从心胆论治针灸治疗脑梗死的临床研究
|
摘要
背景：
脑梗死(cerebral infarction)又称缺血性脑卒中(cerebral ischemic stroke),是指各种原因引起的脑部液供应障碍,使局部脑组织发生不可逆性损伤,导致组织缺血、缺氧性坏死。我国急性脑血管病的发病率和死亡率均居各种疾病之首,65岁以上人群组疾病死亡率高达719/10万,其中急性脑梗死约占50%-70%。随着社会高龄化,患者的发病率有上升趋势,其中脑梗死患者为临床最为常见,也是针灸临床中最为常见的病种之一。有文献报导,脑梗死的发病率不断提高,存在轻型化趋势,如腔隙性梗塞在所有脑梗死患者中占30.45%。随着现代医学的不断进展,脑梗死的死亡率较前虽有所降低,但致残率、复发率仍很高,严重危害着中老年人的健康水平和生活质量,给患者带来巨大的身心痛苦和沉重的经济负担,因此对脑梗死脑血管病研究和防治已成为当今我国重大的公共卫生问题。
目的：
观察从心胆论治针刺治疗气虚血瘀型脑梗死的临床疗效及生活质量的增效性,为提高临床上治疗本型脑梗死的疗效提供更丰富的方案和依据。
方法：
采用简单随机的方法,将130例龙兴中医诊所脑梗死患者按纳入排除标准进行筛选,共纳入受试者124例,按1：1的比例分为治疗组62例和对照组62例。
治疗组进行从心胆论治针灸+中药的整合治疗方案,针刺选穴百会、印堂、内关、曲泽、极泉、阳陵泉、丘墟、足窍阴,腹部穴位中脘、下脘、气海、关元,背部穴位膈俞、胆俞,耳针穴位心、胆。以上穴位按躯体左右分为2组,隔天轮流使用。针刺留针30分钟,留针期间每10分钟行针一次。出针后对腹部及背部穴位进行麦粒灸,每穴5壮,灸疗结束后再在所取耳穴埋入图钉型皮内针,胶布固定,留针3天。治疗每周5次,共治疗4个疗程。中药选用补阳还五汤加减：黄芪30g、川芎12g、当归12g、桃仁12g、红花12g、地龙10g、赤芍15g、石菖蒲15g、远志12g,上肢偏瘫重者加桑枝,下肢偏瘫重者加牛膝、续断。水煎服至500m1,每日1剂,早晚分服、温服。对照组单纯服用中药的治疗方案,方选补阳还五汤加减,方药及煎服法均同治疗组。
采用美国国立卫生研究院卒中量表(NIHSS)及脑卒中专门化生活质量量表(SS-QOL)对结局进行评价,同时对人口学资料,症状及体征和中医症候积分变化进行评价,治疗前后各评价一次。使用EpiDate3.1软件进行数据录入,采用双录入法,以保证数据录入的真实性、准确性和完整性。录入后采用SPSS18.0统计分析软件进行分析处理,一般资料采用描述性分析,计量资料数据以均数±标准差表示,治疗前后比较采用配对t检验、组间比较采用独立样本t检验,计数资料及等级数据采用χ2检验。
结果：
(1)基线比较
人口学资料方面,两组在年龄、性别、文化程度、职业、病程及并发症等一般资料方面差异均无统计学意义(P>0.05),说明本研究中两组患者在治疗前不存在选择性偏倚等的可能性,两组具有可比性。
脑梗死发病的危险因素方面,高血压、高脂血症、糖尿病、心脏疾病(冠心病等)是主要危险因素,与急性脑梗死的发病有直接关系。调查本研究中124例入选的病例发现,在患有这几类高危因素的人群中,其中高血压病81例(占65.32%),高脂血症70例(占56.45%),糖尿病60例(占48.39%),心脏疾病33例(占26.61%),两组四类疾病的既往病史经卡方检验P值均大于0.05,均无统计学意义,说明本研究所纳入的患者中这四类因素仍为脑梗死的主要危险因素,但其并不影响本研究中对结局的判定。
各量表基线比较方面,治疗前两组症状及体征经卡方检验,症状及体征差异无统计学意义(P>0.05),说明治疗前两组症状及体征不存在偏倚；两组治疗前NIHSS评分比较差异无统计学意义(P>0.05),说明治疗前两组病人NIHSS评分无明显差异,两组具有可比性。治疗前两组患者SS-QOL生活质量12个维度得分比较,差异均无统计学意义(P>0.05),说明两组脑梗死患者的生活质量的各维度均具有可比性。
(2)主要临床症状方面,治疗后两组患者半身不遂、言语蹇涩或补语、口舌歪斜等评分比较与治疗前比较,差异有统计学意义(P<0.05),说明治疗后两组患者的上述症状均较治疗前好转。说明心胆针灸+中药治疗法在改善上述症状方面较单纯中药治疗更为有效。
(3)结局比较
主要结局指标方面,组内比较结果显示,治疗后两组NIHSS评分与治疗前比较,差异有统计学意义(P<0.05),说明干预后患者有好转。组间比较结果显示,治疗后两组NIHSS评分比较,差异有统计学意义(P<0.05),说明心胆针灸+中药治疗法在降低NIHSS评分方面较单纯中药治疗更有效果。
生活质量评价方面,两组治疗前与治疗后相比(P<0.01),差异有显著统计学意义；治疗后治疗组与对照组脑梗死患者生活质量总分比较,差别有统计学意义(P<0.05)。组内比较说明两种治疗方案均能改善患者的生活质量；组间比较提示,从心胆论治针灸+中药的治疗方案对于改善患者的生活质量方面更优于单纯中药的治疗方案。
生活质量各维度比较方面,治疗后两组患者生活质量12个维度得分比较,其中语言、活动能力、情绪、个性、自理能力、社会角色、上肢功能、工作或劳动8个维度得分相比,差异均有统计学意义(P<0.05),说明针灸+中药的治疗对改善脑梗死患者躯体运动功能及语言神志方面的8个维度优于单纯中药治疗。
(4)临床有效率方面,治疗后,治疗组总有效率为80.64%,对照组总有效率为66.13%,两组差异比较有统计学意义(P<0.05),提示针灸+中药治疗对脑梗死的治疗效果优于单纯应用中药治疗,提示临床治疗本病当加入针灸治疗为佳。从中医疗效评价指标来看,治疗组的总有效率为85.48%,对照组总有效率为62.90%,两组比较差异有统计学意义(P<0.05),提示针灸+中药组可以明显改善脑梗死病人的中医症候。
(5)安全性方面,经临床观察,治疗组在针刺后未出现晕针、断针等不良反应。两组患者在使用药物后均未出现皮疹、发热、恶心呕吐等不良反应,治疗后经复查血、尿、便常规、肝、肾功能未发现异常改变。提示本研究两种疗法治疗脑梗死急性期、恢复期均安全有效。
结论：
1.高血压、高脂血症、糖尿病、心脏疾病(冠心病等)这四类疾病是引起脑梗死的主要危险因素；
2.从心胆论治针灸+中药治疗气虚血瘀型脑梗死的整合治疗方案较单纯中药治疗疗效确切,通过治疗不仅能缓解患者的症状,而且能较全面的改善本病患者的生活质量。从心胆论治的针灸方案有较好的临床增效作用,是一种有效可行的方案。
Background
Cerebral infarction, also known as ischemic stroke (cerebral ischemic stroke), refers to a variety of causes brain fluid supply bottlenecks, the local brain tissue irreversible damage occurs, resulting in tissue ischemia, hypoxia necrosis. The morbidity and mortality of acute cerebrovascular disease are on the top of the various diseases. Mortality rate of people who over65is as high as719/10000[1], of which about50%-70%is acute cerebral infarction [2]. With an aging population, there is an upward trend in the mobildity of patients, of which patients with cerebral infarction is clinically the most common one, and is also one of the most common clinical acupuncture disease [3]. Literature reported that the mobidity of cerebral infarction continue to increase, and there is a trend of younger patients, and30.45%of all patients with cerebral infarction are lacunar infarction [4]. With the progressing of modern medicine, the mortality rate of cerebral infarction decreased, but despite the reduced morbidity, the disability rate and recurrence rate is still high, which seriously endangering the health and quality of life of the middle-aged and elderly, which could cause a huge physical and mental suffering and a heavy economic burden. Thus, cerebral infarction and cerebrovascular disease research and control has become a major public health program in our country today.
