自拟豁痰开窍方联合针刺治疗脑梗死的疗效观察

Efficacy of Self-made Huotan Kaiqiao Decoction Combined with Acupuncture in Treating Cerebral Infarction

目的探讨自拟豁痰开窍方联合针刺治疗脑梗死的疗效及对脑血流灌注量、血黏度的影响。方法将96例脑梗死患者按照随机数字表法分为对照组与观察组,各48例。对照组应用常规西药治疗,观察组在此基础上联合针刺与自拟豁痰开窍方治疗。两组疗程均为14 d。比较两组的临床疗效、美国国立卫生研究院脑卒中量表(NIHSS)及Barthel指数。同时比较两组治疗前后中医证候积分、脑血灌注情况及血黏度指标。结果1)临床疗效比较:观察组总有效率93.75%,明显高于对照组79.17%(P<0.05)。2)中医证候积分比较:两组治疗后中医证候积分均较治疗前有所下降,且观察组治疗后中医证候积分低于对照组(P<0.05)。3)NIHSS评分及Barthel指数比较:两组治疗后NIHSS评分均有所下降,Barthel指数均有所增加,且观察组治疗后NIHSS评分低于对照组,Barthel指数高于对照组(均P<0.05)。4)脑血灌注情况比较:两组治疗后平均通过时间(MTT)均有所缩短,局部脑血容量(rCBV)及局部脑血流量(rCBF)均有所增高,且观察组治疗后MTT短于对照组,rCBF及rCBV高于对照组(均P<0.05)。5)血黏度指标比较:两组治疗后血浆黏度、全血黏度(高切)、全血黏度(低切)均有所降低,且观察组治疗后血浆黏度、全血黏度(高切)、全血黏度(低切)均较对照组低(均P<0.05)。结论自拟豁痰开窍方联合针刺治疗可有效改善脑梗死患者神经功能及日常生活能力,提高其脑血流灌注量,并降低血黏度,具有较好临床疗效。

Objective:To explore the efficacy of self-made Huotan Kaiqiao Decoction combined with acupuncture in treatment of cerebral infarction and the influence on cerebral blood flow and blood viscosity. Methods:A total of 96 patients with cerebral infarction were selected and numbered according to the admission order. They were randomly divided into the control group and the observation group. The control group was treated with routine western medicine,and the observation group was treated with acupuncture combined with self-made Huotan Kaiqiao Decoction on the basis of the control group. The clinical efficacy of the two groups were comparatively analyzed. The neurological deficits and ability of daily life before and after treatment in both groups were evaluated by National Institutes of Health Stroke Scale(NIHSS)and Barthel Index. The scores of TCM syndromes,cerebral blood perfusion and blood viscosity in both groups before and after treatment were analyzed. Results:The total effective rate in observation group was higher than that in control group(93.75% vs. 79.17%,P < 0.05). After treatment,scores of TCM syndromes in both groups were decreased,and the above scores in observation group were lower than those in control group(P < 0.05). After treatment,the NIHSS scores in both groups were decreased,while Barthel index was increased;NIHSS score of observation group was lower than that of control group,while Barthel index was higher than that of control group(P < 0.05). After treatment,the mean transit time(MTT)in both groups was shortened,while regional cerebral blood volume(rCBV)and regional cerebral blood flow(rCBF)were increased. MTT of observation group was shorter than that of control group,while rCBF and rCBV were higher than those of control group(P < 0.05). After treatment,the plasma viscosity,whole blood viscosity(high shear)and whole blood viscosity(low shear)in both groups were decreased,and the above indexes in observation group were lower than those in control group(P < 0.05). Conclusion:Self-made Huotan Kaiqiao Decoction combined with acupuncture can effectively improve nerve function and daily living ability of cerebral infarction patients,improve their cerebral blood perfusion volume,and reduce blood viscosity. The clinical efficacy is good.