循经放血疗法治疗卒中后风痰瘀阻证上肢感觉障碍的临床研究

Clinical study on the treatment of post-stroke upper limb sensory disorders with wind-phlegm stasis using bloodletting along channels

目的观察循经放血疗法治疗脑卒中后风痰瘀阻证上肢感觉障碍的临床疗效。方法将102例脑卒中后偏身感觉障碍患者随机分为治疗组51例、对照组51例。2组均采用基础治疗控制脑卒中原发病,对照组在基础治疗上予以常规康复训练治疗,治疗组在基础治疗上采用循经放血疗法。观察中医证候积分、Lindmark感觉功能评分、数字疼痛分级评分、体感诱发电位、FMA评分、Barthel指数评分、临床疗效。结果中医证候积分治疗组治疗后较本组降低(P<0.05),治疗后治疗组较对照组降低明显,2组治疗前后差值比较,差异有统计学意义(P<0.05),治疗组优于对照组。Lindmark感觉功能评分治疗组治疗后较本组升高(P<0.05),数字麻木感积分治疗组治疗后较本组降低(P<0.05),治疗后Lindmark感觉功能评分治疗组较对照组升高明显,数字疼痛分级积分治疗组较对照组降低明显,差异均有统计学意义(P<0.05),治疗组均优于对照组。体感诱发电位治疗组治疗后较本组升高(P<0.05),治疗后治疗组较对照组升高明显,2组治疗前后差值比较,差异有统计学意义(P<0.05),治疗组优于对照组。FMA评分和Barthel指数评分治疗组治疗后均较本组升高(P<0.05),治疗后FMA评分和Barthel指数评分治疗组较对照组均升高明显,差异均有统计学意义(P<0.05),治疗组优于对照组。治疗组51例中,痊愈4例,显效13例,有效27例,无效7例,总有效率86.27%;对照组51例中,痊愈1例,显效11例,有效21例,无效18例,总有效率64.71%。经秩和检验,Z=-2.245,P<0.05,说明治疗组疗效优于对照组。结论循经放血疗法治疗脑卒中后风痰瘀阻证上肢感觉障碍具有较好的临床疗效。

Objective To observe the clinical efficacy of bloodletting along channels in the treatment of post-stroke upper limb sensory disorders with wind-phlegm stasis.Methods 102 patients with post-stroke hemianesthesia were randomly divided into 51 in the treatment group and 51 in the control group, both of whom were treated with basic therapy for the stroke, while the control group was treated with conventional rehabilitation training on top of basic therapy and the treatment group was given additional bloodletting along channels. The TCM symptom scores, Lindmark sensory function scores, pain scores, somatosensory evoked potentials(SEP), FMA scores, Barthel index scores and clinical efficacy were observed.Results TCM symptom scores dropped in the treatment group compared after treatment(P<0.05), and the decrease was greater in the treatment group compared with the control group after treatment. The difference between the two groups before and after treatment was statistically significant(P<0.05), and the treatment group was better than the control group. The Lindmark sensory function scores were significantly higher in the treatment group than in the control group, and the numbness scores were significantly lower in the treatment group than in the control group. The difference between the two groups before and after treatment was statistically significant(P<0.05), and the treatment group was better than the control group. SEP was elevated in the treatment group tfter treatment(P<0.05), and SEP in the treatment group was greater than in the control group after treatment, and the difference between the two groups before and after treatment was statistically significant(P<0.05), and the treatment group was better than the control group. FMA scores and Barthel scores were significantly higher in the treatment group than in the control group, and the differences were statistically significant(P<0.05), and the treatment group was superior to the control group. Among 51 cases in the treatment group, 4 were cured, 13 markedly effective, 27 moderately effective, and 7 not effective, with a total effective rate of 86.27%. Among 51 cases in the control group, 1 was cured, 11 markedly effective, 21 moderately effective, and 18 not effective, with a total effective rate of 64.71%. By rank sum test, Z=-2.245, P<0.05, indicating that the efficacy in the treatment group was better than that in the control group. Conclusion Bloodletting along channels therapy has good clinical efficacy in the treatment of post-stroke upper limb sensory disorders with wind-phlegm stasis.