【作者】 熊嘉玮；

【导师】 倪光夏；

【作者基本信息】 南京中医药大学 ， 中医学， 2011， 硕士

【摘要】 目的：观察针药结合治疗脑梗死急性期、恢复期的临床疗效,为临床提出新的有效思路。方法：以脑梗死为研究对象,选取江苏省第二中医院针灸科急性脑梗死住院病人100人：急性期40人、恢复期患者60人。将急性期的患者按住院顺序先后编号,按奇、偶数分为针药治疗组和药物对照组,每组20人；将恢复期的患者按住院顺序先后编号,按1、2、3次序及倍数分为针药治疗组、针刺对照组和药物对照组,每组20人。急性期针药组采用针刺醒脑开窍法结合头针,药物选用依达拉奉和血塞通；药物组和针药组所选药物相同。恢复期针药组针刺采用醒脑开窍法结合头针,药物选用乙酰谷酰胺和血塞通；药物组和针药组所选药物相同；针刺组和针药组所采用针刺法相同。每周连续治疗5天,休息2天,4周为一疗程。根据神经功能缺损程度评分、日常生活能力等指标进行观察,并统计治疗后各组疗效。观察对比脑梗死急性期针刺结合神经保护剂与单纯使用神经保护剂的疗效差异,脑梗死恢复期针刺结合药物治疗、单纯使用药物治疗与单纯使用针刺治疗的疗效差异。结果：急性期：针药结合组基本痊愈7例,显著进步9例,进步3例,无效1例,总有效率为95%;药物组基本痊愈2例,显著进步3例,进步8例,无效7例,总有效率为65.%。神经功能缺损积分降低值比较,治疗后,针药结合组为14.52±5.64,药物组为10.84±6.06,提示针药结合组神经功能缺损积分降低值明显高于针刺组。Barthel指数变化比较,经治疗后,针药结合组为78.89±13.782分,药物组为64.05±15.563分,提示针药结合组Barthel指数明显高于针刺组。经统计学分析,针药结合组疗效优于药物组(P<0.05)。恢复期：针药结合组基本痊愈3例,显著进步9例,进步6例,无效2例,总有效率为90.0%;针刺组基本痊愈2例,显著进步11例,进步4、例,无效3例,总有效率为85.0%,药物组基本痊愈2例,显著进步3例,进步6例,无效9例,总有效率为65.0%。神经功能缺损积分比较,治疗后,针药结合组为18.12±3.81,针刺组为17.35±2.79,药物组12.08士5.20,提示针药结合组神经功能缺损积分降低值明显高于药物组,但和针刺组无明显差异。Barthel指数变化比较,经治疗后,针药结合组为75.63±14.79分,针刺组为71.15±11.02分,药物组56.52±15.26分,提示针药结合组Barthel指数明显高于药物组,但和针刺组无明显差异。经统计学分析,针药结合组疗效优于药物组(P<0.05),但和针刺组无明显差异(P>0.05)。结论：急性期针药结合组治疗效果明显优于药物组,恢复期针药结合组治疗效果虽然优于药物组,但与单纯针刺治疗无明显差异。更多还原

【Abstract】 Objective:This research dies observe the efficacy of acute cerebral infarction with acupuncture and simple drug treatment, and the efficacy of recovery with simple drug treatment,simple acupuncture and acupuncture compared drug, propose new and effective clinical treatment.Method:In this study, as the study with cerebral infarction, acute cerebral infarction through the control of acupuncture combined use of neuroprotective agents with simple differences in the efficacy of neuroprotective agents, controlled study of acupuncture combined with drug treatment cerebral recovery, simple to use and simple drug treatment differences in the efficacy of using acupuncture. Select the second Hospital of Jiangsu Province, acupuncture 100 patients with acute cerebral infarction:acute 40,60 convalescent patients. Patients with acute phase of the order has numbered according to hospital, according to odd and even numbers are divided into acupuncture and drug treatment group control group 20; the recovery of patients by hospital number sequence has, by order of points 1,2,3 for the acupuncture group, acupuncture group and drug control group of 20 people. Continuously for 5 days per week,2 days off for 4 weeks, after a course of treatment based on neurological deficit scores, activities of daily living such as observation, and statistical assessment of treatment efficacy in each group compared.Results:Acute phase:effect of acupuncture combined group than the acupuncture group, drug group (P<0.05). Neurologic impairment effect of comparing acupuncture combined set of basic recovery in 7 cases, significant progress in 9 cases, progress in 3 patients,1 case, the total effective rate was 95%; drugs set of basic recovery in 2 cases, significant progress in 3 cases, progress 8 Cases,7 cases, total effective rate was 65.%. Barthel index in comparison, after treatment, acupuncture combined group was 78.89±13.782 points, the drug group was 64.05±15.563 points, suggesting that acupuncture combined group was significantly higher than the acupuncture group Barthel Index. Recovery:effect of acupuncture combined group than the drug group (P<0.05), and the acupuncture group but no significant difference (P> 0.05). Comparative efficacy of neurologic impairment, the basic acupuncture combined with group 3 patients recovered,9 cases of significant progress, progress in 6 cases,2 cases, the total effective rate was 90.0%; basic acupuncture group recovered in 2 cases,11 cases of significant progress, progress 4 cases and 3 cases, the total effective rate was 85.0%, the basic drug group recovered in 2 cases,3 cases of significant progress, progress in 6 cases,9 cases, total effective rate was 65.0%. Barthel index in comparison, after treatment, acupuncture combined group was 75.65±14.794 points, the acupuncture group was 71.45±15.023 points, drug group,56.52±15.248 points, suggesting that acupuncture combined group was significantly higher than the Barthel index drug group, but, and No significant difference between the acupuncture group.Conclusion:Acute effects of acupuncture combined treatment group was significantly better than the drug group and recovery effect of acupuncture combined treatment group although better than the drug group, acupuncture group, but recovery of cerebral infarction treated with acupuncture combined and simple acupuncture treatment was no significant difference Indicating that acupuncture combined therapy in patients with acute cerebral infarction of limb function, activities of daily living improved significantly improve, with clinical significance. Recovery of cerebral infarction treated with acupuncture alone could be taken.更多还原