针药并用治疗缺血性中风恢复期丘脑痛的临床观察

Clinical Observation on Treatment of Thalamic Pain in Convalescent Stage of Ischemic Stroke with Acupuncture and Medicine

目的探究卡马西平联合通心络配以针灸治疗缺血性中风恢复期丘脑痛患者的疗效以及对疼痛等临床症状的改善。方法选取2018年1月—2020年3月期间于定州市中医医院脑病科就诊的缺血性中风恢复期丘脑痛患者96例。采用随机数表法将患者分为对照组和治疗组,各48例。对照组口服卡马西平片,治疗组在对照组基础上加用通心络胶囊,并辅以针灸治疗。记录所有患者治疗前后视觉模拟评分(visual analogue scale,VAS)、疼痛数字评分(numerical rating scale,NRS)、汉密顿抑郁量表(Hamilton depression scale,HAMD)、汉密顿焦虑量表(Hamilton anxiety scale,HAMA)评分和治疗期间不良反应发生情况。结果治疗后治疗组总有效率93.75%(45/48)高于对照组66.67%(32/48),差异有统计学意义(P<0.05)。两组患者治疗7、14、28 d后VAS、NRS评分均较治疗前降低,差异有统计学意义(P<0.05),且治疗组VAS、NRS评分均低于对照组同期,两组比较,差异有统计学意义(P<0.05)。两组患者治疗7、14、28 d后HAMD、HAMA评分均较治疗前降低,差异有统计学意义(P<0.05),且治疗组治疗后HAMD、HAMA评分均低于对照组同期,两组比较,差异有统计学意义(P<0.05)。治疗期间,两组患者肝肾功能以及血常规均正常,治疗组与对照组总不良反应发生率比较,差异无统计学意义(P>0.05)。结论卡马西平联合通心络配以针灸治疗缺血性中风恢复期丘脑痛疗效较好,对减轻患者疼痛、改善患者抑郁、焦虑症状有明显作用,同时未明显增加药物副作用,安全性较好。

Objective To explore the efficacy of carbamazepine combined with Tongxinluo combined with acupuncture in the treatment of thalamic pain in the recovery stage of ischemic stroke and the improvement of clinical symptoms.Methods From January 2018 to March 2020,96 patients with thalamic pain in the convalescent phase of ischemic stroke were selected in the Department of Brain Disease,Dingzhou Traditional Chinese Medicine Hospital.The patients were divided into a control group and a treatment group with a random number table method,each with 48 cases.The control group took carbamazepine tablets orally.In the treatment group,Tongxinluo Capsule was added to the control group,supplemented by acupuncture and moxibustion.The visual analogue scale(VAS),numerical rating scale(NRS),Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA)scores,and the occurrence of adverse reactions during treatment were recorded in all patients before and after treatment.Results After treatment,the total effective rate of the treatment group was 93.75%(45/48)higher than that of the control group 66.67%(32/48),the difference was statistically significant(P<0.05).The VAS and NRS scores of the two groups of patients after 7,14,and 28 days of treatment were lower than those before treatment(P<0.05),and the VAS and NRS scores of the treatment group were lower than those of the control group during the same period.The difference between the two groups was statistically significant(P<0.05).The HAMD and HAMA scores of the two groups of patients after 7,14,and 28 days of treatment were lower than before treatment(P<0.05),and the HAMD and HAMA scores of the treatment group after treatment were lower than those of the control group during the same period.The difference between the two groups was statistically significant.(P<0.05).During the treatment period,the liver and kidney function and blood routine of the two groups of patients were normal.There was no significant difference in the incidence of total adverse reactions between the treatment group and the control group(P>0.05).Conclusion The combination of carbamazepine and Tongxinluo combined with acupuncture has a good effecton the treatment of thalamic pain in the recovery period of ischemic stroke.It has a significant effect on alleviating the patient′s pain and improving the symptoms of depression and anxiety.At the same time,there is no significant increase in side effects.The safety is better.