补阳还五汤加减联合针灸治疗脑卒中偏瘫的疗效分析

An analysis of curative effect of the Buyang Huanwu decoction plus acupuncture and moxibustion on hemiplegia after stroke

目的:探讨补阳还五汤加减联合针灸治疗脑卒中偏瘫的疗效。方法:将2020年1―12月在龙口市中医医院脑病科治疗的94例脑卒中偏瘫患者随机分为两组,对照组使用单纯西医治疗,在此基础上,观察组使用补阳还五汤加减联合针灸治疗,对比两组的临床疗效,美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、日常生活能力量表(Activity of Daily Living Scale,ADL)评分、Fugl-Meyer运动功能评定量表(Fugl-Meyer Assessment Scale,FMA)评分变化,中医证候积分变化、血清因子水平变化。结果:观察组治疗总有效率明显高于对照组(P<0.05);观察组治疗后NIHSS评分明显低于对照组,ADL评分、FMA评分明显高于对照组(P<0.05);观察组治疗后肢体萎软无力、偏身感觉异常、口舌?斜、颈项强直等中医证候积分明显低于对照组(P<0.05);观察组治疗后C反应蛋白(C-reactive Protein,CRP)、同型半胱氨酸(Homocysteine,Hcy)、D-二聚体水平明显低于对照组,转化生长因子β1(Transforming Growth Factor-β1,TGF-β1)、血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)水平明显高于对照组(P<0.05)。结论:补阳还五汤加减联合针灸治疗脑卒中偏瘫的疗效显著,能促进中枢神经系统功能的修复,改善肢体功能,提高日常生活能力,减轻中医证候,具有积极的临床意义。

Objective:To explore the efficacy of the Buyang Huanwu decoction(补阳还五汤)plus acupuncture and moxibustion on hemiplegia after stroke.Methods:A total of 94 stroke patients with hemiplegia treated in the Department of Encephalopathy of Longkou Hospital of Traditional Chinese Medicine from January 2020 to December 2020 were randomly divided into two groups.The control group was treated with simple Western medicine,and the observation group was treated with the Buyang Huanwu decoction plus acupuncture and moxibustion.The clinical efficacy,NIHSS score,ADL score and FMA score and TCM syndrome integral changes in the two groups were compared.Results:The effective rate in the observation group was significantly higher than the control group(P<0.05).NIHSS score in the observation group was significantly lower than the control group,ADL score and FMA score in the observation group were significantly higher than the control group(P<0.05).After treatment,the scores of TCM syndromes in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:The Buyang Huanwu decoction plus acupuncture and moxibustion has significant curative effect in the treatment of hemiplegia after stroke,it can promote the repair of central nervous system function,improve limb function,enhance the ability of daily life,relieve the TCM syndrome,and has a positive clinical significance.