeding, the bleeding site, the state of consciousness combined with systemic conditions, age, time of onset minimally invasive surgery. Western medicine treatment group of 40 patients with the control group. Chinese medicine： phlegm Fushi, 20mL Xingnaojing＋250mL saline, 1 times/d, intravenous infusion; other types of Salvia Injection to 20mL＋250mL saline, 1 times/d, intravenous infusion. Acupuncture： Shih XNKQ acupuncture, the main points of bilateral customs, people and affected Sanyinjiao, Vice points ipsilateral foot Ze, very spring, Venezuela; vertigo and bilateral Tianzhn points, dysphagia and bilateral Fengchi, complete bone, Yifeng; first stab bilateral Neiguan, piercing 0.5 to 1 inch, lift and thrust twisting reducing method, continuous lmin, after stab people, septum obliquely into the 0.3-0.5-inch, bird pecking techniques, or tearing in the eye moist appropriate, after thorn Sanyinjiao, holding 45° obliquely along the medial tibial edge and the skin, piercing 0.5 to 1 inch, mentioned interpolation method; 30mirdtimes, 1 times/d. Massage, the acute phase improvement Lu massage, head massage with the thumb five times; take upper hand rub, 5; finger tendon unit to do fillip law, 1 or 2 times; rubbing, joint activities; thumb toe massage the back foot among several; 30min/times, 1 times/d. Drug Fumigation, hemiplegia active party （Sangzhi,Niujin,Liangmianzhen,Honghua,Shenjincao,Tougucao each 12g）, decoction 3000mL, Washing the affected area, a/times, 30rain/times, 1 times/＆ 28d for a course of continuous treatment. Observation of clinical symptoms, FMA score, NFD score, adverse reactions. Continuous treatment of 3 courses, to determine efficacy. [Results] The cure 21 cases, 14 cases markedly effective in 3 cases, 2 cases, the total efficiency of 95.00%. The control group 17 cases recovered, 10 cases markedly effective in 5 cases, 8 cases, the total efficiency of 80.00%. Treatment group than the control group （P〈0.05）. Rating indicators improved in both groups （P〈0.01）, the treatment group than the control group improved （P〈0.01）. [Conclusion] Chinese medicine, acupuncture, massage, rehabilitation, drug fumigation combined with Western medicine treatment of acute cerebral hemorrhage satisfactory, no side effects, worthy of promotion.