复元通络汤联合针灸治疗气虚血瘀型脑卒中的疗效观察

Observation on the Efficacy of Fuyuan Tongluo Decoction Combined with Acupuncture in the Treatment of Stroke with Qi Deficiency and Blood Stasis Type

目的:探讨复元通络汤联合针灸治疗气虚血瘀型脑卒中的疗效。方法:采用随机数字表法将2021年6月至2023年9月淮滨县人民医院收治的脑卒中患者106例分为对照组与观察组,各53例。对照组患者予以常规西药治疗,观察组患者在对照组的基础上加用复元通络汤联合针灸治疗,连续治疗4周。比较两组患者临床疗效、血液流变学指标、胰岛素样生长因子-1(IGF-1)、脑源性神经营养因子(BDNF)、Berg平衡量表(BBS)评分、起立-行走计时测试(TUGT)、Fugl-Meyer评定量表(FMA)评分、Barthel指数(BI)评分、中医证候积分及不良反应。结果:观察组患者治疗总有效率较对照组高,差异具有统计学意义(P<0.05);两组患者治疗后红细胞聚集指数、血浆黏度、全血高切黏度、全血低切黏度较治疗前下降,且观察组患者治疗后较对照组低,差异具有统计学意义(P<0.05);两组患者治疗后血清BDNF、IGF-1水平较治疗前提高,且观察组患者治疗后较对照组高,差异具有统计学意义(P<0.05);两组患者治疗后BBS、FMA、BI评分较治疗前提高,TUGT、各项中医证候积分较治疗前下降,且观察组患者治疗后BBS、FMA、BI评分较对照组高,TUGT、各项中医证候积分较对照组低,差异具有统计学意义(P<0.05);两组患者未见明显不良反应。结论:气虚血瘀型脑卒中患者应用复元通络汤联合针灸治疗安全有效,利于改善血液循环、肢体运动功能、平衡能力及日常生活能力,调节血清BDNF、IGF-1水平。

Objective To explore the efficacy of Fuyuan Tongluo Decoction combined with acupuncture in the treatment of stroke with qi deficiency and blood stasis type.Methods A total of 106 stroke patients admitted to Huaibin County People’s Hospital from June 2021 to September 2023 were divided into a control group and an observation group using a random number table,with 53 cases in each group.The control group received conventional Western medicine treatment,while the observation group was additionally treated with Fuyuan Tongluo Decoction combined with acupuncture on the basis of the control group,for a continuous treatment of 4 weeks.The clinical efficacy,hemorheology indicators,insulin-like growth factor-1(IGF-1),brain-derived neurotrophic factor(BDNF),Berg Balance Scale(BBS)score,Timed Up and Go Test(TUGT),Fugl-Meyer Assessment(FMA)score,Barthel Index(BI)score,traditional Chinese medicine(TCM)symptom score,and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the red blood cell aggregation index,plasma viscosity,whole blood high-shear viscosity,and whole blood low-shear viscosity in both groups were lower than those before treatment,and the observation group had lower levels than those in the control group after treatment,with statistically significant differences(P<0.05).the serum levels of BDNF and IGF-1 in both groups were higher after treatment than before,and the observation group had higher levels than those in the control group after treatment,with statistically significant differences(P<0.05).After treatment,the scores of BBS,FMA,and BI in both groups were higher,while TUGT and TCM symptom scores were lower than those before treatment,and the observation group had higher BBS,FMA,and BI scores and lower TUGT and TCM symptom scores than those in the control group,with statistically significant differences(P<0.05).No significant adverse reactions were observed in either group.Conclusion The application of Fuyuan Tongluo Decoction combined with acupuncture in the treatment of stroke with qi deficiency and blood stasis type is safe and effective,beneficial for improving blood circulation,limb motor function,balance ability,and activities of daily living,and regulating BDNF and IGF-1 levels.