经筋针刺联合化痰通络解痉方治疗脑卒中后痉挛性偏瘫的临床研究

Clinical Research of Meridian Acupuncture Combined with Huatan Tongluo Antispastic Prescription in the Treatment of Spastic Hemiplegia after Stroke

目的探讨经筋针刺联合化痰通络解痉方对脑卒中后痉挛性偏瘫的治疗效果。方法选择2015年12月—2017年6月收治的80例脑卒中后痉挛性偏瘫病人,采用随机数字表法分为两组,对照组进行常规药物及康复锻炼,观察组在对照组基础上给予口服化痰通络解痉方及经筋针刺治疗,连续治疗1个月。比较两组治疗前后Fugl-Meyer运功功能(FMA)评分、Berg平衡量表(BBS)评分、Barthel生活能力指数(MBI)、血清血栓素A2(TXA2)、前列环素I2(PGI2)水平以及中医证候积分,并评价临床疗效。结果两组治疗后FMA、MBI、BBS评分均升高,且观察组高于对照组,差异均有统计学意义(P<0.05);两组治疗后血清TXA2水平降低,PGI2水平升高,且观察组优于对照组,差异有统计学意义(P<0.05);两组治疗后半身不遂、舌僵语蹇、口舌歪斜、偏身异常、患肢僵硬等中医证候积分均降低,且观察组低于对照组,差异均有统计学意义(P<0.05);观察组治疗总有效率为87.50%,高于对照组的65.00%,差异有统计学意义(P<0.05)。两组均未发生严重不良反应。结论经筋针刺联合化痰通络解痉方治疗能改善脑卒中后痉挛性偏瘫病人活动能力及运动功能,改善血液微循环,安全有效。

Objective To investigate the effect of meridian acupuncture combined with Huatan Tongluo Antispastic prescription in the treatment of spastic hemiplegia after stroke.Methods Eighty patients with spastic hemiplegia after stroke from December 2015 to June 2017 were enrolled and randomly divided into two groups by the digital table.The patients in control group received routine medication and rehabilitation exercises.The patients in observation group were treated with meridian acupuncture combined with Huatan Tongluo Antispastic prescription on the basis of control group for 1 month.The Fugl-Meyer function(FMA)score,Berg Balance Scale(BBS),Barthel viability index(MBI),serum thromboxane A2(TXA2),prostacyclin I2(PGI2)levels and TCM syndromes scores were compared before and after treatment.The overall efficacy was evaluated.Results After treatment,the FMA score,MBI,and BBS score were significantly increased,and the data in observation group was higher than those in control group(P<0.05);the serum TXA2 level was significantly decreased,PGI2 level was significantly increased in two groups,and the data in observation group were superior to those in control group(P<0.05);the TCM scores such as hemiplegia,tongue stiffness,tongue and tongue deviation,abnormal body,and limb stiffness were significantly decreased,and the scores in observation group were lower than those in control group(P<0.05).The total effective rate of observation group was 87.50%,which was significantly higher than that of control group(65.00%),the difference was statistically significant(P<0.05).There was no serious adverse reactions in either group.Conclusion Meridian acupuncture combined with Huatan Tongluo Antispastic prescription can significantly improve the mobility and motor function,improve blood microcirculation of spastic hemiplegia patients after stroke,which is safe and effective.