早期针刺疗法联合化痰通络汤治疗急性缺血性中风临床疗效观察

Clinical Efficacy and Prognosis of Applying Early Acupuncture Therapy Combined with Huatan Tongluo Decoction in Treatment of Acute Ischemic Stroke

目的:探讨急性缺血性中风患者经早期针刺疗法联合化痰通络汤治疗的效果,观察患者预后,指导未来急性缺血性中风的中医治疗。方法:选取2016年5月~2019年5月期间医院70例急性缺血性中风患者,对患者编号,采用数字奇偶法将其分为观察组(奇数)与对照组(偶数),各35例。全部患者均接受常规治疗与化痰通络汤治疗,在此基础上为观察组患者联合早期针刺疗法,1周为1个疗程,治疗2个疗程。分别于治疗前、治疗2个疗程后,检测两组C-反应蛋白(CRP)及凝血功能[凝血酶时间(TT)、纤维蛋白原(FIB)、活化部分促凝血酶原激酶时间(APTT)、凝血酶原时间(PT)]变化情况并比较;各时点,使用神经功能缺损评分量表(NDS)评估两组神经功能缺损情况;治疗2个疗程后,记录两组功能独立障碍发生情况。结果:治疗2个疗程后,两组CRP、APTT及FIB均小于治疗前,PT及TT大于治疗前,且观察组CRP、APTT及FIB均小于对照组,PT及TT大于对照组(P<0.05);两组NDS量表各维度评分均低于治疗前,且观察组低于对照组(P<0.05);观察组功能独立障碍率为48.57%,低于对照组的74.29%(P<0.05)。结论:急性缺血性中风患者经早期针刺疗法联合化痰通络汤治疗效果确切,有助于减轻患者神经功能损伤程度及全身炎症反应程度,改善凝血功能,患者功能独立障碍发生率降低,预后好,临床应用价值高。

Objective:To investigate the effect of applying early acupuncture therapy combined with Huatan Tongluo Decoction in the treatment of acute ischemic stroke,to observe the prognosis of patients,and to guide the Chinese medicine treatment of acute ischemic stroke.Methods:70patients with acute ischemic stroke in the hospital from May 2016to May 2019were selected and numbered,and they were divided into observation group(odd numbers)and controlled group(even numbers)according to parity number method,with 35cases in each group.All patients were treated with routine treatment and Huatan Tongluo Decoction,and on this basis,the observation group was treated with early acupuncture therapy,with 1week as 1course of treatment,and the treatment lasted for 2courses.The changes of C-reactive protein(CRP)and coagulation function[thrombin time(TT),fibrinogen(FIB),activated partial thromboplastin time(APTT),prothrombin time(PT)]in the two groups were detected and compared before treatment and after 2 courses of treatment.The neurological deficit scale(NDS)was used to evaluate the neurological deficit of the two groups at each time.After 2 courses of treatment,the incidence of functional independence disorder in two groups was recorded.Results:After 2 courses of treatment,the CRP,APTT and FIB in the two groups were lower than those before treatment,the PT and TT were higher than those before treatment,the CRP,APTT and FIB in the observation group were lower than those in the controlled group,and the PT and TT in the observation group were higher than those in the controlled group(P<0.05).The scores of all dimensions of the NDS scale were lower than those before treatment,and the observation group was lower than the controlled group(P<0.05).The rate of functional independence disorder in the observation group was 48.57%,which was lower than 74.29%in the controlled group(P<0.05).Conclusion:Applying early acupuncture therapy combined with Huatan Tongluo Decoction in the treatment of patients with acute ischemic stroke is effective,it can alleviate the severity of neurological deficit and systemic inflammatory response,improve coagulation function,decrease the incidence of functional independence disorder and achieve good prognosis,which has high clinical application value.