2019 年第 10 期 第 14 卷

三七通舒胶囊伴针灸治疗脑梗死引起半身不遂患者的效果及血液流变学变化的研究

Clinical effectiveness and hemorheological changes by using Sanqi Tongshu capsule combined with acupuncture and moxibustion treating hemiplegia due to cerebral infarction

作者：李静张凌志曾哲淳

英文作者：

单位：100029首都医科大学附属北京安贞医院中医理疗科(李静、张凌志)；100029北京市心肺血管疾病研究所人群防治研究室(曾哲淳)

英文单位：

关键词：脑梗死；半身不遂；三七通舒胶囊；针灸治疗；血液流变学

英文关键词：

• 摘要：

• 【摘要】目的    观察三七通舒胶囊伴针灸治疗脑梗死引起的半身不遂患者的效果及血液流变学的变化。方法    选择2015年9月至2016年6月首都医科大学附属北京安贞医院门诊收治的脑梗死引起的半身不遂患者80例，按照随机数字表法分为观察组和对照组，各40例。对照组脱落4例，最终纳入36例，观察组脱落2例，最终纳入38例。观察组患者常规口服降压药、降脂药，并口服三七通舒胶囊，0.2 g/粒，1粒/次，3次/d，连续服用半年，配合针灸治疗；对照组未口服任何中药，常规口服降压药、降脂药，仅针灸治疗。2组以连续针灸治疗10 d为1个疗程，间歇2 d，共治疗10个疗程。比较2组治疗效果、治疗前后全血黏度和血细胞比容，分析治疗效果的影响因素。结果    观察组治疗效果明显优于对照组，差异有统计学意义（Z=-2.886,P=0.004)。治疗后，2组全血黏度和血细胞比容与治疗前比较均有所改善，且观察组全血黏度和血细胞比容均明显低于对照组［（5.64±0.30）mPa·s比（7.13±0.28）mPa·s、（38.9±2.5）%比（45.6±3.0）%］，差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析结果显示，单纯药物治疗、吸烟是治疗效果的独立危险因素（比值比=0.040、0.003，95%置信区间：0.003～0.549、0.000～0.156，P=0.016、0.004），有自我健康管理行为是治疗效果的独立保护因素（比值比=18.432，95%置信区间：1.635～207.792，P=0.018）。结论    三七通舒胶囊配合针灸用于脑梗死引起半身不遂患者康复治疗，临床疗效确切，能提高患者的治愈率，并改善血液流变学指标，且无明显不良反应。在调整混杂因素的情况下三七通舒胶囊伴针灸的治疗效果优于单纯针灸治疗。

• 【Abstract】Objective    To observe the clinical effectiveness and hemorheological changes in patients with hemiplegia due to cerebral infarction treated by Sanqi Tongshu capsule combined with acupuncture and moxibustion. Methods    Eighty patients with hemiplegia caused by cerebral infarction were enrolled from September 2015 to June 2016 in Beijing Anzhen Hospital, Capital Medical University. They were randomly divided into observation group and control group, with 40 cases in each group. Four cases in control group and 2 cases in observation group dropped out during the trial. The observation group took routine antihypertensive drug, lipid-lowering drugs and Sanqi Tongshu capsule(0.2 g/capsule, 1 capsule/time, 3 times/d) for 6 months. The control group only took routine antihypertensive and lipid-lowering drugs. Both groups had acupuncture and moxibustion therapy for 10 days as a course of treatment, intermittent for 2 days, and they were treated 10 courses in total. Whole blood viscosity and hematocrit were detected before and after treatment. Clinical therapeutic effect and the influence factors were analyzed. Results    Therapeutic effect in observation group was significantly better than that in control group(Z=-2.886,P=0.004). After treatment, whole blood viscosity and hematocrit were improved compared with those before treatment in both groups, and the levels in observation group were obviously lower than those in control group［（5.64±0.30）mPa·s vs （7.13±0.28）mPa·s, （38.9±2.5）% vs （45.6±3.0）%］(both P＜0.05). Multivariate logistic regression analysis showed that simple drug therapy and smoking were independent risk factors of the therapeutic effect（odds ratio=0.040, 0.003; 95% confidence interval： 0.003-0.549, 0.000-0.156; P=0.016, 0.004）; self-health management behavior was an independent protective factor of the therapeutic effect（odds ratio=18.432, 95% confidence interval： 1.635-207.792， P=0.018） (all P＜0.05). Conclusions    Sanqi Tongshu capsule combined with acupuncture and moxibustion treating hemiplegia caused by cerebral infarction is effective in improving the cure rate and hemorheological indicators with no significant adverse reaction. With adjustment of confounding factors, Sanqi Tongshu capsule combined with acupuncture and moxibustion shows a better curative effect than acupuncture and moxibustion therapy.