[摘要] 目的 探讨升清益髓开窍针法联合补阳还五汤对缺血性脑卒中（ischemic stroke，IS）患者运动障碍及同型半胱氨酸（homocysteine，Hcy）的影响。方法 选取2022年1月至2024年8月于泰安市中医医院就诊的160例IS患者，根据随机数字表法将其分为联合组（54例）、针刺组（53例）和中药组（53例）。比较治疗前后三组患者的Fugl-Meyer运动功能评估（Fugl-Meyer assessment，FMA）量表、改良Barthel指数（modified Barthel index，MBI）和徒手肌力评定（manual muscle test，MMT）、Hcy和血脂指标。结果 治疗后，联合组患者的FMA、MBI和MMT评分均显著高于针刺组和中药组（Plt;0.05），Hcy、总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平均显著低于针刺组和中药组（Plt;0.05）。联合组患者的治疗有效率显著高于针刺组和中药组（Plt;0.05）。结论 升清益髓开窍针法联合补阳还五汤治疗IS可显著提升患者的肢体运动功能，降低Hcy和血脂水平。

[关键词] 升清益髓开窍针法；缺血性脑卒中；运动障碍；同型半胱氨酸

[中图分类号] R246.1" """"[文献标识码] A """""[DOI] 10.3969/j.issn.1673-9701.2025.19.012

The effect of Shengqing Yisui Kaiqiao acupuncture combined with Buyang Huanwu Tang on movement disorder and Hcy in patients with ischemic stroke

XIANG Xianwen¹， ZHU Jiaying²

1.Department of Rehabilitation， Tai’an Traditional Chinese Medicine Hospital， Tai’an 271000， Shandong， China; 2.Department of Endocrinology Ⅱ， Tai’an Traditional Chinese Medicine Hospital， Tai’an 271000， Shandong， China.

[Abstract] Objective To explore the effect of Shengqing Yisui Kaiqiao acupuncture combined with Buyang Huanwu Tang on movement disorder and homocysteine （Hcy） in patients with ischemic stroke （IS）. Methods A total of 160 patients with IS who visited Tai’an Traditional Chinese Medicine Hospital from January 2022 to August 2024 were selected and divided into combined group （54 cases）， acupuncture group （53 cases）， and traditional Chinese medicine group （53 cases） according to the random number table method. The Fugl-Meyer assessment （FMA） scale， modified Barthel index （MBI）， manual muscle test （MMT）， Hcy and blood lipid indicators of three groups of patients before and after treatment were compared. Results After the treatment， the FMA， MBI and MMT scores of patients in combined group were significantly higher than those in acupuncture group and traditional Chinese medicine group （Plt;0.05）， and the levels of Hcy， total cholesterol， triglycerides and low density lipoprotein-cholesterol were significantly lower than those in acupuncture group and traditional Chinese medicine group （Plt;0.05）. The effective rate of treatment in combined group was significantly higher than that in acupuncture group and traditional Chinese medicine group （Plt;0.05）. Conclusion The Shengqing Yisui Kaiqiao acupuncture combined with Buyang Huanwu Tang in treatment of IS can significantly improve the limb motor function of patients and reduce the levels of Hcy and blood lipid.

[Key words] Shengqing Yisui Kaiqiao acupuncture; Ischemic stroke; Movement disorder; Homocysteine

《中国卒中中心报告2022》指出中国缺血性脑卒中（ischemic stroke，IS）发病率高达538.1/10万^[1]。IS的致死致残率居于高位，超八成患者留存肢体运动障碍^[2-3]。IS进入恢复期后以中西医结合治疗模式为主^[4]。本研究分析升清益髓开窍针法联合补阳还五汤对IS患者肢体运动障碍的影响，并观察同型半胱氨酸（homocysteine，Hcy）的变化，初步探究其临床疗效和作用机制。

1 "资料与方法

1.1" 一般资料

选取2022年1月至2024年8月于泰安市中医医院康复科就诊的160例IS患者。根据随机数字表法将其分为联合组（54例）、针刺组（53例）和中药组（53例）。其中联合组男26例，女28例；年龄35～75岁，平均（57.8±2.0）岁；病程14～38d，平均（18.2±2.1）d。针刺组男27例，女26例；年龄35～74岁，平均（58.3±1.9）岁；病程15～40d，平均（19.1±2.0）d。……