针药并用治疗缺血性中风恢复期丘脑痛的临床观察

Clinical Effect of Acupuncture and Medicine in the Treatment of Thalamic Pain in the Recovery Period of Ischemic Stroke

目的探究阿米替林、通心络和针灸并用治疗缺血性中风恢复期丘脑痛患者的疗效以及对患者抑郁焦虑等临床症状的改善情况。方法选取2018年6月—2020年6月就诊的缺血性中风恢复期丘脑痛患者112例,采用随机数字表法将患者分为对照组和观察组,每组56例。对照组口服盐酸阿米替林片。观察组在对照组基础上加用通心络胶囊,并辅以醒脑开窍针法治疗。记录治疗前、治疗7 d、治疗14 d、治疗28 d视觉模拟评分(Visual analog scale,VAS)、日常生活活动(Activities of daily living,ADL)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分。检测患者治疗前、治疗28 d血液流变学指标。记录患者治疗期间不良反应发生情况。结果治疗后,观察组总有效率高于对照组,差异有统计学意义(P<0.05);治疗7 d、治疗14 d、治疗28 d后,两组患者VAS评分均低于本组治疗前,ADL评分均高于本组治疗前,且观察组VAS评分均低于对照组,ADL评分均高于对照组,差异有统计学意义(P<0.05);治疗7 d、治疗14 d、治疗28 d后,两组患者HAMD、HAMA评分均低于本组治疗前,且观察组HAMD、HAMA评分均低于对照组,差异有统计学意义(P<0.05);治疗28 d后,两组患者全血黏度(高切、低切)、血浆黏度、血浆纤维蛋白原、红细胞聚集指数均低于本组治疗前,且观察组均低于对照组,差异有统计学意义(P<0.05);治疗期间两组患者血常规、肝肾功能均正常,观察组总不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论阿米替林、通心络和针灸并用治疗缺血性中风恢复期丘脑痛疗效较好,能够明显缓解患者疼痛症状,改善患者抑郁焦虑等情绪障碍以及血液流变学指标,安全性好,对丘脑痛的治疗有一定参考价值。

Objective To explore the curative effect of amitriptyline,Tongxinluo and acupuncture in the treatment of patients with thalamic pain during recovery from ischemic stroke and the improvement of clinical symptoms such as depression and anxiety.Methods A total of 112 patients with thalamic pain during the recovery period from ischemic stroke were selected from June 2018 to June 2020.The patients were divided into a control group and an observation group using a random number table method,with 56 cases in each group.The control group took amitriptyline hydrochloride tablets orally.The observation group was treated with Tongxinluo Capsule on the basis of the control group and supplemented with Xingnao Kaiqiao acupuncture.The visual analog scale(VAS),activities of daily living(ADL),Hamilton Depression Scale(HAMD),and Hamilton Anxiety Scale(HAMA)score were tested before treatment,7 days of treatment,14 days of treatment,and 28 days of treatment.The blood rheology indexes of patients before treatment and 28 days of treatment were measured.Record the occurrence of adverse reactions during treatment.Results After treatment,the total effective rate of the observation group was higher than that of the control group(P<0.05).After 7 days of treatment,14 days of treatment,and 28 days of treatment,the VAS scores of the two groups were lower than those of the group before treatment,and the ADL scores were all high Before treatment in this group,the VAS scores of the observation group were lower than those of the control group,and the ADL scores were higher than those of the control group(P<0.05).After 7 days of treatment,14 days of treatment,and 28 days of treatment,the two groups had both HAMD and HAMA scores.Lower than this group before treatment,and the HAMD and HAMA scores of the observation group were lower than those of the control group(P<0.05).After 28 days of treatment,the two groups had whole blood viscosity(high-cut and low-cut),plasma viscosity,and plasma fibrinogen The red blood cell aggregation index was lower than before treatment in this group,and the observation group was lower than the control group(P<0.05).The blood routine,liver and kidney function of the two groups were normal,and the total adverse reaction rate of the observation group was no different from that of the control statistically significant(P>0.05).Conclusion Amitriptyline,Tongxinluo combined with acupuncture are effective in treating thalamic pain during recovery stage of ischemic stroke.It can significantly relieve pain symptoms of patients,improve depression and anxiety and other mood disorders,as well as blood rheological indicators,and have good safety.It has certain reference value for the treatment of thalamic pain.