益肾醒脑汤结合头针在脑中风恢复期应用效果及对远期预后的影响

Effect of Yishen Xingnao Decoction Combined with Scalp Acupuncture on Recovery Period of Cerebral Apoplexy and Its Effect on Long-term Prognosis

目的观察益肾醒脑汤结合头针在脑中风恢复期的应用效果研究及对远期预后的影响。方法选择2016年7月—2018年10月医院收治的缺血性脑卒中恢复期患者96例,依据随机对照法将患者分为研究组和对照组,每组48例。对照组患者给予常规西药治疗,研究组在对照组治疗的基础上,采用益肾醒脑汤和头针辅助治疗。两组均连续治疗12周。比较两组治疗疗效,治疗前后血凝指标,治疗前、治疗后4周、治疗后12周NIHSS评分和IADL评分,治疗前后BDNF、ET-1和NO水平变化,比较治疗后伤残程度。结果研究组疗效高于对照组(P<0.05);研究组治疗后4周和治疗后12周的NIHSS评分对于对照组,IADL评分高于对照组(P<0.05);研究组治疗后4周和治疗后12周PT和APTT高于对照组,FIB和D-二聚体水平低于对照组(P<0.05);研究组治疗后BDNF和NO水平高于对照组,ET-1水平低于对照组(P<0.05);研究组治疗后残疾程度较对照组轻(P<0.05)。结论益肾醒脑汤结合头针能有效改善脑卒中恢复期患者凝血指标和内皮功能,发挥神经保护作用,提高患者日常生活能力,降低致残率,提高治疗效果,改善预后,值得临床进一步的研究与运用。

Objective To observe the effect of Yishen Xingnao Decoction combined with scalp acupuncture in the recovery period of stroke and its influence on long-term prognosis.Methods Ninety-six patients with ischemic stroke in convalescent period from July 2016 to October 2018 were selected and divided into study group and control group according to random control method,48 cases in each group.The patients in the control group were treated with conventional Western medicine,while those in the study group were treated with Yishen Xingnao Decoction and scalp acupuncture on the basis of the treatment in the control group.Both groups were treated continuously for 12 weeks.The curative effect and coagulation index before and after treatment,NIHSS score and IADL score before treatment,4 and 12 weeks after treatment,changes of BDNF,ET-1 and NObefore and after treatment were compared,and the degree of disability after treatment was compared.Results The therapeutic effect of the study group was higher than that of the control group(P<0.05).The NIHSS score of the study group was higher than that of the control group(P<0.05).The PT and APTT of the study group were higher than those of the control group at 4 and 12 weeks after treatment,and the levels of FIB and D-dimer were lower than those of the control group(P<0.05).After treatment,the levels of BDNF and NO in the study group were higher than those in the control group,and the levels of ET-1 were lower than those in the control group(P<0.05).The degree of disability in the study group was lighter than that in the control group(P<0.05).Conclusion Yishen Xingnao Decoction combined with scalp acupuncture can effectively improve the coagulation index and endothelial function of convalescent stroke patients,play a neuroprotective role,improve their daily living ability,reduce disability rate,and improve treatment effect andprognosis,which is worthy of further clinical research and application.