益气通络方对丘脑型感觉障碍患者临床疗效及脑血流变化影响研究

Clinical Effect of Yiqi Tongluo Prescription for Patients with Thalamic Sensory Disorder and Influence Study on Its Cerebral Blood Flow

目的:观察益气通络方对丘脑型感觉障碍患者临床疗效及脑血流变化影响。方法:将我院2017年5月-2019年8月收治的丘脑缺血性卒中后感觉障碍患者74例,随机分为2组,各37例,对照组采用感觉训练联合经颅直流电刺激治疗;观察组在此基础上采用益气通络方治疗,2w为1疗程,持续治疗2个疗程。比较两组患者的临床疗效,治疗前后分别记录Fugl-Meyer感觉评价量表、Barthel指数、神经功能缺损量表(National Institute of Health stroke scale,NIHSS)及大脑后动脉(Posterior cerebral artery,PCA)的平均血流速度(Mean velocity,MEAN)、血管阻力指数(Resistance index,RI)及血管搏动指数(Pulsatility index,PI),记录不良反应状况。结果:与治疗前比,两组患者治疗后Fugl-Meyer量表、Barthel指数升高,NIHSS量表降低;与对照组比,观察组患者治疗后Fugl-Meyer量表、Barthel指数较高,NIHSS量表较低,差异有统计学意义(P<0.05)。与治疗前比,两组患者治疗后大脑中动脉Mean升高,PI、RI降低;与对照组比,观察组患者治疗后大脑中动脉Mean较高,PI、RI较低,差异有统计学意义(P<0.05)。对照组有效率78.38%低于观察组有效率94.59%,差异有统计学意义(P<0.05)。两组患者不良率比较,差异无统计学意义(P>0.05)。结论:益气通络方对丘脑型感觉障碍的临床疗效确切,有助于改善感觉功能和脑血流动力学,提高生活能力,且患者可以耐受,是一种安全有效的治疗方案。

Objective:To investigate the clinical effect and cerebral blood flow of Yiqi Tongluo Method on thalamic sensory disorder.Methods:74 patients form May 2017 to August 2019 in our hospital with sensory disorders after thalamic ischemic stroke were randomly divided into two groups,37 cases each.The controlled group was treated with sensory training combined with transcranial direct current stimulation,the observation group received Yiqi Tongluo Method,2 weeks as 1 course,and 2 groups were continued treated for 2courses.The clinical efficacy of the two groups was compared.Fugl-Meyer Sensory Assessment Scale,Barthel Index,National Institute of Health Stroke Scale(NIHSS),Mean Velocity(MEAN)and Vascular Resistance of Posterior Cerebral Artery(PCA)were recorded before and after treatment.Resistance index(RI)and Pulsatility index(PI)were used to record adverse reactions.Results:Compared with before treatment,the Fugl-Meyer scale and Barthel index increased and the NIHSS scale decreased in the two groups after treatment.Compared with the controlled group,the Fugl-Meyer scale and Barthel index in the observation group were higher and the NIHSS scale was lower after treatment(P<0.05).Compared with before treatment,mean of middle cerebral artery increased and PI and RI decreased in the two groups after treatment.Compared with the controlled group,mean of middle cerebral artery was higher and PI and RI were lower in the observation group after treatment,with statistical significance(P<0.05).The effective rate of the controlled group was 78.38%,which was lower than that of the observation group 94.59%,(P<0.05).There was no significant difference in adverse rate between the two groups(P>0.05).Conclusion:Yiqi Tongluo Method is a safe and effective treatment for thalamic sensory disorder,which is helpful to improve sensory function,cerebral hemodynamics and life ability,and can be tolerated by patients.