针刺与补阳还五汤联合西药治疗脑梗死随机平行对照研究

Acupuncture,Buyanghuanwu Decoction combined with Western Treatment of Cerebral Infarction Randomized Controlled Study

[目的]观察针刺与补阳还五汤联合西药治疗脑梗死疗效。[方法]使用随机平行对照方法,将77例门诊患者按就诊顺序号法简单随机分为两组。对照组38例调整血压、预防并发症、防止血栓进展,减少梗塞范围,控制合并症;梗塞面积静脉滴注250m L 20%甘露醇,2-4次/d,静滴。治疗组39例针刺,阳明经为主,太阳少阳经穴为辅,或阳明经为主,辅以阴经穴;上肢取肩井、极泉、外关、曲池、合谷;下肢取环跳、丰隆、足三里、解溪、昆仑及太冲,三棱针点刺法,30min/次,1次/d;补阳还五汤（生黄芪35g,当归尾、川芎、桃仁、红药、地龙各3g,赤芍5g）,1剂/d,水煎200m L,早晚口服;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、神经功能缺损评分、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组显效21例,有效12例,无效6例,总有效率84.62%。对照组显效11例,有效11例,无效16例,总有效率57.89%。治疗组疗效优于对照组（P〈0.01）。神经功能缺损评分两组均有改善（P〈0.01）,治疗组改善优于对照组（P〈0.01）。[结论]针刺与补阳还五汤联合西药治疗脑梗死疗效满意,无严重不良反应,值得推广。

[Objective]Acupuncture,Buyanghuanwu soup cerebral infarction combined with western medicine.[Methods]Randomized parallel controlled method,77 cases of outpatient treatment order number method is simple and randomly divided into two groups.The control group of 38 patients adjust blood pressure,prevent complications,prevent blood clots progress,reduce infarct size,control complications.Infarct size large to 250 m L 20% mannitol infusion,2-4 times/d,intravenous infusion.Acupuncture treatment group 39 cases,Meridianbased,supplemented by the sun Shaoyang Meridian or Meridian,supplemented Yin Meridian;upper take the shoulder well,very spring,foreign relations,Qu pool,gu;lower limb take the ring jump,Hong Leong,Zusanli,Xie River,Kunlun and Taichong,Needle prick method,30min/time,1 time/d;Buyanghuanwu soup（Shenghuangqi 35 g,Dangguiwei,Chuangxiong,Taoren,Hongyao,Dilong 3g,Chishao 5g）,1/d,decoction 200 m L,sooner or later orally;Western medicine with the control group.7d for a course of continuous treatment.Observation of clinical symptoms,neurological function,adverse reactions.Continuous two courses of treatment,to determine efficacy.[Results]The treatment group 21 cases,12 cases,6 cases,the total efficiency of 84.62%.In the control group,11 cases markedly effective in 11 cases,16 cases,the total efficiency of 57.89%.Treatment group than the control group（P〈0.01）.Neurological function improved in both groups（P〈0.01）,the treatment group than the control group improved（P〈0.01）.[Conclusion]Acupuncture,Buyanghuanwu decoction combined with western treatment of cerebral infarction results were satisfactory,no side effects,worthy of promotion.