关键词:

缺血性脑卒中, 急性期, 针刺, 通窍涤痰汤, 疗效

Abstract:

Objective　To explore the clinical effect of Tongqiao Ditan Tang combined with acupuncture for patients with acute ischemic stroke. Methods　Ninety-six patients with acute ischemic stroke treated at Luohe Hospital of Traditional Chinese Medicine from February 2021 to February 2024 were selected, and were divided into a control group and an observation group according to the treatment methods, with 48 cases in each group. There were 27 males and 21 females in the control group; they were (74.35±3.28) years old; the onset time was (5.42±1.26) h. There were 25 males and 23 females in the control group; they were (73.84±3.46) years old; the onset time was (5.63±1.18) h. The control group were treated with atorvastatin, for 2 months. The observation group were treated with Tongqiao Ditan Tang for 2 months and acupuncture once per day, 6 times per week, for 2 months. The efficacies, levels of neurofactors [brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE), and nerve growth factor (NGF)], coagulation function [activated partial thromboplastin time (APTT), fibrinogen (FIB), and D-dimer (D-D)], scores of Neurological Impairment Scale (NIHSS), Fugl-Meyer Motor Function Assessment Scale (FMA), Ability to Perform Daily Life Scale (ADL), and Comprehensive Quality of Life Questionnaire (GQOLI74), and incidence rates of adverse reactions were compared between the two groups. The independent sample t and χ² tests were used for the statistical analysis. Results　After two months' treatment, the total effective rate in the observation group was higher than that in the control group [95.83% (46/48) vs. 83.33% (40/48)]; the levels of BDNF, NSE, and NGF in the observation group were better than those in the control group [(35.06±3.12) μg/L vs. (31.87±2.75) μg/L, (48.25±3.17) ng/L vs. (44.16±3.02) ng/L, and (13.72±1.24) μg/L vs. (15.85±1.43) μg/L]; the APTT and levels of FIB and D-D in the observation group were better than those in the control group [(18.95±1.21) s vs. (22.79±1.46) s, (2.65±0.34) g/L vs. (3.48±0.41) g/L, and (0.38±0.07) mg/L vs. (0.49±0.09) mg/L]; the scores of NIHSS, FMA, ADL, and GQOLI74 in the observation group were better than those in the control group (14.92±1.24 vs. 21.87±1.68, 67.52±4.15 vs. 40.26±3.43, 61.56±3.24 vs. 50.48±2.75, and 69.46±3.68 vs. 61.57±3.45); there were statistical differences in the above indicators between the two groups (all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the two groups (P>0.05). Conclusion　Tongqiao Ditan Tang combined with acupuncture for patients with acute ischemic stroke is effective and safe, and can improve their neurological function, limb function, ability of daily life, and quality of life and promote their recovery of cerebral function.

Key words:

Ischemic stroke, Acute stage, Acupuncture, Tongqiao Ditan Tang, Treatment effect