目的:观察化瘀清络脑安汤结合脑栓通胶囊对急性期脑梗死患者肢体痉挛状态的影响。方法:采用前瞻性分析研究法,对2019年1月至2020年12月焦作市中医院脑病一区收治的急性期脑梗死患者120例进行研究,按照简单随机法分为观察组和对照组,各60例。对照组给予脑栓通胶囊治疗,观察组给予化瘀清络脑安汤结合脑栓通胶囊治疗。观察两组患者治疗前后中医证候积分、Ashworth量表评级、Fugl-Meyer运动功能评估量表(Fugl-Meyer assessment, FMA)评分、血液流变学指标[全血高切黏度、全血低切黏度、红细胞(red blood cell, RBC)压积、血沉(erythrocyte sedimentation rate, ESR)]、美国国立卫生研究院卒中量表(national institute of health stroke scale, NIHSS)评分、Barthel指数变化情况。结果:观察组治疗后各项中医证候积分低于对照组,Ashworth量表评级优于对照组,FMA评分高于对照组,差异有统计学意义(P<0.05);观察组治疗后全血高切黏度、全血低切黏度、RBC压积、ESR均低于对照组,差异有统计学意义(P<0.05);观察组治疗后NIHSS评分低于对照组,Barthel指数高于对照组,差异有统计学意义(P<0.05)。结论:化瘀清络脑安汤结合脑栓通胶囊能缓解急性期脑梗死患者肢体痉挛状态,改善血液流变学、运动功能和日常生活能力。
Stroke may cause upper motor neurons lesions, and thus limb spasm may occur. Brain plasticity refers to the brain's ability to change and adapt the environment and experience when the nervous system is damaged. Acupuncture can relieve the relevant pathological status due to stroke by enhancing brain plasticity. Specifically, acupuncture may finally achieve the balance between excitatory and inhibitory neurotransmitters by inhibiting the expression of neurotransmitter GABA, neurotrophic factor BDNF and proteins related to synaptic plasticity. This article analyzed and summarized that taking advantage of nervous plasticity the acupuncture could regenerate nervous cells and restore the related regulation of the movement by upper motor neurons, so as to relieving limb spasticity. It also summarized the research and application of acupuncture in regulating related signals, providing a systematic thought for the future study on acupuncture in the treatment of stroke induced limb.
