活血化瘀方联合针灸治疗对脑梗后遗症患者脑血管血液流变动力学及神经功能的影响

Effects of Blood-Invigorating and Stasis-Dissolving Prescriptions Combined with Acupuncture on Cerebrovascular Hemorheology Indexes and Neurological Function in Patients with Sequela of Cerebral Infarction

目的:探讨血化瘀方联合针灸治疗对脑梗后遗症患者脑血管血液流变动力学及神经功能的影响。方法:选取2016年1月至2017年1月沈阳市第二中医医院收治脑梗后遗症患者120例作为研究对象,对照组61例患者接受针灸治疗;观察组59例患者接受活血化瘀方联合针灸治疗。2组连续治疗30 d。比较2组患者脑血流流变学指标、神经功能评分、中医证候积分、临床疗效。结果:治疗前2组患者脑部平均血流速度、左侧椎动脉血流量、右侧椎动脉血流量、基底动脉血流量比较,差异无统计学意义(P> 0. 05)。治疗后观察组患者脑部平均血流速度、左侧椎动脉血流量、右侧椎动脉血流量、基底动脉血流量大于对照组(P <0. 05)。治疗前2组患者NIHSS评分、MMSE评分比较,差异无统计学意义(P> 0. 05)。治疗后观察组患者NIHSS评分显著低于对照组,MMSE评分高于对照组(P <0. 05)。治疗前2组患者头晕目眩、语言謇涩、半身不遂、患侧麻木、舌苔白腻证候评分比较,差异无统计学意义(P> 0. 05)。治疗后研究患者头晕目眩、语言謇涩、半身不遂、患侧麻木、舌苔白腻证候评分显著低于对照组(P <0. 05)。2组患者临床疗效比较,差异有统计学意义(Z=-5. 626,P=0. 000)。结论:活血化瘀方联合针灸能改善脑梗后遗症患者脑血管血液流变动力学指标,保护神经功能。

Objective: To investigate the effects of blood-invigorating and stasis-dissolving prescriptions combined with acupuncture on cerebrovascular hemorheology indexes and neurological function in patients with sequela of cerebral infarction. Methods: In this study,120 patients with sequelae of cerebral infarction admitted to Shenyang Second Hospital of Traditional Chinese Medicine from January 2016 to January 2017 were retrospectively analyzed.The control group including 61 patients received acupuncture treatment,while 59 patients in the study group received blood-invigorating and stasis-dissolving prescriptions combined with acupuncture,both treated for 30 d.The cerebral hemorheological indexes,neurological function scores,TCM symptom scores and clinical effects were compared between the two groups. Results: The average cerebral blood flow velocity,left vertebral artery blood flow,right vertebral artery blood flow and basilar artery blood flow between the two groups showed no significant difference before treatment( P >0.05),and the numbers of the study group were higher than those of the control group after treatment( P <0.05);the NIHSS score and the MMSE score of the patients of the two groups showed no significant difference before the treatment( P >0.05),and patients in the study group had lower NIHSS scores and higher MMSE scores compared with those in the control group( P <0.05);the TCM syndrome scores of dizziness,speech sluggishness,hemiplegia,ipsilateral numbness and white greasy coating of tongues between the two groups showed no difference before treatment( P >0.05),and the scores of the study group were lower than those of the control group after treatment( P <0.05);the clinical efficacy of the two groups presented significance( Z =-5.626 , P =0.000). Conclusion: The blood-invigorating and stasis-dissolving prescriptions combined with acupuncture is an effective way to ameliorate the cerebrovascular hemorheology and protect the neurological function in patients with sequela of cerebral infarction,which is worthy of application.