醒脑开窍针刺法联合星蒌承气汤加减对脑卒中患者日常生活能力及上肢功能的疗效评价

Efficacy Evaluation of Xingnao Kaiqiao Acupuncture Combined with Modified Xinglou Chengqi Decoction on Daily Living Ability and Upper Limb Function in Stroke Patients

目的 探究醒脑开窍针刺法联合星蒌承气汤加减对脑卒中患者日常生活能力及上肢功能的影响。方法 将102例脑卒中患者按照随机数字表法分为观察组与对照组各51例。对照组采用星蒌承气汤治疗,观察组在对照组基础上加用醒脑开窍针刺法治疗。比较两组疗效、治疗前后中医证候积分、美国国立卫生研究院卒中量表(NIHSS)、Fugl-Meyer评定量表(FMA)、日常生活活动能力量表(BI)评分、血流动力学包括脑中动脉平均血流速度(Vm)、收缩期血流速度(Vs)、阻力指数(RI)、神经递质水平包括P物质(SP)、神经肽Y(NPY)、5-羟色胺(5-HT)及不良反应发生率等。结果 观察组总有效率96.08%,高于对照组的82.35%(P<0.05);治疗后观察组中医证候积分较对照组低(P<0.05);治疗后观察组NIHSS评分较对照组低,FMA、BI评分较对照组高(P<0.05);治疗后观察组Vm、Vs较对照组高,RI较对照组低(P<0.05);治疗后观察组血清NPY、SP水平较对照组低,血清5-HT较对照组高(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论醒脑开窍针刺法联合星蒌承气汤加减治疗脑卒中效果显著,可有效减轻神经损伤,促使症状改善,提升上肢运动功能及日常生活能力,改善血流动力学,且对神经递质含量具有良好调节作用,安全性高。

Objective:To explore the effect of Xingnao Kaiqiao acupuncture combined with Xinglou Chengqi Decoction on daily living ability and upper limb function in stroke patients. Methods:A total of 102 stroke patients were divided into the observation group and the control group according to the random number table method,51 cases in each group. The control group was treated with Xinglou Chengqi Decoction,and the observation group was additionally treated with Xingnao Kaiqiao acupuncture on the basis of the control group. The curative effect,TCM syndrome scores before and after treatment,National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment Scale(FMA),Activities of Daily Living(BI) score,and hemodynamics,the middle cerebral artery mean blood flow velocity(Vm),systolic blood flow velocity(Vs),resistance index(RI),neurotransmitter levels[substance P(SP),neuropeptide Y(NPY),serotonin(5-HT)]and the incidence of adverse reactions were compared between the two groups. Results:The total effective rate of the observation group was 96.08%,which was higher than 82.35%of the control group(P< 0.05). After treatment,the TCM syndrome score of the observation group was lower than that of the control group(P< 0.05). After treatment,the NIHSS score of the observation group was lower than that of the control group,the FMA and the BI scores were higher than those in the control group(P<0.05). Vm and Vs in the observation group were higher than those in the control group after treatment,and RI was lower than that in the control group(P< 0.05);the serum NPY and SP levels in the observation group were lower than those in the control group after treatment,and serum 5-HT was higher than that in the control group(P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups(P >0.05).Conclusion:Xingnao Kaiqiao acupuncture combined with Xinglou Chengqi Decoction has a significant effect in the treatment of stroke,which can effectively reduce nerve damage,improve symptoms,improve upper limb motor function and daily living ability,improve hemodynamics,and have a good effect on neurotransmitters. It has a good regulating effect and high safety.