“活血散风针刺法”治疗缺血性脑卒中伴原发性高血压对患者血压负荷、神经功能及脂代谢的影响

Eff ect of the needling therapy for promoting blood circulation and dispelling wind on blood pressure load,nerve function and lipid metabolism in patients with ischemic stroke complicated with essential hypertension

目的探讨“活血散风针刺法”治疗缺血性脑卒中伴原发性高血压对患者血压负荷、神经功能及脂代谢的影响。方法以2018年5月-2020年5月河南省郑州市中医院针灸理疗科收治的200例缺血性脑卒中伴原发性高血压患者为研究对象,按随机数字表法分为对照组与观察组,各100例。2组均给予硝苯地平控释片进行降压治疗,对照组在此基础上给予醒脑开窍针刺法进行治疗,观察组在对照组的基础上加用“活血散风针刺法”进行治疗,2组均持续治疗6周。比较2组治疗前、治疗6周后的血压负荷、血液流变学、脂代谢指标水平及治疗前、治疗3、6周后的神经功能。结果与治疗前比较,治疗6周后,2组收缩压(SBP)负荷、舒张压(DBP)负荷、血清低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)及总胆固醇(TC)水平、全血高切黏度、全血低切黏度及血浆黏度均降低,观察组低于对照组(P<0.05),具有统计学意义。与治疗前比较,治疗3、6周后,2组美国国立卫生研究院卒中量表(NIHSS)评分均呈逐渐降低趋势,观察组低于对照组(P<0.05),具有统计学意义。结论“活血散风针刺法”可明显改善缺血性脑卒中伴原发性高血压患者血压负荷及血液流变学,并可改善患者神经功能及脂代谢,值得推广。

Objective To explore the eff ect of the needling therapy for promoting blood circulation and dispelling wind on the blood pressure load,nerve function and lipid metabolism in patients with ischemic stroke complicated with essential hypertension.Methods From May 2018 to May 2020,200 patients with ischemic stroke and essential hypertension who were admitted to the Department of Acupuncture and Physiotherapy of Zhengzhou Hospital of Traditional Chinese Medicine were selected as the research subjects,and they were randomly divided into the control group and the experimental group,with 100 cases in each group.Both groups were given nifedipine controlled-release tablets for antihypertensive treatment,and the control group was administered acupuncture for refreshing the mind on this basis,while the experimental group was additively administered needling for promoting blood circulation and dispelling wind.Both groups continued the treatment for 6 weeks.The blood pressure load,hemorheology,lipid metabolism index levels before treatment and 6 weeks after treatment were compared between the two groups,and the nerve function before treatment and 3 and 6 weeks after treatment was compared,too.Results Compared with before treatment,the systolic blood pressure(SBP)load,diastolic blood pressure(DBP)load,serum low-density lipoprotein cholesterol(LDL-C),triacylglycerol(TG)and total cholesterol(TC),whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity were all decreased in the two groups after 6 weeks of treatment,and the experimental group was lower than the control group(P<0.05).Compared with before treatment,the scores of the National Institutes of Health Stroke Scale(NIHSS)in the two groups showed a gradual decrease after 3 and 6 weeks of treatment,and the experimental group was lower than the control group(P<0.05).Conclusion The needling therapy for promoting blood circulation and dispelling wind can signifi cantly improve the blood pressure load and hemorheology of patients with ischemic stroke and essential hypertension,as well as improve the neurological function and lipid metabolism,which is worthy of promotion.