激痛点温针灸联合补阳还五汤加减对中风后偏瘫的应用效果及对神经功能的影响

摘要/Abstract

摘要： 目的探讨激痛点温针灸联合补阳还五汤加减对中风后偏瘫的应用效果及对神经功能的影响。方法选取2021年4月—2023年4月汉滨区中医医院收治的78例中风后偏瘫患者,应用抽签法将其分为观察组与对照组,各39例。对照组应用补阳还五汤加减治疗,以对照组为基础,观察组增加激痛点温针灸治疗。对比两组患者临床治疗效果,治疗前后炎症因子水平、神经功能、日常生活能力及运动功能变化。结果与对照组相比,观察组总有效率较高（P<0.05）;与治疗前相比,两组患者治疗后白细胞介素-6（IL-6）、白细胞介素-2（IL-2）、肿瘤坏死因子-α（TNF-α）水平降低,且观察组低于对照组（P<0.05）;与治疗前相比,两组患者美国国立卫生研究院卒中量表（NIHSS）评分降低,简易精神状态检查量表（MMSE）评分升高,治疗后与对照组相比观察组NIHSS评分较低,MMSE评分较高（P<0.05）;与治疗前相比,两组患者治疗后Fugl Meyer（FMA）与改良Barthel指数（MBI）评分升高,治疗后观察组较对照组高（P<0.05）。结论激痛点温针灸联合补阳还五汤加减对中风后偏瘫的应用效果显著,可降低炎症因子水平,有利于神经功能恢复,提升运动功能及日常生活能力。

关键词: 激痛点, 温针灸, 补阳还五汤, 脑卒中, 偏瘫, 神经功能

Abstract: Objective To explore the effect of warm acupuncture and moxibustion on stroke and its effect on hemiplegia after stroke. Methods A total of 78 patients with post-stroke hemiplegia admitted to Hanbin District Traditional Chinese Medicine Hospital from April 2021 to April 2023 were selected and divided into an observation group and a control group using a lottery method, with 39 patients in each group. The control group was treated with Buyang Huanwu Decoction. On the basis of the control group, the observation group was treated with warm acupuncture and moxibustion at the pain trigger point. The two groups of patients were compared with each other in terms of clinical treatment effects, levels of inflammatory factors, neurological function, daily living ability and motor function before and after treatment. Results Compared with the matched group, the total effective rate of the observation group was higher (P<0.05); compared with the pre-treatment, the levels of IL-6, IL-2 and TNF-α were lower in the two groups after treatment, and the observation group was lower than the matched group (P<0.05); compared with the pre-treatment, the patients in the two groups had lower NIHSS scores, and the MMSE scores were elevated, and the NIHSS scores of the observation group were lower after treatment and the MMSE scores were higher (P<0.05); compared with before treatment, FMA and MBI scores were elevated in both groups after treatment, and higher in the observation group than in the matched group after treatment (P<0.05). Conclusion The application effect of warm acupuncture and moxibustion on hemiplegia after stroke is significant, which can reduce the level of inflammatory factors in the body, promote the recovery of nerve function, and improve the motor function and daily living ability.

Key words: pain points, warm acupuncture, Buyang Huanwu Decoction, stroke, hemiplegia, nerve function

中图分类号:

R246

刘绍娟. 激痛点温针灸联合补阳还五汤加减对中风后偏瘫的应用效果及对神经功能的影响[J]. 中华养生保健, 2024, 42(15): 33-36.

LIU Shao-juan. The Application Effect of Warm Acupuncture at Trigger Points Combined with Buyang Huanwu Decoction on Hemiplegia after Stroke and Its Effect on Neurological Function[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(15): 33-36.

参考文献

[1] ROALDSEN M B, JUSUFOVIC M, BERGE E, et al. Endovascular thrombectomy and intra-arterial interventions for acute ischaemic stroke[J].Cochrane Database Syst Rev,2021,6(6):CD007574.
[2] 张扬,严寒,梁永.补阳还五汤对缺血性脑卒中大鼠认知功能的影响[J].中成药,2023,45(4):1309-1314.
[3] 蒋全睿,匡小霞,危威,等.激痛点的形成机制及诊察与物理治疗[J].中华物理医学与康复杂志,2022,44(5):476-480.
[4] 郑全成,刘建浩,张宇.补阳还五汤加减联合针灸治疗中风偏瘫对Hcy,BDNF的变化研究[J].中华中医药学刊,2021,39(3):47-50.
[5] 中华医学会神经病学分会中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
[6] 郑筱萸. 《中药新药临床研究指导原则》[M].北京:中国医药科技出版社,2002:159-121.
[7] 国家中医药管理局.中医病症诊断疗效标准[M].北京:中国中医药出版社,2017:39.
[8] 李文兵,朱珊珊,邹丽娟,等.简易智能精神状态检查量表在脑卒中患者中的应用[J].中国康复,2010,25(6):454-455.
[9] 孙岸弢,王永炎,谢雁鸣,等.缺血性中风早期中医证型与神经功能缺损、肢体运动功能、弛缓性麻痹及肢体痉挛的影响和相关性[J].中医药学报,2014,42(3):39-42.
[10] 沈子祺,谢文军,刘晓平.基于视频的自动Fugl-Meyer评估方法研究[J].电子测量与仪器学报,2022,2(36):11.
[11] 王赛华,施加加,孙莹,等.简体版改良Barthel指数在脑卒中恢复期中的信度与效度研究[J].中国康复,2020,35(4):179-182.
[12] 袁宏伟,刘云霞,张含,等."通督醒神"法针灸联合认知训练治疗卒中后轻度认知障碍:随机对照试验[J].中国针灸,2022,42(8):839-843.
[13] 张斐雪,郑书林,张锡萍,等.针灸联合注射用鼠神经生长因子对脑卒中患者认知水平及神经功能的影响[J].陕西中医,2021,42(10):1462-1465.
[14] 贺强,樊乐,朱杰,等.温针灸联合镜像疗法对老年脑梗死后偏瘫患者的功能恢复及Hcy,BDNF的影响[J].海南医学,2023,34(7):929-932.
[15] 郑全成,刘建浩,萨仁,等.补阳还五汤加减联合针灸治疗中风偏瘫[J].吉林中医药,2022,42(7):842-845.
[16] 李偲,姚弘毅,宋璐,等.温针灸辅以星蒌承气汤治疗老年脑梗死疗效及对患者神经功能,氧化应激指标的影响[J].陕西中医,2022,43(10):1474-1476.
[17] 邵建伟,胡赟赟,倪通天,等.急性脑梗死患者神经功能缺损与颈动脉粥样硬化斑块关系的临床研究[J].内科理论与实践,2021,16(1):32-36.
[18] 陈士炯,倪凌雁,任超,等.针刺配合补阳还五汤加减治疗对中风后肢体偏瘫患者康复的影响[J].实用临床医药杂志,2021,25(22):106-108,125.
[19] 苏俊,李鑫海.肢体缺血预适应联合超早期静脉溶栓减轻急性脑梗死患者神经功能缺损并改善预后[J].内科急危重症杂志,2021,27(6):493-496.