1.河南中医药大学康复医学院 郑州 450046
2.河南省中医院康复科
华晓琼,女,在读硕士生
#李彦杰,女,教授、主任医师,硕士生导师,E-mail:yanjieli2008@126.com
纸质出版日期:2023-01-30,
收稿日期:2022-04-15,
移动端阅览
华晓琼, 李彦杰, 秦合伟, 等. 循经放血疗法治疗卒中后风痰瘀阻证上肢感觉障碍的临床研究[J]. 现代中医临床, 2023,30(1):38-42.
HUA Xiaoqiong, LI Yanjie, QIN Hewei, et al. Clinical study on the treatment of post-stroke upper limb sensory disorders with wind-phlegm stasis using bloodletting along channels[J]. Modern Chinese Clinical Medicine, 2023,30(1):38-42.
华晓琼, 李彦杰, 秦合伟, 等. 循经放血疗法治疗卒中后风痰瘀阻证上肢感觉障碍的临床研究[J]. 现代中医临床, 2023,30(1):38-42. DOI: 10.3969/j.issn.2095-6606.2023.01.009.
HUA Xiaoqiong, LI Yanjie, QIN Hewei, et al. Clinical study on the treatment of post-stroke upper limb sensory disorders with wind-phlegm stasis using bloodletting along channels[J]. Modern Chinese Clinical Medicine, 2023,30(1):38-42. DOI: 10.3969/j.issn.2095-6606.2023.01.009.
目的
2
观察循经放血疗法治疗脑卒中后风痰瘀阻证上肢感觉障碍的临床疗效。
方法
2
将102例脑卒中后偏身感觉障碍患者随机分为治疗组51例、对照组51例。2组均采用基础治疗控制脑卒中原发病,对照组在基础治疗上予以常规康复训练治疗,治疗组在基础治疗上采用循经放血疗法。观察中医证候积分、Lindmark感觉功能评分、数字疼痛分级评分、体感诱发电位、FMA评分、Barthel指数评分、临床疗效。
结果
2
中医证候积分治疗组治疗后较本组降低(
P
<
0.05),治疗后治疗组较对照组降低明显,2组治疗前后差值比较,差异有统计学意义(
P
<
0.05),治疗组优于对照组。Lindmark感觉功能评分治疗组治疗后较本组升高(
P
<
0.05),数字麻木感积分治疗组治疗后较本组降低(
P
<
0.05),治疗后Lindmark感觉功能评分治疗组较对照组升高明显,数字疼痛分级积分治疗组较对照组降低明显,差异均有统计学意义(
P
<
0.05),治疗组均优于对照组。体感诱发电位治疗组治疗后较本组升高(
P
<
0.05),治疗后治疗组较对照组升高明显,2组治疗前后差值比较,差异有统计学意义(
P
<
0.05),治疗组优于对照组。FMA评分和Barthel指数评分治疗组治疗后均较本组升高(
P
<
0.05),治疗后FMA评分和Barthel指数评分治疗组较对照组均升高明显,差异均有统计学意义(
P
<
0.05),治疗组优于对照组。治疗组51例中,痊愈4例,显效13例,有效27例,无效7例,总有效率86.27%;对照组51例中,痊愈1例,显效11例,有效21例,无效18例,总有效率64.71%。经秩和检验,
Z
=-2.245,
P
<
0.05,说明治疗组疗效优于对照组。
结论
2
循经放血疗法治疗脑卒中后风痰瘀阻证上肢感觉障碍具有较好的临床疗效。
Objective
2
To observe the clinical efficacy of bloodletting along channels in the treatment of post-stroke upper limb sensory disorders with wind-phlegm stasis.
Methods
2
102 patients with post-stroke hemianesthesia were randomly divided into 51 in the treatment group and 51 in the control group
both of whom were treated with basic therapy for the stroke
while the control group was treated with conventional rehabilitation training on top of basic therapy and the treatment group was given additional bloodletting along channels. The TCM symptom scores
Lindmark sensory function scores
pain scores
somatosensory evoked potentials (SEP)
FMA scores
Barthel index scores and clinical efficacy were observed.Results TCM symptom scores dropped in the treatment group compared after treatment (
P
<
0.05)
and the decrease was greater in the treatment group compared with the control group after treatment. The difference between the two groups before and after treatment was statistically significant (
P
<
0.05)
and the treatment group was better than the control group. The Lindmark sensory function scores were significantly higher in the treatment group than in the control group
and the numbness scores were significantly lower in the treatment group than in the control group. The difference between the two groups before and after treatment was statistically significant (
P
<
0.05)
and the treatment group was better than the control group. SEP was elevated in the treatment group tfter treatment (
P
<
0.05)
and SEP in the treatment group was greater than in the control group after treatment
and the difference between the two groups before and after treatment was statistically significant (
P
<
0.05)
and the treatment group was better than the control group. FMA scores and Barthel scores were significantly higher in the treatment group than in the control group
and the differences were statistically significant (
P
<
0.05)
and the treatment group was superior to the control group. Among 51 cases in the treatment group
4 were cured
13 markedly effective
27 moderately effective
and 7 not effective
with a total effective rate of 86.27%. Among 51 cases in the control group
1 was cured
11 markedly effective
21 moderately effective
and 18 not effective
with a total effective rate of 64.71%. By rank sum test
Z
=-2.245
P
<
0.05
indicating that the efficacy in the treatment group was better than that in the control group.
