【摘要】：目的評價回醫(yī)烙灸法對缺血性腦卒中功能恢復(fù)的的臨床療效。方法按照隨機、單盲、對照的臨床研究方法,選擇既符合中醫(yī)診斷又符合西醫(yī)診斷納入標(biāo)準(zhǔn)的缺血性腦卒中患者195例作為受試者隨機分為三組,按1:1:1比例分配于相應(yīng)的治療組,治療組1(針刺烙灸組)、治療組2(督脈烙灸組)、對照組(常規(guī)針刺組)每組各65例。在治療前、治療后、12周后隨訪采用中醫(yī)證候療效評價、美國國立衛(wèi)生研究院腦卒中量表(NIHSS)、日常生活活動能力(ADL)評分量表和簡化FuglMeyer量表(FMA)對三組進行療效評價。實驗周期為12周,其中臨床治療4周,常規(guī)針刺每周連續(xù)治療5次,休息2天,烙灸每周一、周五各治療一次,入組12周后隨訪一次。結(jié)果1.總體療效評價:采用全分析集方法(FAS分析):治療4周后總有效率治療組1為89.23%、治療組2為61.54%、對照組為66.15%。12周隨訪時總有效率治療組1為89.23%、治療組2為64.62%、對照組為66.15%。三組總體療效評價具有顯著性(P0.05);采用符合方案集分析(PP分析法):治療4周后總有效率治療組1為90.77%、治療組2為63.08%、對照組為67.69%。12周隨訪時總有效率治療組1為90.77%、治療組2為66.15%、對照組為67.69%。三組總體療效評價具有顯著性(P0.05)。2.各評分指標(biāo):治療四周后組內(nèi)比較:三組治療后卒中量表(NIHSS)評分、ADL評分、FMA評分與治療前比較均具有顯著性差異(分別為P0.01、P0.01、P0.01);組間比較:NIHSS評分、ADL評分、FMA評分比較,治療組1與治療組2、對照組比較,治療組1的各評分改善更明顯,三組治療后各評分改善值都具有顯著性差異P0.05。12周隨訪時FAS分析三組的NIHSS評分不具有顯著性差異,PP分析三組的NIHSS評分具有顯著性差異;ADL評分、FMA評分具有顯著性差異(P0.05)。結(jié)論1.回醫(yī)烙灸法治療缺血性中風(fēng)病在總體療效評價方面:回醫(yī)烙灸法結(jié)合常規(guī)針刺對缺血性中風(fēng)病功能恢復(fù)的臨床療效優(yōu)于單純回醫(yī)烙灸治療與常規(guī)的針刺治療。2.回醫(yī)烙灸法結(jié)合常規(guī)針刺治療缺血性中風(fēng)病在改善患者神經(jīng)功能缺損,恢復(fù)日常活動能力,恢復(fù)肢體運動功能方面優(yōu)于單純烙灸和常規(guī)針刺治療。
[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.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R29

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