中华中医药学刊

补阳还五汤加减结合醒脑开窍针法对缺血性脑卒中恢复期（气虚证）血液流变学、血清IL-6、TNF-α水平的影响

PDF下载

郝世飞 , 张永康 , 李菲

中华中医药学刊 | 国家项目点击 2026,44(4): 53-57

收起

中华中医药学刊 |国家项目点击 2026 , 44 (4) : 53 -57

补阳还五汤加减结合醒脑开窍针法对缺血性脑卒中恢复期（气虚证）血液流变学、血清IL-6、TNF-α水平的影响

全屏

[Author(id=1319630613796204881, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1319630613880090963, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, authorId=1319630613796204881, language=EN, stringName=Shifei HAO, firstName=Shifei, middleName=null, lastName=HAO, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Shanxi Provincial People＇s Hospital, Taiyuan 030024, Shanxi, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1319630613955588436, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, authorId=1319630613796204881, language=CN, stringName=郝世飞, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=山西省人民医院，山西太原 030024, bio={"content":"

郝世飞（1983-），男，山西忻州人，副主任医师，硕士，研究方向：中西结合治疗脑卒中相关疾病。

"}, bioImg=null, bioContent=

郝世飞（1983-），男，山西忻州人，副主任医师，硕士，研究方向：中西结合治疗脑卒中相关疾病。

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1319630613695541581, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, xref=null, ext=[AuthorCompanyExt(id=1319630613703930190, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, companyId=1319630613695541581, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Shanxi Provincial People＇s Hospital, Taiyuan 030024, Shanxi, China), AuthorCompanyExt(id=1319630613712318799, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, companyId=1319630613695541581, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=山西省人民医院，山西太原 030024)])]), Author(id=1319630614035280214, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1319630614127554904, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, authorId=1319630614035280214, language=EN, stringName=Yongkang ZHANG, firstName=Yongkang, middleName=null, lastName=ZHANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Shanxi Provincial People＇s Hospital, Taiyuan 030024, Shanxi, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1319630614203052377, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, authorId=1319630614035280214, language=CN, stringName=张永康, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=山西省人民医院，山西太原 030024, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1319630613695541581, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, xref=null, ext=[AuthorCompanyExt(id=1319630613703930190, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, companyId=1319630613695541581, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Shanxi Provincial People＇s Hospital, Taiyuan 030024, Shanxi, China), AuthorCompanyExt(id=1319630613712318799, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, companyId=1319630613695541581, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=山西省人民医院，山西太原 030024)])]), Author(id=1319630614307909979, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1319630614375018845, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, authorId=1319630614307909979, language=EN, stringName=Fei LI, firstName=Fei, middleName=null, lastName=LI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Shanxi Provincial People＇s Hospital, Taiyuan 030024, Shanxi, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1319630614437933406, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, authorId=1319630614307909979, language=CN, stringName=李菲, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=山西省人民医院，山西太原 030024, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1319630613695541581, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, xref=null, ext=[AuthorCompanyExt(id=1319630613703930190, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, companyId=1319630613695541581, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Shanxi Provincial People＇s Hospital, Taiyuan 030024, Shanxi, China), AuthorCompanyExt(id=1319630613712318799, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1317115128554832047, companyId=1319630613695541581, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=山西省人民医院，山西太原 030024)])])]

郝世飞, 张永康, 李菲

作者信息

山西省人民医院，山西太原 030024

作者简介:

郝世飞（1983-），男，山西忻州人，副主任医师，硕士，研究方向：中西结合治疗脑卒中相关疾病。

Effect of Modified Buyang Huanwu Decoction（补阳还五汤加减）Combined with Consciousness-Restoring and Orifice-Opening Acupuncture on Hemorheology and Serum Levels of IL-6 and TNF-αin Patients with Ischemic Stroke in Convalescent Period（Qi Deficiency Syndrome）

Shifei HAO, Yongkang ZHANG, Fei LI

Affiliations

Shanxi Provincial People＇s Hospital, Taiyuan 030024, Shanxi, China

出版时间: 2026-04-10 doi: 10.13193/j.issn.1673-7717.2026.04.012

文章导航

摘要

收起

目的

分析补阳还五汤加减结合醒脑开窍针法对缺血性脑卒中恢复期（气虚证）患者血液流变学、血清白细胞介素-6（interleukin-6，IL-6）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）水平的影响。

