摘要
目的:观察逐痰祛瘀汤结合针电刺激治疗脑梗死后吞咽障碍(痰瘀互结证)患者的疗效。方法:纳入我院2017年1月~2020年1月期间80例脑梗死后吞咽障碍痰瘀互结证患者,采用随机数字表法分为观察组、对照组各40例,对照组患者予以针电刺激及吞咽功能训练,观察组在此基础上加用逐痰祛瘀汤治疗,4周后评估疗效。比较两组临床疗效,以及治疗前与治疗4周后中医症状积分、吞咽功能[洼田饮水试验(SSA)]评分、日常生活活动能力(Barthel指数)、血液流变学状态(全血粘度高切、全血粘度低切、血浆粘度)变化、血清炎性因子[白细胞介素-18(IL-18)、血脂蛋白相关磷脂酶A2(Lp-PLA2)]及治疗期间不良反应发生情况。结果:治疗4周后,观察组治疗总有效率高于对照组(P<0.05);两组患者口歪眼斜、肢体活动障碍、言语障碍、主观感觉症状积分均较治疗前降低,且观察组低于对照组(P<0.05);两组SSA评分均较治疗前降低,且观察组低于对照组,Barthel指数均较治疗前提高,且观察组高于对照组(P<0.05);两组全血粘度高切、全血粘度低切、血浆粘度均较治疗前降低,且观察组低于对照组(P<0.05);两组血清IL-18、Lp-PLA2水平均较治疗前降低,且观察组低于对照组(P<0.05);两组均顺利完成治疗,且治疗期间均无明显不良反应。结论:逐痰祛瘀汤结合针电刺激治疗脑梗死后吞咽障碍安全有效,可促进吞咽功能恢复,作用机制可能与其改善血液流变学状态、下调炎性因子表达有关。
Objective:To observe the efficacy of Zhutan Quyu Decoction combined with electro-acupuncture stimulation in treating patients with dysphagia after cerebral infarction of intermingled-phlegm and blood-stasis syndrome.Methods:80 patients with dysphagia of intermingled-phlegm and blood-stasis syndrome after cerebral infarction in the hospital were enrolled between January 2017 and January 2020.The patients were divided into an observation group and a controlled group by the random number table method,with 40 cases in each group.The patients in the controlled group received electroacupuncture stimulation and swallowing function training,and the patients in the observation group were combined with Zhutan Quyu Decoction on this basis.The efficacy was evaluated after 4 weeks.The clinical efficacy,as well as scores of TCM symptoms,swallowing function[Water Swallow Test(Standardized Swallowing Assessment,SSA)],activity of daily living(Barthel index),hemorheological status(high-shear whole blood viscosity,low-shear whole blood viscosity,plasma viscosity)and serum inflammatory factors[interleukin-18(IL-18),serum lipoprotein-associated phospholipase A2(Lp-PLA2)]before treatment and after 4 weeks of treatment and adverse reactions during treatment were compared between the two groups.Results:After 4 weeks of treatment,the total effective rate of treatment in the observation group was higher than that in the controlled group(P<0.05).The scores of crooked mouth and skewed eyes,limb movement disorder,speech disorder and subjective sensory symptoms in the two groups were decreased compared with those before treatment,and the scores of the observation group were lower than those of the controlled group(P<0.05).The SSA score of the two groups was lower than that before treatment,and the score of the observation group was lower than that of the controlled group,and the Barthel index was higher than that before treatment,and the score of the observation group was higher than that of the controlled group(P<0.05).The high-shear whole blood viscosity,low-shear whole blood viscosity and plasma viscosity were reduced in the two groups compared to before treatment,and the above three indicators of the observation group were lower than those of the controlled group(P<0.05).The levels of serum IL-18 and Lp-PLA2 in the two groups were lowered compared to before treatment,and the levels were lower in the observation group than those in the controlled group(P<0.05).Both groups successfully completed the treatment,and there were no obvious adverse reactions during treatment.Conclusion:Zhutan Quyu Decoction combined with electro-acupuncture stimulation is safe and effective in treating dysphagia after cerebral infarction,and can promote the recovery of swallowing function.Its role mechanism may be related to its improvement of hemorheological status and down-regulations of expressions of inflammatory factors.
作者
陈燕芳
王丽芬
CHEN Yanfang;WANG Lifen(Department of Acupuncture and Moxibustion,Chaoyang District Hospital of Traditional Chinese Medicine,Beijing 100027,China;Department of Acupuncture and Moxibustion,Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi'an Shaanxi 710003,China)
出处
《四川中医》
2022年第6期138-141,共4页
Journal of Sichuan of Traditional Chinese Medicine
关键词
逐痰祛瘀汤
针电刺激
脑梗死
吞咽障碍
痰瘀互结证
Zhutan Quyu Decoction
Electro-acupuncture stimulation
Cerebral infarction
Dysphagia
Intermingled-phlegm and blood-stasis