Objective
To study the synergia clinical efficacy and quality of life of acupuncture treatment in terms of Heart-Gallbladder therapy for cerebral infarction, providing a richer therapeutic schedule and evidence to improve the clinical efficacy of treating cerebral infarction.
Methods
A simple random method was used for the study, and according to the inclusion and exclusion criteria,124of130cases of Neurology ward patients with cerebral infarction were incorporating, who were divided into a treat group of62patients and a control group of62patients at a1:1ratio.
Patients in treat group were treated with acupuncture with Chinese herbal medicine treatment in terms of Heart-Gallbladder therapy, acupuncture points selection were DU20, EX-HN3, PC6, PC3, HT1, GB34, GB40, GB44, and abdominal acupuncture points including RN12, RN10, RN6, RN4, and back-shu points such as BL17, BL19, and heart and gall bladder of auricular point. All acupuncture points above were divided into two groups by left and right, and take turns for using the next day. Acupuncture for30minutes, and manipulating the needle once every10minutes. Seed-sized moxa cone moxibustion was used after the acupuncture, and5moxa cones per acupoint, auricular were taken after the end of the moxibustion, which will buried a thumbtack-like intradermal needle and tape securely for3days. All treatment were five times a week, totally four weeks for treatment. Chinese herbal medicine was buyang huanwu decoction: Astragalus30g, Chuan Xiong12g, Angelica12g, peach kernel12g, safflower12g, earthworm10g, red peony root15g, the gramineus15g, the Polygala12g, Ghassan sticks for the heavy upper limb hemiplegia, lower extremity hemiplegia plus bidentata, Dipsacus, hemiplegia course of time and leeches, Kouyanwaixie plus silkworm, white aconite. All herbs were cooked in water till500ml, qd. The control group were taking Chinese herbal medicine treatment, and the priscribtion and administration references the treatment group.
National Inst i tutes of Health Stroke Scale (NIHSS) and stroke specialized Quality of Life Scale (SS-QOL) was used to evaluate the outcomes, demographic data, symptoms and signs and symptom scores changes were evaluated before and after treatment. Use EpiDate3.1software for data entry, with double entry method, in order to ensure the authenticity, accuracy and completeness of data. Using SPSS18.0statistical analysis software for analysis and processing, general descriptive analysis, measurement data were expressed as mean±standard deviation, before and after treatment using paired t test groups were compared using independent sample t test, count data and grade data using χ2test.
Results
(1) Baseline comparison
Demographic data, the two groups in terms of age, sex, education, occupation, duration and complications of general information was no significant different (P>0.05), indicating that the two groups of patients before treatment does not exist the possibility of selection bias in the two groups were comparable.
Risk factors for cerebral infarction, hypertension, hyperlipidemia, diabetes, heart disease (CHD) is a major risk factor is directly related to the incidence of acute cerebral infarction, Investigation in this study124patients selected cases found in the crowd with these types of risk factors, hypertension in81cases (65.32%), hyperlipidemia in70cases (56.45%),60cases of diabetes (48.39%), heart disease in33cases (26.61%), past medical history of two groups of four categories of disease by chi-square test P values were greater than0.05, were not statistically significant, indicating that the four of the patients included in the study class factor is still the major risk factors for cerebral infarction, but it does not affect the outcome of this study.
Compared to the scales'baseline, the two groups before treatment symptoms and signs by the chi-square test, symptoms and signs of the difference was not statistically significant (P>0.05) Before treatment, the symptoms and signs of bias does not exist; treatment in both groups before the NIHSS scores was no significant difference (P>0.05), the two groups of patients before treatment NIHSS score no significant difference between two groups were comparable. Before treatment, the12dimensions of the two groups of patients quality of life score comparison, the difference was not statistically significant (P>0.05), description of each dimension of the quality of life of the two groups of patients with cerebral infarction were comparable.
(2) The main clinical symptoms, After treatment, hemiplegia, speech Jian astringent or complement, mouth askew score compared with before treatment, the difference was statistically significant (P<0.05), After treatment the Symptoms improved than before treatment. Description heart bile Acupuncture+Chinese medicine therapy compared with traditional Chinese medicine treatment is more effective in improving the symptoms.
(3) Outcome comparison
The primary outcome measure, the comparative results for the group, NIHSS score of the two groups after treatment compared with before treatment, the difference was statistically significant (P<0.05), patients improved after the intervention. Group comparison results showed that after treatment, the NIHSS score the two groups, the difference was statistically significant (P <0.05) Description heart bile Acupuncture+Chinese medicine therapy in reducing NIHSS score compared with traditional Chinese medicine treatment more effective.
Evaluation of qual ity of life, compared two groups before treatment and after treatment (P<0.01), the difference was statistically significant; treatment group and control group after treatment in patients with cerebral infarction quality of li fe score, the difference was statistically significant (P<0.05). The group compared the two treatment regimens can improve the patient's quality of life; between the two groups prompted from heart bile On Governance Acupuncture+Chinese medicine treatment options to improve the patient's quality of life is better than pure traditional Chinese medicine treatment options.
The quality of life of each dimension comparisons, the12dimensions of the two groups of patients quality of life after treatment score comparison, language, activity, mood, personality, self-care ability, social roles, upper limb function, work or labor eight scores relative differences were statistically significant (P<0.05), Acupuncture+Chinese medicine treatment to improve cerebral infarction in patients with somatic motor functions and language consciousness eight dimensions better than Chinese medicine treatment.
(4) For clinical efficient comparison, the total effective rate of80.64%, total effective rate was66.13%in the control group, the difference was statistically significant (P<0.05), prompted Acupuncture+Chinese medicine treatment of brain infarction is better than the simple application of traditional Chinese medicine treatment, suggesting that the clinical treatment of the disease when adding acupuncture treatment is better. Judging from the TCM Therapeutic Evaluation of the treatment group total effective rate was85.48%, total effective rate was62.90%in the control group, the difference was statistically significant (P<0.05), prompted Acupuncture+Chinese Medicines can significantly improve the brain TCM symptoms of infarction patients.
(5) For security comparison, by clinical observation, the treatment group after acupuncture does not appear fainting, needle and other adverse reactions. Two groups of patients were not there in the use of drugs rash, fever, nausea, vomiting and other adverse reactions, treatment after review of blood, urine, stool routine, liver and kidney function found no abnormal changes. Prompted this study, patients in both treatment of acute cerebral infarction, recovery are safe and effective.
Conclusion
1. Hypertension, hyperlipidemia, diabetes, heart disease (CHD) are four categories of diseases as major risk factors for cerebral infarction;
2. Compared to Chinese herbal medi cine treatment, the integrative theory of acupuncture and moxibustion in terms of Hear-Gallbladder therapy+Chinese herbal medicine treatment for cerebral infarction (Qi deficiency and blood stasis in TCM) has a more exactly efficacy, which can not only alleviate the symptoms, but also overall improve the quality of life of the patients. Acupuncture and moxibustion in terms of Hear-Gallbladder therapy has a synergia clinical efficacy, and it is an effective and feasible solution.
