知变行针法对痰瘀阻络型中风患者的疗效观察

Efficacy of the Zhibian acupuncture on stroke of the Tanyu Zuluo symptom

目的:研究知变行针法对痰瘀阻络型中风患者的疗效作用。方法:选取惠东县中医院2015年1月-2017年1月收治的痰瘀阻络型中风病患者62例为研究对象,采用随机数字表法将患者分为对照组和观察组,每组各31例。对照组参考脑卒中临床路径进行常规药物治疗。观察组在对照组基础上,加予知变行针法治疗。观察两组患者的症状与体征,采用中医证候评分进行疗效评价。采用改良Barthel评分评价日常生活能力,采用Brunnstrom分级评价运动功能状况。检测两组治疗前后患者血清肿瘤坏死因子(Tumor Necrosis Factor,TNF-α)与C反应蛋白(C Reactive Protein,CRP)的浓度水平。结果:观察组患者总有效率明显高于对照组(90.32%VS61.29%),差异有统计学意义(P<0.05)。观察组患者治疗后Barthel评分[(37.26±8.94)分VS(30.88±12.09)分]与治疗前后Barthel评分改善差值[(17.97±5.31)分VS(12.52±4.77)分]均明显高于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后血清TNF-α[(17.49±5.36)pg·mL^-1VS(35.34±6.81)pg·mL^-1]与CRP[(5.45±2.77)mg·L^-1VS(11.34±5.08)mg·L^-1]的浓度水平均明显低于对照组,差异有统计学意义(P<0.05)。结论:知变行针法能够显著改善患者的日常生活能力与机体运动能力,重视从痰、瘀变化调整用穴,其作用可能与调节血清TNF-α与CRP有关,但具体通路仍待进一步研究。

Objective:To study the effect of the Zhibian acupuncture (知变行针法) on stroke of the Tanyu Zuluo symptom (痰瘀阻络型).Methods:72 patients were divided into the control group and observation group,31 cases in each.The control group underwent conventional medicine.The observation group was treated by the Zhibian acupuncture.Results:The total effective rate in the observation group (90.32%) was significantly higher than 61.29% in the control group (P<0.05).Barthel score in the observation group were significantly higher than those in the control group and before treatment (P<0.05).The serum levels of TNF-α and CRP were significantly lower in the observation group (P<0.05).Conclusion:The Zhibian acupuncture can significantly improve daily living ability and body movement ability,and pay attention to the adjustment of the points from sputum and sputum.The effect may be related to the regulation of serum TNF-α and CRP,but the specific pathway remains to be further studied.