*基金項目：河北省中医药管理局科研计划项目（2020303）

第一作者简介：张会凯（1977-），男，硕士，副主任医师，研究方向：脑血管病与康复治疗。

摘要：目的  观察芎蛭通脉方联合针刺运动疗法治疗缺血性脑卒中偏瘫患者肢体功能障碍的临床疗效。方法  按随机数字表法将150例缺血性脑卒中偏瘫患者，分为对照组（n=75），给予针刺运动疗法治疗；观察组（n=75），给予针刺运动疗法和芎蛭通脉方口服，记录2组患者美国国立卫生研究院卒中量表（NIHSS）评分、临床神经功能缺损评分（AS），上下肢运动功能（握力、6 min步行直线距离），血清淀粉样蛋白A（SAA）、血清神经丝轻链蛋白（NFL）水平的变化，客观评价2组患者临床治疗效果。结果  2组患者NIHSS评分、AS评分、上下肢运动功能和SAA、NFL水平在治疗前比较差异无统计学意义（P>0.05）。第12周末，2组患者NIHSS评分、AS评分明显低于对照组（P<0.05），SAA、NFL水平明显低于对照组（P<0.05），半身不遂侧握力、6 min步行直线距离比对照组明显提高（P<0.05）。结论  芎蛭通脉方联合针刺运动疗法治疗缺血性脑卒中偏瘫患者上下肢运动功能明显提高，肢体运动能力增强，生活自理能力显著提高。

关键词：芎蛭通脉方；针刺运动疗法；缺血性脑卒中；偏瘫

中图分类号：R743    文献标志码：B    文章编号：1007-2349（2024）05-0073-05

Observation on the Curative Effect of Xiongzhitongmai Decoction Combined withAcupuncture Exercise Therapy on Hemiplegia Patients after Ischemic Stroke

ZHANG Hui-kai

（Xinle Hospital of Traditional Chinese Medicine， Xinle 050700， China）

【Abstract】Objective： To observe the clinical effect of Xiongzhitongmai Decoction combined with acupuncture exercise therapy on limb dysfunction in hemiplegia patients after ischemic stroke. Methods： According to random number table method， 150 hemiplegia patients after ischemic stroke were divided into control group （n=75） and observation group （n=75）. The control group was given acupuncture exercise therapy and the observation group was given acupuncture exercise therapy and Xiongzhitongmai Decoction. The changes of The National Institutes of Health Stroke Scale （NIHSS） score， clinical neurological impairment score （AS）， motor function of upper and lower limbs （grip strength， 6min walking linear distance）， serum amyloid A （SAA） and serum neurofilament light chain protein （NFL） levels of the two groups were recorded and the clinical effect of the two groups was objectively evaluated. Results： There was no significant difference in NIHSS score， AS score， motor function of upper and lower limbs， SAA and NFL level between the two groups before treatment （P>0.05）. At the end of the 12th week， the NIHSS score and AS score in the two groups were significantly lower than those in the control group （P<0.05）. The levels of SAA and NFL were significantly lower than those in the control group （P<0.05）， and the grip strength of hemiplegic side and the 6-min walking straight distance were significantly higher than those in the control group （P<0.05）. Conclusion： The upper and lower limb motor function， limb motor ability and self-care ability of hemiplegia patients after ischemic stroke were significantly improved by Xiongzhitongmai Decoction combined with acupuncture exercise therapy.

【Key words】Xiongzhitongmai Decoction; Acupuncture Exercise Therapy; Ischemic Stroke; Hemiplegia

隨着我国人口老龄化，脑卒中的发病率也呈逐年递增趋势，并且具有较高的发病率、致残率、死亡率，已经成为我国成年人残疾的首要发病原因［1］。虽然目前治疗缺血性脑卒中有超早期静脉溶栓和（或）动脉取栓等方法，但很多患者还是会遗留肢体瘫痪、吞咽障碍、言语障碍等后遗症，由于脑组织解剖的特殊性，肢体的肌力恢复，尤其是上肢功能恢复较慢，严重影响患者的日常生活［2］，因此脑卒中的早期康复领域一直是近年来关注的热点问题，因此笔者采用芎蛭通脉方联合针刺运动疗法治疗缺血性脑卒中偏瘫，患者上下肢运动功能明显改善，生活自理能力明显改善，现报道如下。