2025 年第 9 期 第 20 卷

温针灸联合益气通络方治疗气虚血瘀型中风恢复期的效果及对患者脑血流动力学和神经功能的影响

Effect of warming acupuncture combined with Yiqi Tongluo recipe in the treatment of stroke of Qi deficiency and blood stasis type in the recovery period and its influence on cerebral hemodynamics and neurological function

作者：陈亚玲唐舒箫周芬曾美琪史小萱廖玲

英文作者：Chen Yaling Tang Shuxiao Zhou Fen Zeng Meiqi Shi Xiaoxuan Liao Ling

单位：湖南中医药大学第一附属医院针灸推拿康复科，长沙410007

英文单位：Department of Acupuncture and Massage Rehabilitation The First Hospital of Hunan University of Chinese Medicine Changsha 410007 China

关键词：中风恢复期；气虚血瘀型；益气通络方；脑血流动力学；神经功能

英文关键词：Strokerecoveryperiod;Qideficiencyandbloodstasistype;YiqiTongluorecipe;Cerebralhemodynamics;Neurologicalfunction

• 摘要：

• 目的 探究温针灸联合益气通络方治疗气虚血瘀型中风恢复期患者的临床效果及对患者脑血流动力学、血清磷脂酶A2（PLA2）、同型半胱氨酸（Hcy）水平的影响。方法 选取湖南中医药大学第一附属医院于2022年5月至2024年5月收治的气虚血瘀型中风恢复期患者125例，采用随机数字表法分为对照组（62例）和观察组（63例）。对照组给予常规治疗，观察组在对照组基础上采用温针灸联合益气通络方治疗，治疗2周后评价2组疗效并比较治疗前后的脑血流动力学指标、PLA2、Hcy水平、神经功能相关因子水平与美国国立卫生研究院卒中量表（NIHSS）评分。结果 观察组总有效率高于对照组［93.6%（59/63）比80.6%（50/62）］（P=0.030）。治疗后，2组脑血管外周阻力均低于治疗前，且观察组低于对照组，2组最小血流量与最小血流速度均高于/快于治疗前，且观察组均高于/快于对照组（均P<0.05）。治疗后，2组血清PLA2、Hcy水平均低于治疗前（均P＜0.05），且观察组均低于对照组［（16±4）mmol/L比（19±5）mmol/L、（14.3±2.1）μmol/L比（17.5±3.3）μmol/L］（均P＜0.05）。治疗后，2组治疗后胶质纤维酸性蛋白、神经元特异性烯醇化酶、髓鞘碱蛋白、脑特异性蛋白、心脏型脂肪酸结合蛋白、NIHSS评分均低于治疗前，且观察组均低于对照组（均P<0.05）。结论 温针灸联合益气通络方可提升气虚血瘀型中风恢复期患者疗效，改善脑血流动力学与神经功能同时降低血清PLA2、Hcy水平。

• Objective To explore the clinical effect of warming acupuncture combined with Yiqi Tongluo recipe in the treatment of stroke of Qi deficiency and blood stasis type patients in the recovery stage and its influence on cerebral hemodynamics, serum phospholipase A2 (PLA2) and homocysteine (Hcy) levels. Methods A total of 125 patients with stroke of Qi deficiency and blood stasis type in the recovery stage admitted to the First Hospital of Hunan University of Chinese Medicine from May 2022 to May 2024 were selected. According to the random number table method, they were divided into the control group (62 cases) and the observation group (63 cases). The control group was given routine treatment, and the observation group was treated with warming acupuncture combined with Yiqi Tongluo recipe on the basis of the control group. After two weeks of treatment, the efficacy of the two groups was evaluated, and the cerebral hemodynamic indexes, PLA2, Hcy levels, neurological function-related factor levels and national institutes of health stroke scale (NIHSS) scores before and after treatment were compared. Results The total effective rate of the observation group was higher than that of the control group ［93.6%（59/63） vs 80.6%（50/62）］（P=0.030）. After treatment, the cerebral vascular peripheral resistances of the two groups were lower than those before treatment, and that of the observation group was lower than that of the control group. The minimum blood flow and minimum blood flow velocity of the two groups were higher/faster than those before treatment, and those of the observation group were higher/faster than those of the control group (all P<0.05). After treatment, the levels of serum PLA2 and Hcy in the two groups were lower than those before treatment (both P<0.05), and those in the observation group were lower than those in the control group ［（16±4）mmol/L vs （19±5）mmol/L, （14.3±2.1）μmol/L vs （17.5±3.3）μmol/L］(all P<0.05). After treatment, the glial fibrillary acidic protein, neuron-specific enolase, myelin basic protein, brain-specific protein, heart-type fatty acid binding protein and NIHSS scores of the two groups after treatment were lower than those before treatment, and those of the observation group were lower than those of the control group (all P<0.05). Conclusion Warming acupuncture combined with Yiqi Tongluo recipe can improve the curative effect of patients with stroke of Qi deficiency and blood stasis type in the recovery period, improve cerebral hemodynamics and neurological function, and reduce serum PLA2 and Hcy levels.