畲医内外合治痰瘀互结型高血压伴脑梗死的临床疗效

Clinical efficacy of internal and external combination of She medicine in the treatment of phlegm-blood stasis type hypertension with cerebral infarction

目的观察畲药组方配合搓痧疗法治疗痰瘀互结型高血压伴脑梗死患者的临床疗效。方法选取符合纳入标准的2018年8月至2020年8月就诊于丽水市中医院心内科门诊及住院部的120例痰瘀互结型高血压伴脑梗死患者,随机分为对照组、内治组、外治组、合治组四组,每组各30例。对照组采用西药治疗;内治组采用西药+畲药治疗;外治组采用西药+搓痧疗法;合治组采用西药+搓痧疗法+畲药治疗。四组疗程为8周,观察治疗前后的中医证候疗效、24 h动态血压全天平均值及Lovett肌力分级。结果①中医证候疗效比较:治疗后,三组治疗组疗效均明显优于对照组(P<0.01);合治组的疗效优于内治组、外治组(P<0.05),差异有统计学意义(P<0.05)。②24 h动态血压全天平均值比较:四组治疗后的组内比较24 hSBP、24 hDBP平均值均较治疗前明显下降,差异有统计学意义(P<0.05);治疗后,三组治疗组的24 hSBP、24 hDBP平均值显著低于对照组;合治组的24 hSBP、24 h DBP平均值均低于内治组、外治组,差异有统计学意义(P<0.05)。③Lovett肌力分级比较:四组治疗后的组内比较肌力等级较治疗前优化;治疗后,合治组的肌力等级优于内治组、外治组,差异有统计学意义(P<0.05)。结论畲药组方配合搓痧疗法可提高痰瘀互结型高血压伴脑梗死患者的临床疗效,有效降压,改善肌力,值得临床推广。

Objective To observe the clinical efficacy of She medicine compound combined with rubbing therapy in the treatment of patients with phlegm-blood stasis type hypertension with cerebral infarction.Methods A total of 120 patients with phlegm-blood stasis type hypertension with cerebral infarction who attended the Outpatient Clinic and the Inpatient Department of the Department of Cardiology in Lishui Hospital of Traditional Chinese Medicine from August 2018 to August 2020 and met the inclusion criteria were selected as the study subjects.They were randomly divided into four groups including the control group,the internal treatment group,the external treatment group and the combined treatment group,with 30 patients in each group.The control group was treated with western medicine;the internal treatment group was treated with western medicine+she medicine;the external treatment group was treated with western medicine+rubbing therapy;the combined treatment group was treated with western medicine+rubbing therapy+she medicine.All the four groups were treated for 8 weeks.The efficacy on traditional Chinese medicine symptoms,the average value of 24 h ambulatory blood pressure throughout the day and Lovett muscle strength grading were observed before and after treatment.Results①In terms of the efficacy on traditional Chinese medicine symptoms,the efficacy of all the three treatment groups after treatment was significantly better than that of the control group(P<0.01).The efficacy of the combined treatment group was better than that of the internal treatment group and the external treatment group(P<0.05),with statistical difference in the indicator(P<0.05).②In terms of the average value of 24-h ambulatory blood pressure throughout the day,the average values of 24 h systolic blood pressure(SBP)and 24-h diastolic blood pressure(DBP)in the four groups after treatment were all significantly lower than those before treatment,with statistically significant differences(P<0.05).After treatment,the average values of 24 hSBP and 24 hDBP in the three treatment groups were significantly lower than those in the control group.The average values of 24 hSBP and 24 hDBP in the combined treatment group were lower than those in the internal treatment group and the external treatment group,with statistically significant differences in the two indicators(P<0.05).③In terms of Lovett muscle strength grading,the muscle strength grades of the four groups were optimized after treatment compared with those before treatment.After treatment,the muscle strength grades of the combined treatment group were superior to those of the internal treatment group and the external treatment group,with statistical significance in each indicator(P<0.05).Conclusion The She medicine compound combined with rubbing therapy can improve the clinical efficacy of patients with phlegm-blood stasis type hypertension with cerebral infarction by effectively lowering blood pressure and improving muscle strength,which is worthy of promotion in clinic.