脑梗死(cerebral infarction)又称缺血性脑卒中(cerebral ischemic stroke),是指各种原因引起的脑部液供应障碍,使局部脑组织发生不可逆性损伤,导致组织缺血、缺氧性坏死。我国急性脑血管病的发病率和死亡率均居各种疾病之首,65岁以上人群组疾病死亡率高达719/10万,其中急性脑梗死约占50%-70%。随着社会高龄化,患者的发病率有上升趋势,其中脑梗死患者为临床最为常见,也是针灸临床中最为常见的病种之一。有文献报导,脑梗死的发病率不断提高,存在轻型化趋势,如腔隙性梗塞在所有脑梗死患者中占30.45%。随着现代医学的不断进展,脑梗死的死亡率较前虽有所降低,但致残率、复发率仍很高,严重危害着中老年人的健康水平和生活质量,给患者带来巨大的身心痛苦和沉重的经济负担,因此对脑梗死脑血管病研究和防治已成为当今我国重大的公共卫生问题。
目的：
观察从心胆论治针刺治疗气虚血瘀型脑梗死的临床疗效及生活质量的增效性,为提高临床上治疗本型脑梗死的疗效提供更丰富的方案和依据。
方法：
采用简单随机的方法,将130例龙兴中医诊所脑梗死患者按纳入排除标准进行筛选,共纳入受试者124例,按1：1的比例分为治疗组62例和对照组62例。
治疗组进行从心胆论治针灸+中药的整合治疗方案,针刺选穴百会、印堂、内关、曲泽、极泉、阳陵泉、丘墟、足窍阴,腹部穴位中脘、下脘、气海、关元,背部穴位膈俞、胆俞,耳针穴位心、胆。以上穴位按躯体左右分为2组,隔天轮流使用。针刺留针30分钟,留针期间每10分钟行针一次。出针后对腹部及背部穴位进行麦粒灸,每穴5壮,灸疗结束后再在所取耳穴埋入图钉型皮内针,胶布固定,留针3天。治疗每周5次,共治疗4个疗程。中药选用补阳还五汤加减：黄芪30g、川芎12g、当归12g、桃仁12g、红花12g、地龙10g、赤芍15g、石菖蒲15g、远志12g,上肢偏瘫重者加桑枝,下肢偏瘫重者加牛膝、续断。水煎服至500m1,每日1剂,早晚分服、温服。对照组单纯服用中药的治疗方案,方选补阳还五汤加减,方药及煎服法均同治疗组。
采用美国国立卫生研究院卒中量表(NIHSS)及脑卒中专门化生活质量量表(SS-QOL)对结局进行评价,同时对人口学资料,症状及体征和中医症候积分变化进行评价,治疗前后各评价一次。使用EpiDate3.1软件进行数据录入,采用双录入法,以保证数据录入的真实性、准确性和完整性。录入后采用SPSS18.0统计分析软件进行分析处理,一般资料采用描述性分析,计量资料数据以均数±标准差表示,治疗前后比较采用配对t检验、组间比较采用独立样本t检验,计数资料及等级数据采用χ2检验。
结果：
(1)基线比较
人口学资料方面,两组在年龄、性别、文化程度、职业、病程及并发症等一般资料方面差异均无统计学意义(P>0.05),说明本研究中两组患者在治疗前不存在选择性偏倚等的可能性,两组具有可比性。
脑梗死发病的危险因素方面,高血压、高脂血症、糖尿病、心脏疾病(冠心病等)是主要危险因素,与急性脑梗死的发病有直接关系。调查本研究中124例入选的病例发现,在患有这几类高危因素的人群中,其中高血压病81例(占65.32%),高脂血症70例(占56.45%),糖尿病60例(占48.39%),心脏疾病33例(占26.61%),两组四类疾病的既往病史经卡方检验P值均大于0.05,均无统计学意义,说明本研究所纳入的患者中这四类因素仍为脑梗死的主要危险因素,但其并不影响本研究中对结局的判定。
各量表基线比较方面,治疗前两组症状及体征经卡方检验,症状及体征差异无统计学意义(P>0.05),说明治疗前两组症状及体征不存在偏倚；两组治疗前NIHSS评分比较差异无统计学意义(P>0.05),说明治疗前两组病人NIHSS评分无明显差异,两组具有可比性。治疗前两组患者SS-QOL生活质量12个维度得分比较,差异均无统计学意义(P>0.05),说明两组脑梗死患者的生活质量的各维度均具有可比性。
(2)主要临床症状方面,治疗后两组患者半身不遂、言语蹇涩或补语、口舌歪斜等评分比较与治疗前比较,差异有统计学意义(P<0.05),说明治疗后两组患者的上述症状均较治疗前好转。说明心胆针灸+中药治疗法在改善上述症状方面较单纯中药治疗更为有效。
(3)结局比较
主要结局指标方面,组内比较结果显示,治疗后两组NIHSS评分与治疗前比较,差异有统计学意义(P<0.05),说明干预后患者有好转。组间比较结果显示,治疗后两组NIHSS评分比较,差异有统计学意义(P<0.05),说明心胆针灸+中药治疗法在降低NIHSS评分方面较单纯中药治疗更有效果。
生活质量评价方面,两组治疗前与治疗后相比(P<0.01),差异有显著统计学意义；治疗后治疗组与对照组脑梗死患者生活质量总分比较,差别有统计学意义(P<0.05)。组内比较说明两种治疗方案均能改善患者的生活质量；组间比较提示,从心胆论治针灸+中药的治疗方案对于改善患者的生活质量方面更优于单纯中药的治疗方案。
生活质量各维度比较方面,治疗后两组患者生活质量12个维度得分比较,其中语言、活动能力、情绪、个性、自理能力、社会角色、上肢功能、工作或劳动8个维度得分相比,差异均有统计学意义(P<0.05),说明针灸+中药的治疗对改善脑梗死患者躯体运动功能及语言神志方面的8个维度优于单纯中药治疗。
(4)临床有效率方面,治疗后,治疗组总有效率为80.64%,对照组总有效率为66.13%,两组差异比较有统计学意义(P<0.05),提示针灸+中药治疗对脑梗死的治疗效果优于单纯应用中药治疗,提示临床治疗本病当加入针灸治疗为佳。从中医疗效评价指标来看,治疗组的总有效率为85.48%,对照组总有效率为62.90%,两组比较差异有统计学意义(P<0.05),提示针灸+中药组可以明显改善脑梗死病人的中医症候。
(5)安全性方面,经临床观察,治疗组在针刺后未出现晕针、断针等不良反应。两组患者在使用药物后均未出现皮疹、发热、恶心呕吐等不良反应,治疗后经复查血、尿、便常规、肝、肾功能未发现异常改变。提示本研究两种疗法治疗脑梗死急性期、恢复期均安全有效。
结论：
1.高血压、高脂血症、糖尿病、心脏疾病(冠心病等)这四类疾病是引起脑梗死的主要危险因素；
2.从心胆论治针灸+中药治疗气虚血瘀型脑梗死的整合治疗方案较单纯中药治疗疗效确切,通过治疗不仅能缓解患者的症状,而且能较全面的改善本病患者的生活质量。从心胆论治的针灸方案有较好的临床增效作用,是一种有效可行的方案。
Background
Cerebral infarction, also known as ischemic stroke (cerebral ischemic stroke), refers to a variety of causes brain fluid supply bottlenecks, the local brain tissue irreversible damage occurs, resulting in tissue ischemia, hypoxia necrosis. The morbidity and mortality of acute cerebrovascular disease are on the top of the various diseases. Mortality rate of people who over65is as high as719/10000[1], of which about50%-70%is acute cerebral infarction [2]. With an aging population, there is an upward trend in the mobildity of patients, of which patients with cerebral infarction is clinically the most common one, and is also one of the most common clinical acupuncture disease [3]. Literature reported that the mobidity of cerebral infarction continue to increase, and there is a trend of younger patients, and30.45%of all patients with cerebral infarction are lacunar infarction [4]. With the progressing of modern medicine, the mortality rate of cerebral infarction decreased, but despite the reduced morbidity, the disability rate and recurrence rate is still high, which seriously endangering the health and quality of life of the middle-aged and elderly, which could cause a huge physical and mental suffering and a heavy economic burden. Thus, cerebral infarction and cerebrovascular disease research and control has become a major public health program in our country today.
