回医烙灸法对缺血性脑卒中功能恢复的临床疗效评价研究

发布时间：2018-07-21 14:51

【摘要】：目的评价回医烙灸法对缺血性脑卒中功能恢复的的临床疗效。方法按照随机、单盲、对照的临床研究方法,选择既符合中医诊断又符合西医诊断纳入标准的缺血性脑卒中患者195例作为受试者随机分为三组,按1:1:1比例分配于相应的治疗组,治疗组1(针刺烙灸组)、治疗组2(督脉烙灸组)、对照组(常规针刺组)每组各65例。在治疗前、治疗后、12周后随访采用中医证候疗效评价、美国国立卫生研究院脑卒中量表(NIHSS)、日常生活活动能力(ADL)评分量表和简化FuglMeyer量表(FMA)对三组进行疗效评价。实验周期为12周,其中临床治疗4周,常规针刺每周连续治疗5次,休息2天,烙灸每周一、周五各治疗一次,入组12周后随访一次。结果1.总体疗效评价:采用全分析集方法(FAS分析):治疗4周后总有效率治疗组1为89.23%、治疗组2为61.54%、对照组为66.15%。12周随访时总有效率治疗组1为89.23%、治疗组2为64.62%、对照组为66.15%。三组总体疗效评价具有显著性(P0.05);采用符合方案集分析(PP分析法):治疗4周后总有效率治疗组1为90.77%、治疗组2为63.08%、对照组为67.69%。12周随访时总有效率治疗组1为90.77%、治疗组2为66.15%、对照组为67.69%。三组总体疗效评价具有显著性(P0.05)。2.各评分指标:治疗四周后组内比较:三组治疗后卒中量表(NIHSS)评分、ADL评分、FMA评分与治疗前比较均具有显著性差异(分别为P0.01、P0.01、P0.01);组间比较:NIHSS评分、ADL评分、FMA评分比较,治疗组1与治疗组2、对照组比较,治疗组1的各评分改善更明显,三组治疗后各评分改善值都具有显著性差异P0.05。12周随访时FAS分析三组的NIHSS评分不具有显著性差异,PP分析三组的NIHSS评分具有显著性差异;ADL评分、FMA评分具有显著性差异(P0.05)。结论1.回医烙灸法治疗缺血性中风病在总体疗效评价方面:回医烙灸法结合常规针刺对缺血性中风病功能恢复的临床疗效优于单纯回医烙灸治疗与常规的针刺治疗。2.回医烙灸法结合常规针刺治疗缺血性中风病在改善患者神经功能缺损,恢复日常活动能力,恢复肢体运动功能方面优于单纯烙灸和常规针刺治疗。
[Abstract]:Objective to evaluate the clinical effect of cauterization and moxibustion on functional recovery of ischemic stroke. Methods according to the randomized, single-blind and controlled clinical study, 195 patients with ischemic stroke, who met the criteria of both TCM diagnosis and western medicine diagnosis, were randomly divided into three groups, which were assigned to the corresponding treatment group according to the proportion of 1:1:1. Treatment group 1 (acupuncture cauterization group), treatment group 2 (du vein cautery moxibustion group), control group (routine acupuncture group) 65 cases in each group. The efficacy of TCM syndrome evaluation, NIHSS, ADL scale and simplified FuglMeyer scale (FMA) were evaluated before and after 12 weeks of treatment in the three groups. The therapeutic effects of the three groups were evaluated with the National Institutes of Health Stroke scale (NIHSS), the activity of Daily living (ADL) scale and the simplified Fugl Meyer scale (FMA). The experimental period is 12 weeks, in which clinical treatment is 4 weeks, routine acupuncture treatment 5 times a week, rest 2 days, cautery moxibustion once every Monday, Friday, 12 weeks into the group followed up once. Result 1. The total effective rate was 89.23 in treatment group, 61.54 in treatment group 2, 89.23 in control group, 89.23 in treatment group 2, 66.15.12 in control group, 64.62 in treatment group 2, 66.15.12 in control group. The total effective rate of treatment group 1 was 90.777.77 after 4 weeks, that of treatment group 2 was 63.08, and that of control group was 67.69.12 weeks follow-up: the total effective rate of treatment group 1 was 90.777.77, and that of control group 67.69.12 weeks follow-up was 90.775.The total effective rate of treatment group 1 was 90.77 after 4 weeks of treatment, and that of treatment group 2 was 63.08 and that of control group was 67.69.12 weeks follow-up. Group 2 was 66.15 and control group 67.69. The overall curative effect evaluation of the three groups was significant (P0.05). 2. Scores: after four weeks of treatment, there were significant differences in ADL scores and FMA scores between the three groups (P0.01and P0.01P0.01, respectively), and the comparison between the two groups in the scores of NIHSS and ADL and FMA scores. Compared with treatment group 2 and control group, the scores of treatment group 1 were better than those of control group. There was no significant difference in NIHSS score between the three groups after treatment (P0.05.12 week follow-up P0.05.12). There was significant difference in NIHSS score in PP analysis group and FMA score in PP analysis group (P0.05). Conclusion 1. Evaluation of the overall curative effect of cauterization and moxibustion in treating ischemic apoplexy: the clinical effect of traditional cauterization and moxibustion combined with routine acupuncture on functional recovery of ischemic apoplexy is better than that of simple cauterized moxibustion and routine acupuncture. 2. The treatment of ischemic apoplexy with cauterization and moxibustion combined with routine acupuncture is superior to that of simple cauterization moxibustion and routine acupuncture in improving the neurological deficit, restoring the daily activity and restoring the motor function of the limbs.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R29

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