温阳化痰通络汤联合温针灸对气虚血瘀型缺血性脑卒中偏瘫患者神经功能、运动功能的影响

The Influence of Yang⁃Warming and Phlegm⁃Resolving and Collateral⁃Dredging Decoction Combined with Warming Needle Moxibustion on Nerve Function and Motor Function of Ischemic Stroke Hemiplegia Patients with Qi Deficiency and Blood Stasis Syndrome

目的:观察温阳化痰通络汤联合温针灸对气虚血瘀型缺血性脑卒中偏瘫患者神经功能、运动功能的影响。方法:选取2020年5月至2022年2月唐河县人民医院治疗的缺血性脑卒中偏瘫患者120例,遵循简单随机数字表法分为观察组与对照组,每组60例。两组患者入院后均给予常规治疗,统一进行肢体康复,包括侧卧位躯干控制训练、健侧踏板站立平衡训练等。对照组另给予温针灸治疗,观察组给予温阳化痰通络汤联合温针灸治疗。观察两组治疗前后中医证候评分、肢体运动能力、日常生活活动能力、全血黏度(低切、高切)、红细胞聚集指数、纤维蛋白原(fibrinogen,FIB)等,并比较凝血酶时间(thrombin time,TT)、活化部分凝血活酶时间(activated partially thrombin time,APTT)、三酰甘油(three acyl glycerin,TG)、总胆固醇(total cholesterol,TC)变化情况及不良反应发生情况。结果:观察组治疗后中医证候评分均低于对照组,差异有统计学意义(P<0.05);观察组治疗后全血黏度(高切、低切)、红细胞聚集指数、FIB均低于对照组,差异有统计学意义(P<0.05);观察组治疗后APTT、PT长于对照组,TC、TG水平低于对照组,差异有统计学意义(P<0.05);观察组治疗后上肢MRC六级肌力评分、下肢Fugl-Meyer评测法评分均高于对照组,差异有统计学意义(P<0.05);观察组治疗后日常生活活动能力优于对照组,差异有统计学意义(P<0.05);两组均未见明显不良反应发生。结论:温阳化痰通络汤联合温针灸治疗气虚血瘀型缺血性脑卒中偏瘫,能明显改善患者中医证候、日常生活活动能力,还可有效促进肢体运动功能、神经功能的恢复。

Objective:To observe the influence of Yang⁃Warming and Phlegm⁃Resolving and Collateral⁃Dredging Decoction combined with warming needle moxibustion on nerve function and motor function of ischemic stroke hemiplegia patients with qi deficiency and blood stasis syndrome.Methods:A total of 120 patients with ischemic stroke hemiplegia who were treated in Tanghe County People′s Hospital from May 2020 to February 2022 were selected and divided into the observation group and the control group according to the simple random number table method,with 60 cases in each group.After admission,both groups of patients were given routine treatment and underwent limb rehabilitation,including lateral lying trunk control training and contralateral pedal standing balance training.The control group was also given warming needle moxibustion treatment,while the observation group was additionally given Yang⁃Warming and Phlegm⁃Resolving and Collateral⁃Dredging Decoction combined with warming needle moxibustion.Then the changes in the TCM syndrome scores,limb movement ability,activities of daily living ability,whole blood viscosity(low shear,high shear),red blood cell aggregation index,fibrinogen(FIB),etc.,thrombin time(TT),activated partial thrombin time(APTT),three acyl glycerol(TG),total cholesterol(TC),and adverse reactions were compared.Results:After treatment,the TCM syndrome scores of the observation group were lower than those of the control group,with a statistically significant difference(P<0.05).After treatment,the whole blood viscosi⁃ty(high shear,low shear),red blood cell aggregation index,and FIB in the observation group were lower than those in the control group,with statistically significant differences(P<0.05);APTT and PT in the observation group were longer than those in the control group,while TC and TG levels were lower than those in the control group,with statistically significant differences(P<0.05);The up⁃per limb MRC level 6 muscle strength score and lower limb Fugl Meyer evaluation score in the observation group were higher than those in the control group,with statistically significant differences(P<0.05);The ability of activities of daily living in the observation group was better than that in the control group,with a statistically significant difference(P<0.05);However,no significant adverse reactions were observed in the two groups.Conclusion:Yang⁃Warming and Phlegm⁃Resolving and Collateral⁃Dredging Decoction combined with warming needle moxibustion can significantly improve the patients′TCM syndromes and activities of daily living,and also effectively promote the recovery of limb motor function and nerve function.