Objective
To study the synergia clinical efficacy and quality of life of acupuncture treatment in terms of Heart-Gallbladder therapy for cerebral infarction, providing a richer therapeutic schedule and evidence to improve the clinical efficacy of treating cerebral infarction.
Methods
A simple random method was used for the study, and according to the inclusion and exclusion criteria,124of130cases of Neurology ward patients with cerebral infarction were incorporating, who were divided into a treat group of62patients and a control group of62patients at a1:1ratio.
Patients in treat group were treated with acupuncture with Chinese herbal medicine treatment in terms of Heart-Gallbladder therapy, acupuncture points selection were DU20, EX-HN3, PC6, PC3, HT1, GB34, GB40, GB44, and abdominal acupuncture points including RN12, RN10, RN6, RN4, and back-shu points such as BL17, BL19, and heart and gall bladder of auricular point. All acupuncture points above were divided into two groups by left and right, and take turns for using the next day. Acupuncture for30minutes, and manipulating the needle once every10minutes. Seed-sized moxa cone moxibustion was used after the acupuncture, and5moxa cones per acupoint, auricular were taken after the end of the moxibustion, which will buried a thumbtack-like intradermal needle and tape securely for3days. All treatment were five times a week, totally four weeks for treatment. Chinese herbal medicine was buyang huanwu decoction: Astragalus30g, Chuan Xiong12g, Angelica12g, peach kernel12g, safflower12g, earthworm10g, red peony root15g, the gramineus15g, the Polygala12g, Ghassan sticks for the heavy upper limb hemiplegia, lower extremity hemiplegia plus bidentata, Dipsacus, hemiplegia course of time and leeches, Kouyanwaixie plus silkworm, white aconite. All herbs were cooked in water till500ml, qd. The control group were taking Chinese herbal medicine treatment, and the priscribtion and administration references the treatment group.
National Inst i tutes of Health Stroke Scale (NIHSS) and stroke specialized Quality of Life Scale (SS-QOL) was used to evaluate the outcomes, demographic data, symptoms and signs and symptom scores changes were evaluated before and after treatment. Use EpiDate3.1software for data entry, with double entry method, in order to ensure the authenticity, accuracy and completeness of data. Using SPSS18.0statistical analysis software for analysis and processing, general descriptive analysis, measurement data were expressed as mean±standard deviation, before and after treatment using paired t test groups were compared using independent sample t test, count data and grade data using χ2test.
Results
(1) Baseline comparison
Demographic data, the two groups in terms of age, sex, education, occupation, duration and complications of general information was no significant different (P>0.05), indicating that the two groups of patients before treatment does not exist the possibility of selection bias in the two groups were comparable.
Risk factors for cerebral infarction, hypertension, hyperlipidemia, diabetes, heart disease (CHD) is a major risk factor is directly related to the incidence of acute cerebral infarction, Investigation in this study124patients selected cases found in the crowd with these types of risk factors, hypertension in81cases (65.32%), hyperlipidemia in70cases (56.45%),60cases of diabetes (48.39%), heart disease in33cases (26.61%), past medical history of two groups of four categories of disease by chi-square test P values were greater than0.05, were not statistically significant, indicating that the four of the patients included in the study class factor is still the major risk factors for cerebral infarction, but it does not affect the outcome of this study.
Compared to the scales'baseline, the two groups before treatment symptoms and signs by the chi-square test, symptoms and signs of the difference was not statistically significant (P>0.05) Before treatment, the symptoms and signs of bias does not exist; treatment in both groups before the NIHSS scores was no significant difference (P>0.05), the two groups of patients before treatment NIHSS score no significant difference between two groups were comparable. Before treatment, the12dimensions of the two groups of patients quality of life score comparison, the difference was not statistically significant (P>0.05), description of each dimension of the quality of life of the two groups of patients with cerebral infarction were comparable.
(2) The main clinical symptoms, After treatment, hemiplegia, speech Jian astringent or complement, mouth askew score compared with before treatment, the difference was statistically significant (P<0.05), After treatment the Symptoms improved than before treatment. Description heart bile Acupuncture+Chinese medicine therapy compared with traditional Chinese medicine treatment is more effective in improving the symptoms.
(3) Outcome comparison
The primary outcome measure, the comparative results for the group, NIHSS score of the two groups after treatment compared with before treatment, the difference was statistically significant (P<0.05), patients improved after the intervention. Group comparison results showed that after treatment, the NIHSS score the two groups, the difference was statistically significant (P <0.05) Description heart bile Acupuncture+Chinese medicine therapy in reducing NIHSS score compared with traditional Chinese medicine treatment more effective.
Evaluation of qual ity of life, compared two groups before treatment and after treatment (P<0.01), the difference was statistically significant; treatment group and control group after treatment in patients with cerebral infarction quality of li fe score, the difference was statistically significant (P<0.05). The group compared the two treatment regimens can improve the patient's quality of life; between the two groups prompted from heart bile On Governance Acupuncture+Chinese medicine treatment options to improve the patient's quality of life is better than pure traditional Chinese medicine treatment options.
The quality of life of each dimension comparisons, the12dimensions of the two groups of patients quality of life after treatment score comparison, language, activity, mood, personality, self-care ability, social roles, upper limb function, work or labor eight scores relative differences were statistically significant (P<0.05), Acupuncture+Chinese medicine treatment to improve cerebral infarction in patients with somatic motor functions and language consciousness eight dimensions better than Chinese medicine treatment.
(4) For clinical efficient comparison, the total effective rate of80.64%, total effective rate was66.13%in the control group, the difference was statistically significant (P<0.05), prompted Acupuncture+Chinese medicine treatment of brain infarction is better than the simple application of traditional Chinese medicine treatment, suggesting that the clinical treatment of the disease when adding acupuncture treatment is better. Judging from the TCM Therapeutic Evaluation of the treatment group total effective rate was85.48%, total effective rate was62.90%in the control group, the difference was statistically significant (P<0.05), prompted Acupuncture+Chinese Medicines can significantly improve the brain TCM symptoms of infarction patients.
(5) For security comparison, by clinical observation, the treatment group after acupuncture does not appear fainting, needle and other adverse reactions. Two groups of patients were not there in the use of drugs rash, fever, nausea, vomiting and other adverse reactions, treatment after review of blood, urine, stool routine, liver and kidney function found no abnormal changes. Prompted this study, patients in both treatment of acute cerebral infarction, recovery are safe and effective.
Conclusion
1. Hypertension, hyperlipidemia, diabetes, heart disease (CHD) are four categories of diseases as major risk factors for cerebral infarction;
2. Compared to Chinese herbal medi cine treatment, the integrative theory of acupuncture and moxibustion in terms of Hear-Gallbladder therapy+Chinese herbal medicine treatment for cerebral infarction (Qi deficiency and blood stasis in TCM) has a more exactly efficacy, which can not only alleviate the symptoms, but also overall improve the quality of life of the patients. Acupuncture and moxibustion in terms of Hear-Gallbladder therapy has a synergia clinical efficacy, and it is an effective and feasible solution.
引文
[1]牟善初.重视和加强老年心脑血管病的流行病学研究[J].中华老年心脑血.管病杂志,1999,1(1)：7
[2]贺宪武.心脑血管急诊[M].北,梁冰.电针治京：人民军医出版社,1997：390-404.
