中医针灸结合穴位敷贴治疗急性缺血性脑中风的随机、对照研究

Clinical Effects on Treatment of Acute Ischemic Stroke by Acupuncture Combined with Acupoint Application

目的：研究中医针灸结合穴位敷贴治疗急性缺血性脑中风的临床疗效。方法：选取于2013年6月—2016年5月本院收治的100例急性缺血性脑中风患者作为本次研究对象。按入组顺序经数字随机表法分为观察组和对照组。对照组患者在入组后采取阿司匹林、注射血栓通等常规治疗;观察组则采用中医针灸结合穴位敷贴进行治疗。比较两组患者治疗后的临床疗效,并对两组患者治疗前后Barthel指数、NIHSS评分及中医症状总积分进行评分比较。检测患者治疗前后血清指标包括超敏C反应蛋白（hs-CRP）、血清超氧化物歧化酶（SOD）和丙二醛（MDA）在治疗前后水平变化。结果：两组经治疗后针对疗效评价,观察组总有效率94.00%明显大于对照组总有效率78.00%,观察组临床疗效明显优于对照组（P〈0.05）;两组患者血清中丙二醛（MDA）、血清超敏C反应蛋白（hs-CRP）明显下降,而SOD水平则相对升高。观察组血清指标包括氧化应激和炎症因子水平改善情况明显优于对照组（P〈0.05）;患者经治疗后的Barthel指数评分均呈上升趋势,而NIHSS评分及中医症状总积分则显著降低;观察组治疗后Barthel指数评分明显高于对照组,而NIHSS评分和中医症状总积分明显低于对照组（P〈0.05）。结论：中医针灸结合穴位敷贴治疗急性缺血性脑中风疗效确切,能有效改善患者临床症状及神经功能缺损。

Objective： To study the clinical effects on treatment of acute ischemic stroke by acupuncture combined with acupoint application. Methods： From June 2013 to May 2016 in our hospital,100 cases of acute ischemic stroke patients were as the research object and were randomly divided into the observation group and the control group according to the group order. Patients in the control group were treated with conventional therapy,thrombolytic therapy with aspirin and injection of Xueshuantong treatment,while the observation group was treated with traditional Chinese medicine combined with acupoint application. The clinical efficacies of the two groups were compared,and the scores of Barthel index,NIHSS score and TCM symptom score before and after treatment were compared between the two groups. Before and after treatment,serum levels of serum high-sensitivity C reactive protein（ hs-CRP）,serum superoxide dismutase（ SOD） and malondialdehyde（ MDA） were detected before and after treatment.Results： After treatment,the two groups＇ total effective rate of the observation group was significantly higher than that of the control group. The total effective rate was 78%,significantly better than that of the control group（ P〈0. 05）. Two groups＇ serum malondialdehyde（ MDA）,serum high-sensitivity C reactive protein（ hs-CRP） decreased significantly,while the SOD level was relatively high. The improvement of serum indexes including oxidative stress and inflammatory factors in observation group was significantly better than that in control group（ P〈0. 05）. After treatment,the Barthel index score showed an upward trend,while the NIHSS score and the total score of TCM symptoms were significantly reduced. The Barthel index score of the observation group was significantly higher than that of the control group,while the NIHSS score and the total score of TCM symptoms were significantly lower than those of the control group（ P〈0. 05）. Conclusion： The curative effect in the treatment of acute ischemic stroke is safe and effective in treating acute ischemic stroke with acupuncture combined with acupoint application and can effectively improve the clinical symptoms and nerve function defect of patients.