针灸联合补阳还五汤加减治疗脑卒中后痉挛性瘫痪的临床疗效

Clinical effects of acupuncture combined with Buyang Huanwu Decoction in patients with spastic paralysis after cerebral stroke

目的探究针灸联合补阳还五汤加减治疗脑卒中后痉挛性瘫痪的临床疗效。方法选取2017年3月-2018年12月大连市某医院神经内科收治的100例脑卒中后痉挛性瘫痪患者作为研究对象,采用随机数字表法将患者分为对照组和观察组,每组50例。对照组患者予以补阳还五汤加减治疗,观察组患者在对照组治疗基础上联合针灸治疗,2组患者均治疗2周。比较2组患者的治疗效果及治疗前后肌痉挛量表(MAS)评分,Barthel指数量表(MBI)评分,外周血中基质金属蛋白酶-9(MMP-9)及血管内皮生长因子(VEGF)水平。结果治疗后,观察组患者治疗总有效率为90.00%,明显高于对照组(64.00%),差异有统计学意义(P<0.05)。治疗前,2组患者上肢MAS评分、下肢MAS评分、MBI评分比较,差异均无统计学意义(P>0.05)。治疗后,2组患者上、下肢MAS评分均低于治疗前,且观察组明显低于对照组。差异有统计学意义(P<0.05);2组患者MBI评分高于治疗前,且观察组明显高于对照组,差异有统计学意义(P<0.05)。治疗前,2组患者血清MMP-9及VEGF水平比较,差异均无统计学意义(P>0.05)。治疗后,2组患者血清MMP-9及VEGF水平低于治疗前,且观察组明显低于对照组,差异均有统计学意义(P<0.05)。结论采用针灸联合补阳还五汤加减治疗脑卒中后痉挛性瘫痪疗效显著,优势明显,值得临床推广应用。

Objective To explore the clinical effects of acupuncture combined with Buyang Huanwu Decoction on the treatment of spastic paralysis after cerebral stroke.Methods A total of 100 patients with spastic paralysis after cerebral stroke who were treated in the department of neurology in a hospital in Dalian from March 2017 to December 2018 were selected as the research subjects.The patients were divided into a control group and an observation group by random number table,with 50 cases in each group.Patients in the control group were treated with Buyang Huanwu Decoction,and patients in the observation group were treated with acupuncture on the basis of the control group.At week 2 of treatment,the efficacy of treatment as well as at baseline and 2 weeks after intervention the scores in muscle spasm scale(MAS)and modified Barthel Index(MBI),and the levels of matrix metalloproteinase-9(MMP-9)and vascular endothelial growth factor(VEGF)in peripheral blood in the two groups were compared.Results After treatment,the total effective rate of treatment in the observation group was 90.00%,which was significantly higher than that in the control group(64.00%)(P<0.05).Before treatment,there was no significant difference in the upper limb MAS,lower limb MAS in the two groups were lower than those before treatment,and MBI scores between the two groups(P>0.05).After treatment,the upper limb MAS,lower limb MAS,and those in the observation group were significantly lower than those in the control group(P<0.05);MBI scores in the two groups were higher than those before treatment,and those in the observation group were significantly higher than those in the control group(P<0.05).Before treatment,there was no significant difference in serum MMP-9 and VEGF levels between the two groups(P>0.05).After treatment,the levels of serum MMP-9 and VEGF in the two groups were lower than those before treatment,and those in the observation group was significantly lower than those in the control group(P<0.05).Conclusion Combining acupuncture with Buyang Huanwu Decoction can significantly enhance the clinical effect,and is worthy of wider application.