复元通络汤结合针刺治疗气虚血瘀型脑梗死恢复期的疗效研究#br#

摘要/Abstract

摘要： 目的：探讨复元通络汤结合针刺在气虚血瘀型脑梗死患者恢复期中的治疗价值。方法：纳入我院2021年12月至2022年11月收治的气虚血瘀型脑梗死恢复期患者100例，按随机数字表法分为常规组与治疗组，每组各50例。常规组给予常规治疗，治疗组在常规组治疗的基础上加用复元通络汤结合针刺治疗。在疗程结束后，比较两组患者的治疗效果。分别在治疗前与疗程结束后评估两组患者的气虚血瘀证积分、简易运动功能（FMA）评分、Barthel指数（BI）评分、修正版跌倒效能量表（MFES）评分、Berg平衡量表（BBS）评分及起立-行走计时测试（TUGT）结果，并检测血清胰岛素样生长因子-1（IGF-1）、胶质纤维酸性蛋白（GFAP）、脑源性神经营养因子（BDNF）水平。观察两组患者不良反应发生率。结果：治疗组的治疗总有效率（94.00%）高于常规组（80.00%）（P＜0.05）。治疗后，两组患者气虚血瘀证各症状积分均低于治疗前，且治疗组低于常规组（P＜0.05）。治疗后，两组患者FMA、BI、MFES、BBS评分均高于治疗前，且治疗组FMA、BI、MFES、BBS评分均高于常规组（P＜0.05）。治疗后，两组患者TUGT时间均短于治疗前，且治疗组TUGT时间短于常规组（P＜0.05）。治疗后，两组患者血清IGF-1、BDNF水平均高于治疗前，且治疗组高于常规组；两组患者GFAP水平均低于治疗前，且治疗组低于常规组（P＜0.05）。治疗组患者不良反应发生率（10.00%）与常规组（4.00%）比较，差异无统计学意义（P＞0.05）。结论：气虚血瘀型脑梗死恢复期患者经复元通络汤结合针刺治疗，能进一步改善气虚血瘀症状，提升运动功能与总体疗效，作用机制可能与其对血清IGF-1、GFAP、BDNF水平的调控作用有关。

关键词: 脑梗死恢复期, 气虚血瘀, 复元通络汤, 针刺, 治疗效果

Abstract: Objective： To investigate the therapeutic value of Fuyuan Tongluo decoction combined with acupuncture in erebral infarction convalescence patients with Qi deficiency and blood stasis syndrome. Methods：100 cases of erebral infarction convalescence patients with Qi deficiency and blood stasis syndrome admitted to our hospital from December 2021 to November 2022 were included and divided into the conventional group and the treatment group according to random number table method，with 50 cases in each group. The conventional group was given conventional treatment， and the treatment group was treated with Fuyuan Tongluo decoction combined with acupuncture on the basis of conventional group. At the end of the treatment course， the therapeutic effect of the two groups was compared.The Qi deficiency and blood stasis syndrome score， Fugl-Meyer assessment (FMA) score， Barthel Index (BI) score， modified falls efficacy scale (MFES) score， Berg balance scale (BBS) score and timed up and go test (TUGT) were evaluated before and after treatment. The serum levels of insulin-like growth factor-1 (IGF-1)， glial fibrillary acid protein (GFAP) and brain-derived neurotrophic factor (BDNF) of the two groups of patients were detected before and after the treatment. The in cidence of adverse reactions inboth groups was observed. Results： The total effective rate of the treatment group (94.00%) was higher than that of the conventional group (80.00%) (P<0.05). After treatment， the symptom scores of Qi-deficiency and blood-stasis in both groups were lower than those before treatment， and the treatment group was lower than the conventional group (P<0.05). After treatment， the scores of FMA， BI， MFES and BBS in both groups were higher than those before treatment， and the scores of the treatment group were higher than the conventional group(P<0.05).After treatment， the TUGT time of patients in both groups was shorter than that before treatment， and the TUGT time of patients in the treatment groups was shorter than that of the conventional group (P<0.05).After treatment， the serum IGF-1 and BDNF levels of patients in both groups were higher than those before treatment， and the treatment group was higher than the conventional group.After treatment， the GFAP levels in both groups were lower than that before treatment， and the treatment group was lower than the conventional group(P<0.05). There was no statistical difference in the adverse reaction rate between the treatment group (10.00%) and the conventional group (4.00%) (P>0.05). Conclusion： Fuyuan Tongluo decoction combined with acupuncture treatment can further improve the symptoms of Qi deficiency and blood stasis， improve the motor function and the overall curative effect in erebral infarction convalescence patients with Qi deficiency and blood stasis syndrome. The mechanism of action may be related to the regulation of serum IGF-1， GFAP and BDNF levels.

Key words: Cerebral infarction convalescence, Qi deficiency and blood stasis, Fuyuan Tongluo decoction, Acupuncture, Therapeutic effect

中图分类号:

R743.3

陈振中, 陈晨, 朱化珍, 龚惠莉, 张燕玲, 陈吉, 陶剑青, 顾浏英, 黄叶婷. 复元通络汤结合针刺治疗气虚血瘀型脑梗死恢复期的疗效研究#br#[J]. 中国医药导刊, 2023, 25(10): 1002-1007.

CHEN Zhenzhong, CHEN Chen, ZHU Huazhen, GONG Huili, ZHANG Yanling, CHEN Ji, TAO Jianqing, GU Liuying, HUANG Yeting. Effects of Fuyuan Tongluo Decoction Combined with Acupuncture in the Treatment of Cerebral Infarction Convalescence Patients with Qi Deficiency and Blood Stasis Syndrome#br#[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(10): 1002-1007.

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