桂陈宣化汤联合针刺对气虚血瘀证脑卒中患者临床效果的影响

Clinical Effect of Guichen Xuanhua Decoction Combined with Acupuncture on Stroke Patients with Qi Deficiency and Blood Stasis Syndrome

目的:观察和评价气虚血瘀证脑卒中患者采用桂陈宣化汤与针刺联合治疗对其预后所产生的影响。方法:选取2022年1月—2023年2月永泰县中医院和福建省福州神经精神病防治院进行治疗的94例气虚血瘀证脑卒中患者,依据患者就诊时间编号,以随机数字表法将其分成对照组(n=47)和观察组(n=47),对照组采用阿司匹林肠溶片联合阿托伐他汀钙片治疗,观察组应用桂陈宣化汤与针刺联合治疗,比较两组临床疗效[美国国立卫生研究院卒中量表(NIHSS)]、不良反应情况,以及治疗前后上肢及下肢Fugl-Meyer运动功能评定量表(FMA)评分、Barthel指数(BI)评分,血液流变学指标变化情况。结果:观察组临床总有效率显著高于对照组(P<0.05)。治疗前两组上肢、下肢FMA及BI评分差异均无统计学意义(P>0.05),治疗后观察组上述评分均显著高于对照组(P<0.05)。治疗前两组红细胞聚集指数、红细胞压积、血液黏稠度、全血高切黏度、全血低切黏度指标差异均无统计学意义(P>0.05),治疗后观察组上述血液流变学指标均低于对照组(P<0.05)。两组不良反应总发生率差异无统计学意义(P>0.05)。结论:气虚血瘀证脑卒中患者采用桂陈宣化汤与针刺联合治疗可有效改善神经功能、肢体功能及日常生活能力,效果确切,安全性良好。

Objective:To observe and evaluate the effect of Guichen Xuanhua Decoction combined with acupuncture treatment on the prognosis of stroke patients with Qi deficiency and blood stasis syndrome.Method:A total of 94 stroke patients with Qi deficiency and blood stasis syndrome from Yongtai County Traditional Chinese Medicine Hospital and Fuzhou Neuropsychiatric Hospital,Fujian Province who underwent treatment from January 2022 to February 2023 were selected and divided into the control group(n=47)and the observation group(n=47)by the random number table method according to the visiting time number.The control group was treated with Aspirin Enteric Coated Tablets combined with Atorvastatin Calcium Tablets,and the observation group was treated with Guichen Xuanhua Decoction and acupuncture.The clinical efficacy[national institutes of health stroke scale(NIHSS)],adverse reactions,and Fugl-Meyer assessment(FMA)scores of upper and lower limbs,Barthel index(BI)scores and hemorheology indexes were compared between the two groups before and after treatment.Result:The total clinical effective rate of the observation group was significantly higher than that of the control group(P<0.05).Before treatment,there were no significant differences in the FMA of upper and lower limbs and BI scores between the two groups(P>0.05);after treatment,the above scores of the observation group were significantly higher than those of the control group(P<0.05).There were no statistically significant differences in the values of erythrocyte aggregation index,hematocrit,blood viscosity,whole blood high shear viscosity and whole blood low shear viscosity between the two groups before treatment(P>0.05);after treatment,the above hemorheology indexes in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups after treatment(P>0.05).Conclusion:Guichen Xuanhua Decoction combined with acupuncture can effectively improve neurological function,limb function and activity of daily living in the treatment of stroke patients with Qi deficiency and blood stasis,with definite effect and good safety.