| 引用本文: |
黄翔, 陈梨花, 陈茜, 尹鹭峰.补阳还五汤联合针刺治疗气虚血瘀型后循环短暂性脑缺血发作的临床研究[J].湖南中医药大学学报,2026,46(5):925-931[点击复制] |
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| 补阳还五汤联合针刺治疗气虚血瘀型后循环短暂性脑缺血发作的临床研究 |
| 黄翔,陈梨花,陈茜,尹鹭峰 |
| (福建中医药大学附属第三人民医院, 福建 福州 350108) |
| 摘要: |
| 目的 探讨补阳还五汤联合针刺治疗气虚血瘀型后循环短暂性脑缺血发作（P-TIA）的临床疗效。方法 选取2024年7月至2025年7月就诊于福建中医药大学附属第三人民医院的P-TIA患者84例为研究对象，采用随机数字表法分为对照组、针刺组、中药组、联合组，每组21例。对照组予以常规西药治疗；中药组在常规西药治疗的基础上，予以补阳还五汤加味治疗；针刺组在常规西药治疗的基础上，予以针刺治疗（取穴：三阴交、水沟、内关、风池、百会、风府、大椎，1次/d）；联合组在常规西药治疗的基础上，予以补阳还五汤加味联合针刺治疗。疗程均为2周。采用肌电图/诱发电位仪测量各组患者治疗前后早反射（R1）、晚反射（R2）、Ⅲ波、Ⅴ波潜伏期；使用经颅多普勒超声检测各组患者治疗前后基底动脉（BA）、左椎动脉（LVA）及右椎动脉（RVA）的血流速度；采用眩晕残障评定量表（DHI）和眩晕评估评分量表（DARS）评估各组患者治疗前后的眩晕情况；比较各组患者治疗前后中医证候积分、治疗后临床疗效及复发率。结果 与治疗前比较，4组患者治疗后R1、R2、Ⅲ波、Ⅴ波的潜伏期均降低（P＜0.05），BA、LVA、RVA血流速度均增快（P＜0.05），DHI、DARS评分和中医证候积分均降低（P＜0.05）；与对照组比较，中药组、针刺组、联合组治疗后R1、R2、Ⅲ波、Ⅴ波的潜伏期均降低（P＜0.05），血流速度均增快（P＜0.05），DHI、DARS评分和中医证候积分均降低（P＜0.05）；与中药组、针刺组比较，联合组治疗后R1、R2、Ⅲ波、Ⅴ波的潜伏期均降低（P＜0.05），血流速度增快（P＜0.05），DHI、DARS评分和中医证候积分均降低（P＜0.05）；联合组临床总有效率（90.48%）高于对照组（76.19%）、中药组（85.71%）、针刺组（85.71%）（P＜0.05），且中药组（85.71%）和针刺组（85.71%）高于对照组（76.19%）（P＜0.05）；中药组、针刺组、联合组治疗后的复发率均低于对照组（P＜0.05），且联合组低于中药组、针刺组（P＜0.05）。结论 补阳还五汤联合针刺治疗可显著改善P-TIA患者的BR、BAEP及脑部血液循环，降低中医证候积分，改善临床症状。 |
| 关键词: 补阳还五汤|后循环短暂性脑缺血发作|针刺|随机对照试验|瞬目反射|脑干听觉诱发电位|血流动力学 |
| DOI：10.3969/j.issn.1674-070X.2026.05.007 |
| 投稿时间：2026-03-14 |
| 基金项目:福建省卫生健康青年科研课题（2023QNA080）；福建中医药大学校管课题临床专项（XB2024044）。 |
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| Clinical study on Buyang Huanwu Decoction combined with acupuncture in treating posterior circulation transient ischemic attack with qi deficiency and blood stasis pattern |
| HUANG Xiang, CHEN Lihua, CHEN Xi, YIN Lufeng |
| (The Third Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350108, China) |
| Abstract: |
| Objective To investigate the clinical efficacy of Buyang Huanwu Decoction (BYHWD) combined with acupuncture in treating posterior circulation transient ischemic attack (P-TIA) with qi deficiency and blood stasis pattern. Methods A total of 84 P-TIA patients admitted to the Third Affiliated Hospital of Fujian University of Traditional Chinese Medicine from July 2024 to July 2025 were selected as the study subjects. They were randomly divided into control group, acupuncture group, Chinese medicines group, and combination group using a random number table method, with 21 patients in each group. The control group received conventional Western medicine treatment. On this basis, the Chinese medicines group additionally received modified BYHWD; the acupuncture group additionally received acupuncture [acupoints: Sanyinjiao (SP6), Shuigou (GV26), Neiguan (PC6), Fengchi (GB20), Baihui (GV20), Fengfu (GV16), and Dazhui (GV14), once daily]. The combination group received modified BYHWD combined with acupuncture on the basis of conventional Western medicine treatment. The treatment duration for all groups was two weeks. An electromyography/evoked potential instrument was used to measure the latencies of early reflex (R1), late reflex (R2), wave Ⅲ, and wave Ⅴ before and after treatment. Transcranial Doppler ultrasound was used to measure blood flow velocities of the basilar artery (BA), left vertebral artery (LVA), and right vertebral artery (RVA). The Dizziness Handicap Inventory (DHI) and Dizziness Assessment Rating Scale (DARS) were used to assess vertigo before and after treatment. TCM pattern scores before and after treatment, clinical efficacy after treatment, and recurrence rates were compared among groups. Results Compared with before treatment, all four groups showed significant reductions in latencies of R1, R2, wave Ⅲ, and wave Ⅴ (P<0.05), significant increases in blood flow velocities of BA, LVA, and RVA (P<0.05), and significant reductions in DHI, DARS, and TCM pattern scores (P<0.05). Compared with the control group, the Chinese medicines, acupuncture, and combination groups showed significantly shorter latencies of R1, R2, wave Ⅲ, and wave Ⅴ (P<0.05), increased blood flow velocities (P<0.05), and reduced DHI, DARS, and TCM pattern scores (P<0.05). Compared with the Chinese medicines and acupuncture groups, the combination group showed significantly shorter latencies of R1, R2, wave Ⅲ, and wave Ⅴ (P<0.05), increased blood flow velocities (P<0.05), and reduced DHI, DARS, and TCM pattern scores (P<0.05). The total clinical effective rate in the combination group (90.48%) was higher than that in the control group (76.19%), the Chinese medicines group (85.71%), and the acupuncture group (85.71%) (P<0.05), and the rates in the Chinese medicines group (85.71%) and the acupuncture group (85.71%) were higher than those in the control group (76.19%) (P<0.05). The recurrence rates after treatment in the Chinese medicines group, acupuncture group, and combination group were all lower than those in the control group (P<0.05), and the recurrence rate in the combination group was lower than that in the Chinese medicines and acupuncture groups (P<0.05). Conclusion BYHWD combined with acupuncture can significantly improve the blink reflex (BR), brainstem auditory evoked potential (BAEP), and cerebral blood circulation in P-TIA patients, reduce TCM pattern scores, and alleviate clinical symptoms. |
| Key words: Buyang Huanwu Decoction|posterior circulation transient ischemic attack|acupuncture|randomized controlled trial|blink reflex|brainstem auditory evoked potential|hemodynamics |
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