[3]王敏,王敏华疗对脑梗死死偏瘫急性期运动功能的影响[J].针灸临床杂志,2005,21(5)：43-44
[4]范吉平,吴燕,孙塑伦,等.2003例急性脑血管病的临床资料分析[J].北京中医药大学学报,1999,22(1)：61-63
[5]李忠.缺血性脑血管疾病[M].北京：北京科学出版社,2002：1
[6]许继宗.脑梗死死的中医治疗现状[J].中国中医药现代远程教育,2011,(4)：192
[7]王新志,韩群英,郭学芳.中风脑病诊疗全书[M].中国医药科技出版社,2000(1)：282
[8]韩仲岩.实用脑血管病学[M].上海：上海科学技术出版社,1994：94
[9]黄如训,苏镇培.脑卒中[M).北京：人民卫生出版社,2001：155
[10]高希言.针药结合研究的探讨[J].中医杂志,1999,40(9)：562-5633.
[11]王永炎.关于提高脑血管疾病疗效难点的思考[J].中国中西医结合杂志,1997,17(4)：195-196
[12]王新志,韩群英,郭学芳.中风脑病诊疗全书[M].北京：中国医药科技出版社,2000：62-63
[13]蔡秀英.中药基本方分型论治对脑梗死治疗作用的观察[J].中医药临床杂志,2006,18(4)：340-341
[14]刘菊.周伸瑛教授治疗缺血性中风经验案[J].新中医,2006,37(12)：70-77
[15]骆磊,章培林.益气活血.中药治疗进展性脑梗死的早期疗效观察[J].中国中药杂志,2009,34(10)：1295-1296
[16]翟小燕,顾玉潜,陈思好,等.六味地黄丸加减治疗脑梗死死恢复期的临床研究[J].河北中医,2009,31(6)：873
[17]张敬华.中风发病启动之因一痰瘀毒邪[J].辽宁中医药大学学报,2001,10(1)：28
[18]李十权.浅析中医辨证论治中风后遗症[J].医学导刊,2008；5(5)：71.
[19]丁元庆,宋代波.中风病痰瘀痹阻证治探讨[J].辽宁中医杂志,1996,23(6)：255-256
[20]刘宝海,朴雪花.李延教授治疗脑梗死经验拾萃[J].中医研究,2007,20(6)：57-58
[21]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
[22]隋强.中西医结合治疗急性脑梗塞48例疗效观察[J].北京中医,2007,26(1)：34-35.
[23]金方伟.脑梗死中医分型论治观察[J].浙江中西医结合杂志,2006,’16(2)：113-114
[24]李七一,方祝元.中医诊治心脑血管疾病[M].北京：人民卫生出版社,2001
[25]史大卓,李立志.专科专病名医临证经验丛书·心脑血管病[M].北京：人民卫生出版社,2002
[26]杨国荣.中医辨证合黄芪血塞通静点治疗脑梗死死80例[J].天津中医,2000,17(1)：9
[27]李省让.分型论治中风后遗症138例分析[J].中华中医药杂志,2009,24(4)：467-468
[28]赵翼.浅析中风病恢复期的病机与治疗[J].山西中医,2008,24(5)：59-60
[29]蒋红玉.缺血性中风108例临床观察[J].中医杂志,1996,(2)：96-97
[30]姚廷周.缺血性脑中风新论[J].新医学导刊,2008,7(5)：67-68
[31]王建华,王永炎.出血性中风＆缺血性中风急性期证候演变规律的研究[J].中国中医急症,2001,10(4)：215-217
[32]沈思钰,傅晓东,钱善风.中医药对缺血性中风神经保护作用的机理探讨及评价[J].中国中医急症,2004,13(12)：535-539
[33]屈营,董雪.中风辨证治疗恢复期中风106例[J].辽宁中医学院学报,2002,4(4)：300
[34]张树泉.调气法在急性脑梗死死溶栓治疗中的应用[J].山东中医杂志,2005,24(5)：265-266
[35]于锋,金亦涛.脉络宁注射液药理学研究进展[J].中国新药杂志,2002,11(12)：920-924
[36]肖勤选,金香兰,蒋红信,等.络宁治疗急性期脑梗塞398例临床疗效观察[J].辽宁医学杂志,2001,15(2)：97-98.
[37]刘方,白文.醒脑静注射液治疗急性脑血管病35例临床研究[J].中西医结合心脑血管病杂志,2004,2(9)：511-513
[38]裘昌林.中风病研究概况[J].浙江中西医结合杂志,2000,10(12)：705-707
[39]王妍,李成.清开灵治疗脑卒中急性期34例[J].天津中医,2000,17(3)：15-17
[40]张丹莉.针刺阳明经腧穴对脑卒中患者运动功能的影响[J].中国临床康复.2005,9(13)：14
[41]郑谅,江钢辉,李艳慧.调和阴阳法治疗中风偏瘫的临床研究[J].针刺研究,1999,24(4)：249-250
[42]陈丽.以八脉交会穴针刺法治疗脑梗死死后偏瘫的临床研究.中国小区医师.2010,35(12)：116-117
[43]孙振杰.手足十二针治疗脑梗死150例疗效观察.中医中药,2009,16(17)：82-83
[44]石学敏.针刺治疗中风病的临宋研究[J].上海针灸杂志,1992,(4)：4
[45]张少君,骆均梵,陈竟芬.周围神经探测针刺法治疗中风偏瘫38例疗效观察[J].云南中医中药杂志,2006,27(1)：32-33
[46]尧彦.脑梗死康复治疗中针灸的应用效果观察[J].按摩与康复医学,2011,(62)：58
[47]熊杰,温景荣,路明,等.醒脑开窍针刺法治疗急性脑梗死超早期38例[J].中医杂志,2005,416(9)：684-685.
[48]马向明,谢爱华.针刺头三穴结合体针治疗脑梗死死92例.湖南中医杂志,2003,19(2)：35
[49]贾仰春,史亮,孙志方.头皮针抽添法对脑梗死死偏瘫患者患肢功能的影响[J].山东中医杂志,2007,26(9)：620-621
[50]单丽华,周正国,曲芳,等.头皮针体针并用治疗急性脑梗死死偏瘫76例.实用中医内科杂志.2008,22(4)：90
[51]王志军,王锦春.头皮针治疗急性脑梗死死120例临床观察[J].湖北中医杂志,2005,27(8)：11-12
[52]杨国荣,韩舰华.头皮针治疗急性脑梗死的疗效观察[J].湖北中医杂志,2003,25(1)：9-10
[53]符少杨.86例头体针治疗脑梗死死偏瘫患者[J].实用医技杂志,2005,12(6)：1478-1479
[54]桑鹏,王顺,赵佳辉.头穴透刺治疗急性脑梗死40例临床疗效观察[J].中国中医药科技,2011,18(4)：330-331
[55]张颖新,许广里.头针配合体针治疗脑梗死偏瘫的临床观察[J].中国老年学杂志,2007,27：1726
[56]王健,白丽.头针体针并用治疗脑梗死死疗效观察[J].针灸杂志,2006,25(11)：8-9
[57]李志.头针与体针结合治疗急性脑梗死死疗效观察[J].现代中西医结合杂志.,2005,14(13)：1723-1724
[58]王敏,王敏华,梁冰.电针治疗对脑梗死偏瘫急性期运动功能的影响[J].针灸临床杂志,2005, 21(5)：43-44
[59]黄光辉,夏培鑫,张晓兵.电针治疗脑梗死疗效观察[J].湖北中医杂志,2000,22(6)：415
[60]张彦通,常通海,张中华.头体针电交替治疗急性脑梗死死疗效观察[J].中国实用神经疾病杂,2007,10(7)：72
[61]石奕丽.刺络拔罐法治疗假性球麻痹46例临床观察[J].河北中医,1997,19(2)：43
[62]郭义,周智良,周国平,等.中风初起的急救措施—手十二井穴刺络放血法的临床与实验研究[J].上海针灸杂志,1997,16(2)：11
[63]韩宝杰.刺络疗法对中风病患者血液流变学影响的临床观察[J].天津中医,2001,18(1)：28-29
[64]滕安琪,陈宁昆,何智武.十二井穴刺络放血治疗急性脑梗死死的疗效观察[J].现代中西医结合杂志,2009,18(29)：3555-3556
[65]王田,邢舒恒,刘更.中风熏洗方配合放血疗法治疗脑梗死死后肩手综合征疗效观察[J].现代中西医结合杂志,2010,19(31)：3417-3418
[66]闰国平,李积胜.十二经穴针刺放血治疗急性脑梗死疗效观察[J].中华实用中西医杂志,2004,4(17)：1785-1786
[67]张晓霞,冯毅.火针治疗缺血性中风的临床观察[J].北京中医,2001,(5)：54-55
[68]高先凤.川芎嗪穴位注射对脑梗死肢体功能恢复的疗效观察[J].中医药临床杂志,2008,20(6)：583-584
[69]陈丽贤,丁晓虹.腹针治疗脑梗死50例[J].中国临床康复,2004,8(19)：3823
[70]解庆凡,田胜利.大全息针法治疗中风偏瘫230例临床观察[J].北京中医药大学学报,2005,23(3)：7
[71]周莉萨,朱书秀.梅花针叩刺配合针刺治疗脑梗死93例临床观察[J].湖北中医杂志.,2001,23(10)：45-46
[72]姜华,王满侠,郭健,等.子午流注纳甲法治疗急性缺血性脑血管病及对IL-6水平的影响[J].甘肃中医学院学报,2003,20(1)：45-47
[73]钟华萍,吕志宇,唐兴江.早期针灸结合康复综合治疗脑梗死的疗效观察[J].陕西中医,2012,33(3)：340-341
[74]吴佳梅.针刺推拿配合康复训练治疗中风后遗症50例[J].现代中西医结合杂志,2003,12(20)：2212.
