运动针刺法联合醒脑治瘫方治疗脑梗死急性期(风痰阻络证)的临床观察

Clinical Observation on Exercise Acupuncture and Xingnao Zhitan Prescription(醒脑治瘫方)in the Treatment of Acute Cerebral Infarction(Syndrome of Wind-Phlegm Obstructing Collaterals)

目的:观察运动针刺法联合醒脑治瘫方治疗脑梗死急性期(风痰阻络证)患者的疗效。方法:选取2017年7月至2020年7月芜湖市中医医院收治的60例急性脑梗死(风痰阻络证)患者为观察对象,随机分为治疗组和对照组各30例,对照组予西医常规治疗配合醒脑治瘫方,治疗组在对照组基础上配合运动针刺疗法治疗,连续治疗14 d,在治疗前后比较两组患者NIHSS评分、洼田饮水试验、mRS评分、BI评分,检测外周血红细胞分布宽度、红细胞分布宽度与血小板计数的比值、纤维蛋白原、D-二聚体、超敏C反应蛋白、同型半胱氨酸的结果及分析临床疗效。结果:治疗组总有效率为96.67%(29/30),高于对照组的73.33%(22/30),差异有统计学意义(P<0.05);治疗后两组患者NIHSS评分、洼田饮水试验分级、mRS评分均降低,其中治疗组降低程度明显大于对照组;治疗后两组BI评分均较治疗前升高,其中治疗组升高程度大于对照组;两组患者治疗后红细胞分布宽度、红细胞分布宽度与血小板计数的比值、纤维蛋白原、D-二聚体、超敏C反应蛋白、同型半胱氨酸均降低,其中治疗组降低程度明显高于对照组,差异均有统计学意义(P<0.05)。结论:运动针刺法联合醒脑治瘫方治疗脑梗死急性期患者(风痰阻络证)可更有效改善其临床症状及神经功能缺损评分,降低脑血管危险因素相关实验室指标。

Objective:To observe the curative effect of exercise acupuncture combined with Xingnao Zhitan Prescription in the treatment of patients with acute cerebral infarction(syndrome of wind-phlegm obstructing collaterals).Methods:From July 2017 to July 2020,60 patients with acute cerebral infarction(syndrome of wind-phlegm obstructing collaterals)were randomly divided into treatment group and control group,30 cases in each group.The control group was given Western medicine conventional treatment combined with Xingnao Zhitan Prescription,and the treatment group was treated with exercise acupuncture on the basis of the control group for14 consecutive days.Before and after treatment,NIHSS score,Watian drinking water score,mRS score and BI score were compared between the two groups.The distribution width of peripheral blood red blood cells,the ratio of red blood cell distribution width to platelet count,fibrinogen,D-dimer,high-sensitivity C-reactive protein and homocysteine were detected,and the clinical efficacy was analyzed.Results:The total effective rate in the treatment group was 96.67%(29/30),which was higher than 73.33%(22/30)in the control group(P<0.05).After treatment,the NIHSS scores,Watian drinking water test grades,and mRS scores of the two groups of patients were reduced,and the reduction in the treatment group was significantly greater than that of the control group.After treatment,the BI scores of the two groups were higher than those before treatment,and the increase in the treatment group was greater than that of the control group.After treatment,the red blood cell distribution width,the ratio of red blood cell distribution width to platelet count,fibrinogen,D-dimer,high-sensitivity C-reactive protein and homocysteine of the two groups were decreased,and the reduction degree of the treatment group was significantly higher than that of the control group(P<0.05).Conclusion:Exercise acupuncture combined with Xingnao Zhitan Prescription in the treatment of patients with acute cerebral infarction(syndrome of windphlegm obstructing collaterals)can more effectively improve the clinical symptoms and neurological deficit score,and reduce the laboratory indexes related to cerebrovascular risk factors.