脐腹灸及解语膏穴位贴敷联合针刺辅助治疗脑梗死风痰瘀阻证30例临床观察

Clinical observation on 30 cases of cerebral infarction with wind-phlegm and blood stasis obstructing syndrome adjunctively treated by moxibustion in perinavel region and acupoint application with Jieyu Gao(解语膏) combined with acupuncture

目的 观察脐腹灸及解语膏穴位贴敷联合针刺辅助治疗脑梗死风痰瘀阻证的临床疗效。方法选取安徽中医药大学第二附属医院2019年11月至2020年8月收治的60例脑梗死风痰瘀阻证患者作为研究对象,采用随机数字表法分为对照组和治疗组,各30例。2组均给予西医常规基础治疗,在此基础上,对照组采用针刺治疗,治疗组采用脐腹灸及解语膏穴位贴敷联合针刺治疗。治疗14 d后比较2组的临床疗效,治疗前后的中医证候积分、日常生活能力(ADL)评分、神经功能缺损(NIHSS)评分,以及低密度脂蛋白(LDL)、超敏C反应蛋白(hc-CRP)、同型半胱氨酸(HCY)水平。结果 治疗组总有效率为86.67%(26/30),对照组为73.33%(22/30),2组比较差异有统计学意义(P<0.05);治疗后2组ADL评分明显升高,中医证候积分及NIHSS评分明显降低,与同组治疗前比较差异均有统计学意义(P<0.05),且治疗组改善更明显,与对照组治疗后比较差异均有统计学意义(P<0.05);治疗后2组LDL、hc-CRP、HCY水平明显降低,与同组治疗前比较差异均有统计学意义(P<0.05),且治疗组降低更明显,与对照组治疗后比较差异均有统计学意义(P<0.05)。结论 脐腹灸及解语膏穴位贴敷联合针刺辅助治疗脑梗死风痰瘀阻证能有效改善患者的临床症状,提高患者的日常生活能力,减轻患者的神经功能缺损程度,降低LDL、hc-CRP、HCY水平,疗效确切,且无明显不良反应,值得临床推广应用。

Objective To observe the clinical efficacy of moxibustion in perinavel region and acupoint application with Jieyu Gao(解语膏)combined with acupuncture in adjunctive treatment of cerebral infarction with windphlegm and blood stasis obstructing syndrome.Methods From November 2019 to August 2020,60 cases of cerebral infarction with wind-phlegm and blood stasis obstructing syndrome admitted into the Second Affiliated Hospital of Anhui University of Chinese Medicine were chosen as research objects and divided into control group and treatment group according to random number table method,with 30 cases in each group.The 2 groups were both given Western medicine routine treatment,on this basis,the control group was given acupuncture therapy,whereas the treatment group was given moxibustion in perinavel region and acupoint application with Jieyu Gao combined with acupuncture.After 14 days of treatment,the clinical efficacy,TCM syndrome score,activities of daily living(ADL)score,national institute of health stroke scale(NIHSS)score,low-density lipoprotein(LDL),high-sensitivity C-reactive protein(hc-CRP)and homocysteine(HCY)levels between the 2 groups before and after treatment were compared.Results The total effective rate of the treatment group was 86.67%(26/30),that of the control group was73.33%(22/30),and the difference was statistically significant between the 2 groups(P<0.05).After treatment,the ADL score of the 2 groups significantly increased,the TCM syndrome score and NIHSS score thereof significantly decreased,and the difference was statistically significant as compared with the same group before treatment(P<0.05),and the improvement of the treatment group was more significant,and the difference was statistically significant as compared with the control group after treatment(P<0.05).After treatment,the levels of LDL,hc-CRP and HCY in the 2 groups significantly decreased as compared with the same group before treatment(P<0.05),moreover,the treatment group decreased more significantly,and the difference was statistically significant as compared with the control group after treatment(P<0.05).Conclusion It can effectively improve the clinical symptoms of patients,improve their daily living ability,reduce the degree of neurological impairment,and reduce the levels of LDL,hc-CRP and HCY with definite efficacy and without marked adverse reactions to use moxibustion in perinavel region and acupoint application with Jieyu Gao combined with acupuncture in adjunctive treatment of cerebral infarction with wind-phlegm and blood stasis obstructing syndrome,which deserves clinical promotion and application.