[75]李庆.电针灸配合补阳还五汤加味治疗脑梗死恢复期疗效观察[J].中国现代医生,2010,48(1)：137-138.
[76]张静.针灸联合脑心通胶囊治疗脑梗死恢复期患者的疗效观察[J].按摩与康复医学,2011,2(12)：52-53
[77]卢春生,于凌燕,乔丽.针灸联合药物治疗脑梗死30例疗效观察[J].中国实用神经疾病杂志,2011,14(23)：8687
[78]黄光怀,黄中华.中药结合针灸综合治疗脑梗死恢复期39例[J].中医药导报,2007,13(11)：51-52
[79]王金虎.中西医结合治疗脑梗死34例临床疗效[J].内蒙古中医药,2011,12：24-25
[80]王虹.针灸配合药物治疗脑梗死45例观察[J].中国现代医生,2007,45(4)：104
[81]韩圣亭,袁建喜.中西医结合治疗急性脑梗死120例疗效观察[J].医学创新研究,2007,4(36)：27
[82]贾永忠.补阳还五汤加味治疗脑梗死疗效观察[J].山西中医,2005,21(6)：23
[83]李顺喜,李忠桥,贾莹梅.补阳还五汤加昧配合针灸治疗脑梗70例[J].世界中医,2011,6(4)：346
[84]王友杰.补阳还五汤治疗急性脑梗死40例疗效观察[J].湖北中医杂志,2003,25(10)：30
[85]宋先仁.补阳还五汤配合针灸治疗脑梗死后遗症的疗效观察[J].湖北中医杂志,2010,32(9)：26-27
[86]许能贵,马勤耘,许冠蒸,等.电针对局灶性脑缺血大鼠脑血流量、脑含水量,SOD,MDA的影响[J].针刺研究,1995,23(3)：74-75
[87]许能贵,马勤耘,侯思伟.1电针对局灶性脑缺血大鼠兴奋性氨基酸含量的影响[J].中国针灸,1999,19(7)：431-432.
[88]许能贵,马勤耘,朱舜丽,等.电针对局灶性脑缺血大鼠中枢单胺类神经递质的影响[J].中国中医基础医学杂志,1999,5(12)：56-57
[89]彭兴甫,彭英,朱德军,等.针灸对脑梗死大鼠血液流变学的影响及其与学习记忆的关系[J].四川医学,2011,32(9)：1334-1335
[90]李抒云,李杰.针药结合治疗脑梗死67例[J].中国实用神经疾病杂志,2010,13(7)：38-39
[91]蒋戈利.通关利窍制法治疗脑中风假性延髓麻痹300例.上海针灸杂志,1997,16(2)：17
[92]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
[93]全国第四届脑血管病学术会议.脑卒中患者临床神经功能缺损程度评分标准[J].中华神经科杂志,1996,29(6)：381
[94]高建,徐先祥,徐先俊等.黄芪总皂苷抗血栓形成作用实验研究[J].中成药,2002,24(2)：116 118
[95]储利胜,邵亮,孟丁瑜,等.补阳还五汤对大鼠局灶性脑缺血损伤的长期保护作用[J].中国临床康复,2006,10(11)：56-58
[96]谢人明,王朝铃,马存谱.补阳还五汤对血小板聚集及体内血栓形成的影响[J].云南中医学院学报.1989,12(2)：10-13
[97]王宾.补阳还五汤对中风患者血.血小板及纤维蛋白原的影响[J].天津中医.2000,17(2)：42
[98]孙晋浩,杨琳,高英茂.补阳还五汤对神经干细胞生长分化的影响[J].山东医科大学学报(医学版),2002,40(5)：406-408
[99]刘孔江.针刺在中风中的早期干预和思路[J].中国针灸,2003,10：15
[100]许能贵,汪克明,王月兰,等.针刺对大鼠局灶性脑缺血后脑电变化的影响[J].安徽中医学院学报,1997,16(5)：116
[101]骆仲达,骆仲连,许能贵,等.电针对局灶性脑缺血大鼠脑源性神经营养因子影响的研究[J].针刺研究,2002,27(2)：105
[102]冯学功.论肾虚气弱风痰瘀血阻络在缺血性中风恢复期病机中的重要性[J].中医杂志,1998,39(8)：458
[103]李庆.电针灸配合补阳还五汤加味治疗脑梗死恢复期疗效观察[J].中国现代医生,2010,48(1)：137-138.
[104]廉全荣.针刺治疗中风早期临床观察[J].针灸临床杂志,2003；19(2)：15.
[105]张琳英.中风的针灸治疗概况叮[J].针灸临床杂志,2004, 6：6
[106]翟晓翔,邹积隆.黄芪、水蛙、地龙不同配伍治疗缺血性中风实验研究[J].山东中医药大学学报,2000,24(1)：52-55
[107]蔚志刚,范刚启.脑梗死上肢瘫针刺治疗方案的优选及其对N0的影响[J].南京军医学院学报,2002,24(3)：186-188
[108]陈跃.腔隙性脑梗死是怎么回事[J].健康博览,2012,1：17
[109]贾建平.神经病学[M].北京：人民卫生出版社,2008：176-183
[110]中华医学会神经病学分会脑血管病学组缺血性脑卒中二级预防指南撰写组.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2010.中华神经科杂志,2010.43(2)：146-160
[111]中华医学会.临床诊疗指南-物理医学与康复分册[M].北京：人民卫生出版社,2005：168-175
[112]中华医学会.临床诊疗指南-神经病学分册[M].北京：人民卫生出版社,2006：1-15
[113]Wil Hams LS, Weinberger M, Harris LE, et al. Development of a stroke-specific quality of life scale [J]. Stroke,1999,30(7):1362-1369
[114]蔡业峰,贾真,何春霞等.卒中专门生活质量量表(SSQOL)中文版多中心测评研究[J].中国中医基础医学杂志,2007,13(7)：551-553
[2]贺宪武.心脑血管急诊[M].北,梁冰.电针治京：人民军医出版社,1997：390-404.
