循经灸联合祛瘀通络开窍汤治疗缺血性脑卒中疗效观察

Clinical Observation on Moxibustion along the Meridians and Stasis-eliminating Collateral-dredging Resuscitation Decoction in the Treatment of Ischemic Stroke

目的:探讨循经灸联合祛瘀通络开窍汤治疗缺血性脑卒中患者的临床疗效。方法:选取97例缺血性脑卒中患者,按照随机数字表法分为对照组(48例)和观察组(49例)。对照组采用基础对症治疗方案,观察组在此基础上另行循经灸联合祛瘀通络开窍汤治疗。1周为1疗程,两组均连续治疗4个疗程。比较两组临床疗效、证候积分、脑动脉最大峰值血流速度(systolic peak flow velocity,Vs)、平均血液流速(mean flow velocity,Vm)和脉动指数(perfusion Index,PI)、血清同型半胱氨酸(homocysteine,Hcy)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)含量和mRS评分。结果:观察组临床总有效率[97.95%(48/49)]明显优于对照组[87.50%(42/48)](P<0.05)。治疗后两组证候积分均下降(P<0.05),且观察组明显低于对照组(P<0.05)。治疗后两组脑动脉Vs、Vm均升高(P<0.05),PI降低(P<0.05),且观察组改善程度优于对照组(P<0.05);治疗后两组血清Hcy和hs-CRP含量及mRS评分均较治疗前降低(P<0.05),且观察组明显低于对照组(P<0.05)。结论:循经灸联合祛瘀通络开窍汤治疗缺血性脑卒中疗效较好,可显著改善患者临床症状和脑动脉血流动力学指标,降低血清Hcy和hs-CRP含量,降低致残程度,促进康复。

Objective:To explore clinical effects of moxibustion along the meridians and stasis-eliminating collateral-dredging resuscitation decoction in the treatment of ischemic stroke.Methods:A total of 97 patients were chosen,and divided into the control group(48 cases)and the observation group(49 cases)in light of random number table method.The control group adopted basic symptomatic therapeutic regimen,and the observation group was treated by moxibustion along the meridians and stasis-eliminating collateral-dredging resuscitation decoction.One week was one course,both groups were treated for four courses consecutively.To compare clinical effects,syndrome integrals,Vs,Vm and PI of cerebral artery,the contents of Hcy,hs-CRP and mRS scores between both groups.Results:Total effective rate of the observation group was[97.95%(48/49)],notably better than[87.50%(42/48)]of the control group(P<0.05).After the treatment,syndrome integrals of both groups were reduced(P<0.05),and the observation group was remarkably lower than the control group(P<0.05).After the treatment,Vs and Vm of cerebral artery of both groups were increased(P<0.05),PI was decreased(P<0.05),and the improvements of the observation group were better than these of the control group(P<0.05);after the treatment,the contents of Hcy and hs-CRP,and mRS scores of both groups were reduced than these before the treatment(P<0.05),and the observation group was lower than the control group obviously(P<0.05).Conclusion:Moxibustion along the meridians and stasis-eliminating collateral-dredging resuscitation decoction could obtain better clinical effects in the treatment of ischemic stroke,it could notably improve clinical symptoms and cerebral artery hemodynamics,reduce the contents of Hcy and hs-CRP,decrease disability,and promote the recovery.