加味玉屏风散联合电针治疗进展性穿支动脉疾病型缺血性脑卒中临床研究

Clinical Observation of Modified Yupingfeng Powder(加味玉屏风散)Combined with Electroacupuncture in the Treatment of Progressive Ischemic Stroke with Perforating Artery Disease

目的:观察加味玉屏风散联合电针治疗进展性穿支动脉疾病型缺血性脑卒中的临床疗效。方法:选取64例进展性穿支动脉疾病型缺血性脑卒中患者,随机分为对照组和观察组各32例。对照组予以电针及脑卒中常规临床路径治疗,观察组在对照组基础上加用加味玉屏风散中药治疗。分别评定两组治疗前、治疗后美国国立卫生院卒中量表(NIHSS)评分、Barthel指数(BI)评分、改良Rankin量表(MRS)评分、中医证候积分、临床疗效、血清学指标及治疗后不良反应。结果:与治疗前比较,治疗后14 d两组NIHSS评分、MRS评分与中医证候积分均下降(P<0.05),两组BI评分均升高(P<0.05),观察组NIHSS评分与MRS评分、中医证候积分显著低于对照组(P<0.05),BI评分显著高于对照组(P<0.05),观察组总有效率93.75%高于对照组的75.0%(P<0.05);两组治疗期间未发生不良反应,血清学指标差异无统计学意义(P>0.05)。结论:加味玉屏风散联合电针治疗进展性穿支动脉疾病型缺血性脑卒中能显著促进神经功能的恢复及日常生活能力改善。

Objective:To observe the clinical effect of Modified Yupingfeng Powder(加味玉屏风散)combined with electroacupuncture in the treatment of progressive ischemic stroke with perforating artery disease.Methods:A total of 64 cases of ischemic stroke with progressive perforating artery disease were randomly divided into the control group and the observation group,with 32 cases in each group.The control group was treated with acupuncture and routine clinical pathway for stroke,and the observation group was treated with Modified Yupingfeng Powder on the basis of treatment of the control group.National Institutes of Health Stroke Scale(NIHSS)score,Barthel index(BI)score,Modified Rankin Scale(MRS)score,traditional Chinese medicine(TCM)syndrome score,clinical efficacy、serological indexes before and after treatment and adverse reactions after treatment were compared between the two groups.Results:Compared with before treatment,NIHSS score,MRS score and TCM syndrome score in both groups decreased 14 days after treatment(P<0.05),while BI score in both groups increased(P<0.05).NIHSS score,MRS score and TCM syndrome score in the observation group were significantly lower than those in the control group(P<0.05).BI score of the observation group was significantly higher than that of the control group(P<0.05).The total effective rate of the observation group was 93.75%,which was higher than that of the control group(75.0%)(P<0.05).No adverse reactions occurred in the two groups during treatment.There was no statistics difference in serological indexes(P>0.05).Conclusion:The application of Modified Yupingfeng Powder combined with electroacupuncture can significantly promote the recovery of neurological function and the improvement of daily living ability in the treatment of progressive ischemic stroke with perforating artery disease.