[3]王敏,王敏华疗对脑梗死死偏瘫急性期运动功能的影响[J].针灸临床杂志,2005,21(5)：43-44
[4]范吉平,吴燕,孙塑伦,等.2003例急性脑血管病的临床资料分析[J].北京中医药大学学报,1999,22(1)：61-63
[5]李忠.缺血性脑血管疾病[M].北京：北京科学出版社,2002：1
[6]许继宗.脑梗死死的中医治疗现状[J].中国中医药现代远程教育,2011,(4)：192
[7]王新志,韩群英,郭学芳.中风脑病诊疗全书[M].中国医药科技出版社,2000(1)：282
[8]韩仲岩.实用脑血管病学[M].上海：上海科学技术出版社,1994：94
[9]黄如训,苏镇培.脑卒中[M).北京：人民卫生出版社,2001：155
[10]高希言.针药结合研究的探讨[J].中医杂志,1999,40(9)：562-5633.
[11]王永炎.关于提高脑血管疾病疗效难点的思考[J].中国中西医结合杂志,1997,17(4)：195-196
[12]王新志,韩群英,郭学芳.中风脑病诊疗全书[M].北京：中国医药科技出版社,2000：62-63
[13]蔡秀英.中药基本方分型论治对脑梗死治疗作用的观察[J].中医药临床杂志,2006,18(4)：340-341
[14]刘菊.周伸瑛教授治疗缺血性中风经验案[J].新中医,2006,37(12)：70-77
[15]骆磊,章培林.益气活血.中药治疗进展性脑梗死的早期疗效观察[J].中国中药杂志,2009,34(10)：1295-1296
[16]翟小燕,顾玉潜,陈思好,等.六味地黄丸加减治疗脑梗死死恢复期的临床研究[J].河北中医,2009,31(6)：873
[17]张敬华.中风发病启动之因一痰瘀毒邪[J].辽宁中医药大学学报,2001,10(1)：28
[18]李十权.浅析中医辨证论治中风后遗症[J].医学导刊,2008；5(5)：71.
[19]丁元庆,宋代波.中风病痰瘀痹阻证治探讨[J].辽宁中医杂志,1996,23(6)：255-256
[20]刘宝海,朴雪花.李延教授治疗脑梗死经验拾萃[J].中医研究,2007,20(6)：57-58
[21]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
[22]隋强.中西医结合治疗急性脑梗塞48例疗效观察[J].北京中医,2007,26(1)：34-35.
[23]金方伟.脑梗死中医分型论治观察[J].浙江中西医结合杂志,2006,’16(2)：113-114
[24]李七一,方祝元.中医诊治心脑血管疾病[M].北京：人民卫生出版社,2001
[25]史大卓,李立志.专科专病名医临证经验丛书·心脑血管病[M].北京：人民卫生出版社,2002
[26]杨国荣.中医辨证合黄芪血塞通静点治疗脑梗死死80例[J].天津中医,2000,17(1)：9
[27]李省让.分型论治中风后遗症138例分析[J].中华中医药杂志,2009,24(4)：467-468
[28]赵翼.浅析中风病恢复期的病机与治疗[J].山西中医,2008,24(5)：59-60
[29]蒋红玉.缺血性中风108例临床观察[J].中医杂志,1996,(2)：96-97
[30]姚廷周.缺血性脑中风新论[J].新医学导刊,2008,7(5)：67-68
[31]王建华,王永炎.出血性中风＆缺血性中风急性期证候演变规律的研究[J].中国中医急症,2001,10(4)：215-217
[32]沈思钰,傅晓东,钱善风.中医药对缺血性中风神经保护作用的机理探讨及评价[J].中国中医急症,2004,13(12)：535-539
[33]屈营,董雪.中风辨证治疗恢复期中风106例[J].辽宁中医学院学报,2002,4(4)：300
[34]张树泉.调气法在急性脑梗死死溶栓治疗中的应用[J].山东中医杂志,2005,24(5)：265-266
[35]于锋,金亦涛.脉络宁注射液药理学研究进展[J].中国新药杂志,2002,11(12)：920-924
[36]肖勤选,金香兰,蒋红信,等.络宁治疗急性期脑梗塞398例临床疗效观察[J].辽宁医学杂志,2001,15(2)：97-98.
[37]刘方,白文.醒脑静注射液治疗急性脑血管病35例临床研究[J].中西医结合心脑血管病杂志,2004,2(9)：511-513
[38]裘昌林.中风病研究概况[J].浙江中西医结合杂志,2000,10(12)：705-707
[39]王妍,李成.清开灵治疗脑卒中急性期34例[J].天津中医,2000,17(3)：15-17
[40]张丹莉.针刺阳明经腧穴对脑卒中患者运动功能的影响[J].中国临床康复.2005,9(13)：14
[41]郑谅,江钢辉,李艳慧.调和阴阳法治疗中风偏瘫的临床研究[J].针刺研究,1999,24(4)：249-250
[42]陈丽.以八脉交会穴针刺法治疗脑梗死死后偏瘫的临床研究.中国小区医师.2010,35(12)：116-117
[43]孙振杰.手足十二针治疗脑梗死150例疗效观察.中医中药,2009,16(17)：82-83
[44]石学敏.针刺治疗中风病的临宋研究[J].上海针灸杂志,1992,(4)：4
[45]张少君,骆均梵,陈竟芬.周围神经探测针刺法治疗中风偏瘫38例疗效观察[J].云南中医中药杂志,2006,27(1)：32-33
[46]尧彦.脑梗死康复治疗中针灸的应用效果观察[J].按摩与康复医学,2011,(62)：58
[47]熊杰,温景荣,路明,等.醒脑开窍针刺法治疗急性脑梗死超早期38例[J].中医杂志,2005,416(9)：684-685.
[48]马向明,谢爱华.针刺头三穴结合体针治疗脑梗死死92例.湖南中医杂志,2003,19(2)：35
[49]贾仰春,史亮,孙志方.头皮针抽添法对脑梗死死偏瘫患者患肢功能的影响[J].山东中医杂志,2007,26(9)：620-621
[50]单丽华,周正国,曲芳,等.头皮针体针并用治疗急性脑梗死死偏瘫76例.实用中医内科杂志.2008,22(4)：90
[51]王志军,王锦春.头皮针治疗急性脑梗死死120例临床观察[J].湖北中医杂志,2005,27(8)：11-12
[52]杨国荣,韩舰华.头皮针治疗急性脑梗死的疗效观察[J].湖北中医杂志,2003,25(1)：9-10
[53]符少杨.86例头体针治疗脑梗死死偏瘫患者[J].实用医技杂志,2005,12(6)：1478-1479
[54]桑鹏,王顺,赵佳辉.头穴透刺治疗急性脑梗死40例临床疗效观察[J].中国中医药科技,2011,18(4)：330-331
[55]张颖新,许广里.头针配合体针治疗脑梗死偏瘫的临床观察[J].中国老年学杂志,2007,27：1726
[56]王健,白丽.头针体针并用治疗脑梗死死疗效观察[J].针灸杂志,2006,25(11)：8-9
[57]李志.头针与体针结合治疗急性脑梗死死疗效观察[J].现代中西医结合杂志.,2005,14(13)：1723-1724
[58]王敏,王敏华,梁冰.电针治疗对脑梗死偏瘫急性期运动功能的影响[J].针灸临床杂志,2005, 21(5)：43-44
[59]黄光辉,夏培鑫,张晓兵.电针治疗脑梗死疗效观察[J].湖北中医杂志,2000,22(6)：415
[60]张彦通,常通海,张中华.头体针电交替治疗急性脑梗死死疗效观察[J].中国实用神经疾病杂,2007,10(7)：72
[61]石奕丽.刺络拔罐法治疗假性球麻痹46例临床观察[J].河北中医,1997,19(2)：43
[62]郭义,周智良,周国平,等.中风初起的急救措施—手十二井穴刺络放血法的临床与实验研究[J].上海针灸杂志,1997,16(2)：11
[63]韩宝杰.刺络疗法对中风病患者血液流变学影响的临床观察[J].天津中医,2001,18(1)：28-29
[64]滕安琪,陈宁昆,何智武.十二井穴刺络放血治疗急性脑梗死死的疗效观察[J].现代中西医结合杂志,2009,18(29)：3555-3556
[65]王田,邢舒恒,刘更.中风熏洗方配合放血疗法治疗脑梗死死后肩手综合征疗效观察[J].现代中西医结合杂志,2010,19(31)：3417-3418
[66]闰国平,李积胜.十二经穴针刺放血治疗急性脑梗死疗效观察[J].中华实用中西医杂志,2004,4(17)：1785-1786
[67]张晓霞,冯毅.火针治疗缺血性中风的临床观察[J].北京中医,2001,(5)：54-55
[68]高先凤.川芎嗪穴位注射对脑梗死肢体功能恢复的疗效观察[J].中医药临床杂志,2008,20(6)：583-584
[69]陈丽贤,丁晓虹.腹针治疗脑梗死50例[J].中国临床康复,2004,8(19)：3823
[70]解庆凡,田胜利.大全息针法治疗中风偏瘫230例临床观察[J].北京中医药大学学报,2005,23(3)：7
[71]周莉萨,朱书秀.梅花针叩刺配合针刺治疗脑梗死93例临床观察[J].湖北中医杂志.,2001,23(10)：45-46
[72]姜华,王满侠,郭健,等.子午流注纳甲法治疗急性缺血性脑血管病及对IL-6水平的影响[J].甘肃中医学院学报,2003,20(1)：45-47
[73]钟华萍,吕志宇,唐兴江.早期针灸结合康复综合治疗脑梗死的疗效观察[J].陕西中医,2012,33(3)：340-341
[74]吴佳梅.针刺推拿配合康复训练治疗中风后遗症50例[J].现代中西医结合杂志,2003,12(20)：2212.
