| 引用本文: |
王冰,陈秋菊.温针灸联合栝楼桂枝汤对脑卒中躯干控制能力障碍患者神经功能、生活质量的影响[J].湖南中医药大学学报,2022,42(8):1341-1346[点击复制] |
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| 温针灸联合栝楼桂枝汤对脑卒中躯干控制能力障碍患者神经功能、生活质量的影响 |
| 王冰,陈秋菊 |
| (衡水市人民医院, 河北 衡水 053000) |
| 摘要: |
| 目的 探讨温针灸联合栝楼桂枝汤对脑卒中躯干控制能力障碍患者神经功能、生活质量的影响。方法 选取2019年10月至2020年10月在本院接诊的脑卒中躯干控制能力障碍患者80例，按随机数字表法均分为2组。汤剂组40例给予栝楼桂枝汤单药治疗，联合组40例给予栝楼桂枝汤、温针灸联合治疗。评估比较两组神经功能、日常生活能力及心理状态，检测神经营养指标、脑血管血流动力学指标、躯干控制能力评分，分析两组疗效。结果 治疗后，两组美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分、汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety rating scale,HAMA)及轴索过度生长抑制因子-A (neurite outgrowth inhibitor-A,Nogo-A)表达低于治疗前，改良Barthel指数(modified Barthel index,MBI)、简式Fugl-Meyer (FMA)评分、Sdeikh躯干控制评分及血管内皮生长因子(vascular endothelial growth factor,VEGF)、脑源性神经生长因子(brain-derived neurotrophic factor,BDNF)表达高于治疗前，差异均有统计学意义（P＜0.05）；且联合组NIHSS评分、HAMA评分、HDMA评分及Nogo-A表达低于汤剂组，MBI评分、FMA评分、Sdeikh躯干控制评分及VEGF、BDNF表达高于汤剂组，差异均有统计学意义（P＜0.05）。治疗后，两组脑血管血流动力学指标较治疗前均有所改善，且联合组脑血管血流动力学指标改善优于汤剂组，差异均有统计学意义（P＜0.05）。联合组有效率高于汤剂组，差异有统计学意义（P＜0.05）。结论 在栝楼桂枝汤基础上辅以温针灸治疗脑卒中躯干控制能力障碍患者疗效显著，可减轻临床症状，改善躯干控制功能、神经功能及脑血管血流动力学，同时显著提升患者生活质量，效果理想。 |
| 关键词: 脑卒中 躯干控制能力障碍 温针灸 栝楼桂枝汤 神经功能 血流动力学 |
| DOI：10.3969/j.issn.1674-070X.2022.08.017 |
| 投稿时间：2021-12-17 |
| 基金项目:河北医学科学研究重点课题计划（20191775）。 |
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| Effect of warming needle moxibustion combined with Gualou Guizhi Decoction on neurological function and quality of life in stroke patients with trunk control disorder |
| WANG Bing,CHEN Qiuju |
| (Hengshui People's Hospital, Hengshui, Hebei 053000, China) |
| Abstract: |
| Objective To investigate the effect of warming needle moxibustion combined with Gualou Guizhi Decoction on neurological function and quality of life in stroke patients with trunk control disorder. Methods A total of 80 patients with stroke patients with trunk control disorder who were admitted to our hospital from October 2019 to October 2020 were selected. They were divided into two groups according to the random number table method. Forty cases in the decoction group were given the single-drug treatment of Gualou Guizhi Decoction, and 40 cases in the combination group were given the combined treatment of Gualou Guizhi Decoction and warming needle moxibustion. The neurological function, daily living ability and psychological state between the two groups were evaluated and compared. The neurotrophic index, cerebrovascular hemodynamic indexes, trunk control ability score were detected. The therapeutic effects of the two groups were analyzed. Results After treatment, the national institutes of health stroke scale (NIHSS) score, Hamilton depression rating scale (HAMD), and Hamilton anxiety rating scale (HAMA), and neurite outgrowth inhibitor-A (Nogo-A) expression were lower than before treatment, modified Barthel index (MBI), simplified Fugl-Meyer (FMA) score, Sdeikh trunk control score, vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF) expression were higher than before treatment, and the differences were statistically significant (P<0.05). The NIHSS score, HAMA, HDMA score and Nogo-A expression in the combination group were lower than those in the decoction group, and the MBI score, the FMA score, Sdeikh trunk control score, and the expression of VEGF and BDNF were higher than those in the decoction group, and the differences were statistically significant (P<0.05). After treatment, the cerebrovascular hemodynamic indexes of both groups were improved compared with those before treatment, and the improvement of cerebrovascular hemodynamic indexes in the combination group was better than that in the decoction group, the differences were statistically significant (P<0.05). The effective rate of the combination group was higher than that of the decoction group, and the difference was statistically significant (P<0.05). Conclusion On the basis of Gualou Guizhi Decoction, combined with warming needle moxibustion in the treatment of stroke patients with trunk control disorder has a significant therapeutic effects, relieves clinical symptoms, improves trunk control function, neurological function and cerebrovascular hemodynamics, and significantly improves the quality of life of patients, with ideal effect. |
| Key words: stroke trunk control disorder warming needle moxibustion Gualou Guizhi Decoction neurological function hemodynamics |
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