针药并用治疗急性期脑卒中后便秘60例临床观察

Clinical observation on 60 cases with constipation after stroke in acute stage treated by acupuncture medication combined

目的观察针药并用治疗急性期脑卒中后便秘的临床疗效。方法将120例急性期脑卒中后便秘患者随机分为2组,各60例。对照组予麻仁丸治疗;治疗组给予针刺治疗,取穴大椎、曲池(双侧)、鱼际(双侧)、天枢(双侧)、上巨虚(双侧)、足三里(双侧)、丰隆(双侧)、外关(双侧),并配合中药汤剂(全瓜蒌30 g、芒硝5 g、厚朴12 g、炒枳实12 g、炒黄芩8 g、火麻仁20 g、炙黄芪15 g、甘草6 g)口服,2组均连续治疗14 d。比较2组治疗前,治疗24 h、2周,随访2,4周日常生活能力量表(ADL)评分及便秘临床评分量表(CCS)评分。结果与同组治疗前比较,治疗组治疗2周,随访2,4周ADL评分均明显升高,差异有统计学意义(P<0.05),且治疗组明显高于对照组(P<0.05);与同组治疗前比较,治疗组治疗24 h、2周,随访2,4周CCS评分均明显降低,差异有统计学意义(P<0.05),且治疗组明显低于对照组(P<0.05)。结论针药并用治疗急性期脑卒中后便秘近期及远期疗效显著,同时还可提高患者生活质量,值得临床推广应用。

Objective To observe the clinical efficacy of acupuncture medication combined in the treatment of constipation after stroke in acute stage.Methods Totally 120 patients with constipation after stroke in acute stage were randomly divided into 2 groups,with 60 cases in each.The control group was given Maren Wan(麻仁丸),while the treatment group was given acupuncture treatment by acupoint selection at Dazhui(GV 14),bilateral Quchi(LI 11),Yuji(LU 10),Tianshu(ST 25),Shangjuxu(ST 37),Zusanli(ST 36)and Fenglong(ST 40)bilateral Waiguan(SJ 5),and cooperated with Chinese materia medica decoction[30 g of Quangualou(Trichosanthis fructus),5 g of Mangxiao(Natrii sulfas),12 g of Houpu(Magnoliae officinalis Rehd.et Wils.)],12 g of Chaozhishi(Aurantii Fructus immaturus),8 g of Chaohuangqin(Scutellaria baicalensis Georgi),20 g of Huomaren(Cannabidis semen),15 g of Zhihuangqi(Astragali radix Praepaprata cum Melle),6 g of Gancao(Glycyrrhiza uralensis Fisch.)]orally.The 2 groups were both treated consecutively for 14 days.The activities of daily living(ADL)scale and Clinical Classification System(CCS)scale of the 2 groups before treatment and after treatment for 24 h,2 weeks,and follow-up for 2 and 4 weeks were compared.Results Compared with the same group before treatment,the ADL scores of the treatment group after treatment for 2 weeks,and follow-up for 2 and 4 weeks increased significantly,and the difference was statistically significant(P<0.05),moreover,the treatment group was significantly higher than the control group(P<0.05);compared with the same group before treatment,the CCS scale of the treatment group after treatment for 24 h,2 weeks,and follow-up for 2 and 4 weeks decreased more significantly,and the difference was statistically significant(P<0.05),moreover,the treatment group was significantly lower than the control group(P<0.05).Conclusion Acupuncture medication combined in the treatment of constipation after stroke in acute stage has significant short-term and long-term curative effect,and it can also improve the quality of life of patients,which is worthy of clinical promotion and application.