[75]李庆.电针灸配合补阳还五汤加味治疗脑梗死恢复期疗效观察[J].中国现代医生,2010,48(1)：137-138.
[76]张静.针灸联合脑心通胶囊治疗脑梗死恢复期患者的疗效观察[J].按摩与康复医学,2011,2(12)：52-53
[77]卢春生,于凌燕,乔丽.针灸联合药物治疗脑梗死30例疗效观察[J].中国实用神经疾病杂志,2011,14(23)：8687
[78]黄光怀,黄中华.中药结合针灸综合治疗脑梗死恢复期39例[J].中医药导报,2007,13(11)：51-52
[79]王金虎.中西医结合治疗脑梗死34例临床疗效[J].内蒙古中医药,2011,12：24-25
[80]王虹.针灸配合药物治疗脑梗死45例观察[J].中国现代医生,2007,45(4)：104
[81]韩圣亭,袁建喜.中西医结合治疗急性脑梗死120例疗效观察[J].医学创新研究,2007,4(36)：27
[82]贾永忠.补阳还五汤加味治疗脑梗死疗效观察[J].山西中医,2005,21(6)：23
[83]李顺喜,李忠桥,贾莹梅.补阳还五汤加昧配合针灸治疗脑梗70例[J].世界中医,2011,6(4)：346
[84]王友杰.补阳还五汤治疗急性脑梗死40例疗效观察[J].湖北中医杂志,2003,25(10)：30
[85]宋先仁.补阳还五汤配合针灸治疗脑梗死后遗症的疗效观察[J].湖北中医杂志,2010,32(9)：26-27
[86]许能贵,马勤耘,许冠蒸,等.电针对局灶性脑缺血大鼠脑血流量、脑含水量,SOD,MDA的影响[J].针刺研究,1995,23(3)：74-75
[87]许能贵,马勤耘,侯思伟.1电针对局灶性脑缺血大鼠兴奋性氨基酸含量的影响[J].中国针灸,1999,19(7)：431-432.
[88]许能贵,马勤耘,朱舜丽,等.电针对局灶性脑缺血大鼠中枢单胺类神经递质的影响[J].中国中医基础医学杂志,1999,5(12)：56-57
[89]彭兴甫,彭英,朱德军,等.针灸对脑梗死大鼠血液流变学的影响及其与学习记忆的关系[J].四川医学,2011,32(9)：1334-1335
[90]李抒云,李杰.针药结合治疗脑梗死67例[J].中国实用神经疾病杂志,2010,13(7)：38-39
[91]蒋戈利.通关利窍制法治疗脑中风假性延髓麻痹300例.上海针灸杂志,1997,16(2)：17
[92]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
[93]全国第四届脑血管病学术会议.脑卒中患者临床神经功能缺损程度评分标准[J].中华神经科杂志,1996,29(6)：381
[94]高建,徐先祥,徐先俊等.黄芪总皂苷抗血栓形成作用实验研究[J].中成药,2002,24(2)：116 118
[95]储利胜,邵亮,孟丁瑜,等.补阳还五汤对大鼠局灶性脑缺血损伤的长期保护作用[J].中国临床康复,2006,10(11)：56-58
[96]谢人明,王朝铃,马存谱.补阳还五汤对血小板聚集及体内血栓形成的影响[J].云南中医学院学报.1989,12(2)：10-13
[97]王宾.补阳还五汤对中风患者血.血小板及纤维蛋白原的影响[J].天津中医.2000,17(2)：42
[98]孙晋浩,杨琳,高英茂.补阳还五汤对神经干细胞生长分化的影响[J].山东医科大学学报(医学版),2002,40(5)：406-408
[99]刘孔江.针刺在中风中的早期干预和思路[J].中国针灸,2003,10：15
[100]许能贵,汪克明,王月兰,等.针刺对大鼠局灶性脑缺血后脑电变化的影响[J].安徽中医学院学报,1997,16(5)：116
[101]骆仲达,骆仲连,许能贵,等.电针对局灶性脑缺血大鼠脑源性神经营养因子影响的研究[J].针刺研究,2002,27(2)：105
[102]冯学功.论肾虚气弱风痰瘀血阻络在缺血性中风恢复期病机中的重要性[J].中医杂志,1998,39(8)：458
[103]李庆.电针灸配合补阳还五汤加味治疗脑梗死恢复期疗效观察[J].中国现代医生,2010,48(1)：137-138.
[104]廉全荣.针刺治疗中风早期临床观察[J].针灸临床杂志,2003；19(2)：15.
[105]张琳英.中风的针灸治疗概况叮[J].针灸临床杂志,2004, 6：6
[106]翟晓翔,邹积隆.黄芪、水蛙、地龙不同配伍治疗缺血性中风实验研究[J].山东中医药大学学报,2000,24(1)：52-55
[107]蔚志刚,范刚启.脑梗死上肢瘫针刺治疗方案的优选及其对N0的影响[J].南京军医学院学报,2002,24(3)：186-188
[108]陈跃.腔隙性脑梗死是怎么回事[J].健康博览,2012,1：17
[109]贾建平.神经病学[M].北京：人民卫生出版社,2008：176-183
[110]中华医学会神经病学分会脑血管病学组缺血性脑卒中二级预防指南撰写组.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2010.中华神经科杂志,2010.43(2)：146-160
[111]中华医学会.临床诊疗指南-物理医学与康复分册[M].北京：人民卫生出版社,2005：168-175
[112]中华医学会.临床诊疗指南-神经病学分册[M].北京：人民卫生出版社,2006：1-15
[113]Wil Hams LS, Weinberger M, Harris LE, et al. Development of a stroke-specific quality of life scale [J]. Stroke,1999,30(7):1362-1369
[114]蔡业峰,贾真,何春霞等.卒中专门生活质量量表(SSQOL)中文版多中心测评研究[J].中国中医基础医学杂志,2007,13(7)：551-553
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |