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[目的]观察针刺与补阳还五汤联合西药治疗脑梗死疗效。[方法]使用随机平行对照方法,将77例门诊患者按就诊顺序号法简单随机分为两组。对照组38例调整血压、预防并发症、防止血栓进展,减少梗塞范围,控制合并症;梗塞面积静脉滴注250m L 20%甘露醇,2~4次/d,静滴。治疗组39例针刺,阳明经为主,太阳少阳经穴为辅,或阳明经为主,辅以阴经穴;上肢取肩井、极泉、外关、曲池、合谷;下肢取环跳、丰隆、足三里、解溪、昆仑及太冲,三棱针点刺法,30min/次,1次/d;补阳还五汤(生黄芪35g,当归尾、川芎、桃仁、红药、地龙各3g,赤芍5g),1剂/d,水煎200m L,早晚口服;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、神经功能缺损评分、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组显效21例,有效12例,无效6例,总有效率84.62%。对照组显效11例,有效11例,无效16例,总有效率57.89%。治疗组疗效优于对照组(P<0.01)。神经功能缺损评分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]针刺与补阳还五汤联合西药治疗脑梗死疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of acupuncture combined with Buyang Huanwu Decoction and western medicine on cerebral infarction. [Methods] Using randomized parallel control method, 77 outpatients were randomly divided into two groups according to the sequence number of visiting doctor. In the control group, 38 cases were given blood pressure, prevention of complications, prevention of thrombus progression, reduction of infarct size, and control of comorbidities. Infarction area was infused intravenously with 250 ml of 20% mannitol 2 to 4 times daily. In the treatment group, 39 cases were acupunctured, the main body of Yangming meridian was supplemented by Sun Shaoyang meridian or Yangming meridian, supplemented by meridian acupoints; Lower limbs take ring jump, Hong Leong, Zusanli, Jiexiu, Kunlun and Taichong, triangular needle prick, 30min / times, 1 times / d; Buyang Huanwu Tang (raw Astragalus 35g, Angelica tail, Peach kernel, red medicine, earthworm each 3g, red peony 5g), 1 / d, decoction 200m L, morning and evening oral; western medicine treatment with the control group. Continuous treatment 7d for a course of treatment. Observation of clinical symptoms, neurological deficit score, adverse reactions. Continuous treatment of 2 courses to determine the efficacy. [Result] In the treatment group, 21 cases were markedly effective, 12 cases were effective and 6 cases were ineffective. The total effective rate was 84.62%. In the control group, 11 cases were markedly effective, 11 cases were effective, 16 cases were ineffective, and the total effective rate was 57.89%. The treatment group than the control group (P <0.01). Neurological deficit scores were improved in both groups (P <0.01), and the treatment group improved better than the control group (P <0.01). [Conclusion] Acupuncture and Buyang Huanwu Decoction combined with Western medicine in treating cerebral infarction have satisfactory curative effect and no serious adverse reactions, which deserves promotion.