Conclusion
2
Bloodletting along channels therapy has good clinical efficacy in the treatment of post-stroke upper limb sensory disorders with wind-phlegm stasis.
脑卒中风痰瘀阻证偏身感觉障碍循经放血
strokewind-phlegm stagnationhemianesthesiabloodletting along channels
JOHNSON W,ONUMA O,OWOLABI M,et al.Stroke:a global response is needed[J/OL].Bull World Health Organ,2016,94(9):634[2022-05-17].https://doi.org/10.2471/BLT.16.181636.
梁天佳,龙耀斌,周开斌,等.谐振治疗对脑卒中偏瘫上肢痉挛和运动功能的影响[J].实用医学杂志,2017,33(10): 1628-1630.
钟晓燕,彭生辉,汪孝红,等.镜像视觉反馈疗法对脑卒中后上肢功能康复的研究进展[J].实用医学杂志,2018,34(8): 1383-1386.
贾建平,陈生弟.神经病学[M].北京:人民卫生出版社,2018: 186-195.
厚晓昀,戴智勇,徐延庭.针刺结合中药治疗中风后偏身感觉障碍患者的疗效观察及安全性评价[J].河北医药,2017,39(1): 122-123,126.
安菊平.中西医结合综合治疗脑卒中后感觉障碍的临床价值[J].临床医药文献电子杂志,2016,3(42): 8364.
王陶陶,古剑雄.脑卒中后手运动功能障碍的康复治疗进展[J].中西医结合心脑血管病杂志,2021,19(22): 3920-3922.
中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点(1995)[J].临床和实验医学杂志,2013,12(7): 559.
国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1): 55-56.
张通.中国脑卒中康复治疗指南(2011完全版)[J].中国康复理论与实践,2012,18(4): 301-318.
中华医学会神经病学分会神经康复学组.中国脑卒中康复治疗指南(2011完全版)[J].中国医学前沿杂志:电子版,2012,4(6): 55-76.
高小月,侯黎莉,商丽艳.Barthel指数评估操的制定及多中心应用研究[J].护理学杂志,2018,33(9): 49-51.
郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002: 101-102.
闵瑜,吴媛媛,燕铁斌.改良Barthel指数(简体中文版)量表评定脑卒中患者日常生活活动能力的效度和信度研究[J].中华物理医学与康复杂志,2008,30(3): 185-188.
余智.病灶头皮反射区埋线治疗脑卒中后感觉障碍临床研究[J].中国针灸,2014,34(7): 631-635.
申晓光,马将,王晓芳,等.轻点刺络法联合早期康复治疗对脑卒中后偏身感觉障碍的临床研究[J].中国中医急症,2019,28(11): 1976-1979.
严莉,李晶,卫义兰,等.轻点刺络法联合针刺对脑卒中偏身感觉障碍患者感觉功能和生活质量的影响[J].现代中西医结合杂志,2019,28(17): 1856-1860.
金泽,刘承薇.针刺结合刺络疗法治疗中风后偏身感觉障碍的临床观察[J].针灸临床杂志,2013,29(7): 25-26.
王丛军,蔡圣朝.刺络放血疗法的临床研究进展[J].甘肃中医学院学报,2012,1(2): 65-67.
庄竞翔.腕踝针治疗气虚血瘀型脑卒中偏身感觉障碍的临床观察[D].福州:福建中医药大学,2018.
陈明,孔繁智,朱婉萍.论麻、木之异[J].中华中医药杂志,2013,28(8): 2236-2238.
杨继洲.针灸大成[M].靳贤,补辑重编.黄龙祥,整理.北京:人民卫生出版社,2006: 13-14.
0
浏览量
84
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构