“足部三针”隔姜灸法治疗中风后下肢麻木临床观察

Clinical Observation of “Foot three stitches” with Ginger Moxibustion Isolation Treating Lower Numbness after Stroke

目的 :观察"足部三针"隔姜灸法治疗中风后下肢麻木的临床疗效,并探讨其作用机制。方法 :按照随机数字法,随机选取90例中风后下肢麻木的患者,以1∶1比例分为常规针刺对照组和"足部三针"隔姜灸治疗组,每组各45例。"足部三针"隔姜灸法选取足部三穴:足三里、血海、阳陵泉。两组患者均常规采用静脉及口服给药,治疗总疗程均为18 d。观察两组患者在治疗前后的感觉功能障碍评定、日常生活活动能力评定(Barthel指数)、治疗前后实验室检查中血同型半胱氨酸(Hcy)、凝血指标(选取PT及APTT指数)及临床疗效的变化。结果 :治疗后治疗组的治愈率为46.67%,总有效率95.56%,明显优于治愈率为15.56%及总有效率为71.11%的对照组,差异显著有统计学意义(P=0.0002<0.05)。治疗后两组患者感觉障碍评分均较前明显改善(P<0.05),且治疗组改善程度优于对照组,差异有统计学意义(P<0.05)。治疗后治疗组的BI指数评分较对照组评分高,提示治疗组日常生活活动能力状况改善更明显,两者相比较差异有统计学意义(P<0.05)。治疗组治疗后PT、APTT较治疗前显著提高,治疗后Hcy较治疗前明显降低,差异具有统计学意义(均P<0.05);对照组治疗后PT较治疗前有所提高(P<0.05),但治疗后APTT及Hcy对比均未见明显变化(P>0.05),且对照组治疗后PT的增高幅度较治疗组治疗后低,差异具有统计学意义(P<0.05)。结论 :"足部三针"隔姜灸法能显著改善中风后下肢麻木的状况,能有效调节机体内环境,促进患肢感觉及运动功能的恢复,值得临床运用及推广。

Objective ：To observe the effect of＂foot three stitches＂with ginger moxibustion isolation to treat lower numbness after stroke,and study the mechanism of its effect. Methods ：According to random number table method,selected 90 cases of patients who were suffering from lower numbness after stroke. Randomly divided those patients into a convention acupuncture control group and foot three stitches ginger moxibustion treatment group,each group has 45 cases of patients. The＂foot three stitches＂with ginger moxibustion group selected three points ：Zusanli,Xuehai,and Yanglingquan. Two groups of patients were given intravenous and oral administration,and the total course of treatment was 18 days. Observed two groups of patients sensory dysfunction rates,daily life activity abilities（Barthel index）,laboratory tests of the serum homocysteine（Hcy index）,blood coagulation indexes（selected PT and APTT index）changes and clinical curative effect before and after treatment. Results ：After treatment,cure rates of treatment group were 46.67%,and the totally effective rates were 95.56%,obviously better than that of the cure rates were 15.56% and the totally effective rates were 71.11% in control group,difference between each other was statistically significant（P=0.00020.05）. After treatment,sensory dysfunction rates of both groups were significantly improved（P0.05）,and the improvement of treatment group was superior to the control group,difference between each other was statistically significant（P0.05）. BI index rating scores of the treatment group was higher than the control group,which showed that the improvement of daily life activity abilities in treatment group was more apparent,difference between each oher was statistically significant（P0.05）. PT and APTT grades were significantly improved than before in treatment group,and Hcy scores were obviously decreased after treatment,the difference was statistically significant（P0.05）;PT scores also improved than before in control group（P0.05）,but APTT and Hcy scores hardly any obvious change after treatment（P0.05）,and the growth of PT scores in control group was lower than those of the treatment group after treatment,the difference was statistically significant（P0.05）. Conclusion ：Effect of＂foot three stitches＂with ginger moxibustion isolation to treat lower numbness after stroke was obviously,which could effective regulated the body＇s internal environment,and promoted limb＇s sensory and motor function recovery,worthy of clinical application and promotion.