方法

选取2022年4月—2024年3月医院康复医学科收治的缺血性脑卒中恢复期患者80例，依据随机数字表法将其分为对照组（予以补阳还五汤加减等常规治疗4周）、观察组（予以补阳还五汤加减联合醒脑开窍针法治疗4周）各40例，比较两组中医临床效果、治疗前后血液流变学[全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原（fibrinogen，FIB）]、神经功能指标[美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）、神经生长因子（nerve growth factor，NGF）、脑源性神经生长因子（brain-derived neurotrophic factor，BDNF）]、血清IL-6、TNF-α水平、生活质量[简明健康状况量表（short form 36，SF-36）]、不良反应发生率。

结果

观察组治疗有效率（92.50%，37/40）高于对照组（75.00%，30/40）（P<0.05）；治疗后观察组全血高切黏度、全血低切黏度、血浆黏度、FIB低于对照组（P<0.05）；治疗后观察组NIHSS评分低于对照组，NGF、BDNF水平高于对照组（P<0.05）；观察组治疗2周、4周血清IL-6、TNF-α水平低于对照组（P<0.05）；观察组治疗2周、4周SF-36评分高于对照组（P<0.05）；两组不良反应发生率[12.50%（5/40）、10.00%（4/40）]差异无统计学意义（P>0.05）。

结论

补阳还五汤加减结合醒脑开窍针法用于气虚型缺血性脑卒中恢复期患者，可明显提高临床疗效，改善患者血液流变学、血清IL-6、TNF-α水平及神经功能、生活质量，且安全可靠，值得在临床推广实践。

关键词

补阳还五汤 / 醒脑开窍针法 / 缺血性脑卒中恢复期 / 气虚证 / 血液流变学 / IL-6 / TNF-α

Abstract

收起

Objective

To analyze the effects of Modified Buyang Huanwu Decoction（补阳还五汤加减）combined with consciousness-restoring and orifice-opening acupuncture on hemorheology and serum levels of interleukin-6（IL-6）and tumor necrosis factor-α（TNF-α） in patients with ischemic stroke in the convalescent period（Qi deficiency syndrome）.

Methods

From April 2022 to March 2024, 80 patients with ischemic stroke in the convalescent period who were admitted to rehabilitation medicine department of the hospital were selected and divided into the control group（4 weeks of conventional treatment with Modified Buyang Huanwu Decoction）and the observation group（4 weeks of combined treatment with Modified Buyang Huanwu Decoction and consciousness-restoring and orifice-opening acupuncture）using the random number table method, with 40 cases in each group. The TCMclinical effect, hemorheology[whole blood high-shear viscosity, whole blood low-shear viscosity, plasma viscosity and fibrinogen（FIB）], neurological function indicators[the National Institutes of Health Stroke Scale（NIHSS）, nerve growth factor（NGF）and brain-derived neurotrophic factor（BDNF）], serum levels of IL-6 and TNF-α, quality of life[Short Form 36（SF-36）]and the incidence of adverse reactions were compared between the groups.

Results

The effective rate of treatment in the observation group（92.50%, 37/40）was higher than that in the control group（75.00%, 30/40）（P<0.05）. After treatment, the levels of whole blood high-shear viscosity, whole blood low-shear viscosity, plasma viscosity and FIB in the observation group were lower than those in the control group（P<0.05）. After treatment, NIHSS score of the observation group was lower than that of the control group, and the levels of NGF and BDNF were higher than those of the control group（P<0.05）. The serum levels of IL-6 and TNF-αin the observation group after 2 and 4 weeks of treatment were lower than those in the control group, while SF-36 scores were higher than those of the control group（P<0.05）. The incidence rates of adverse reactions in the two groups were 12.50%（5/40）and 10.00%（4/40）, without statistically significant difference between two groups（P>0.05）.

Conclusion

Applying Modified Buyang Huanwu Decoction combined with consciousness-restoring and orifice-opening acupuncture in the treatment of patients with Qi deficiency type of ischemic stroke in the convalescent period can significantly improve the clinical effect, hemorheology, serum levels of IL-6 and TNF-α, neurological function and quality of life. It is safe and reliable.

Key words

Buyang Huanwu Decoction（补阳还五汤） / consciousness-restoring and orifice-opening acupuncture / ischemic stroke in convalescent period / Qi deficiency syndrome / hemorheology / IL-6 / TNF-α

引用本文

郝世飞, 张永康, 李菲. 补阳还五汤加减结合醒脑开窍针法对缺血性脑卒中恢复期（气虚证）血液流变学、血清IL-6、TNF-α水平的影响. 中华中医药学刊, 2026 , 44 (4) : 53 -57 . DOI: 10.13193/j.issn.1673-7717.2026.04.012

Shifei HAO, Yongkang ZHANG, Fei LI. Effect of Modified Buyang Huanwu Decoction（补阳还五汤加减）Combined with Consciousness-Restoring and Orifice-Opening Acupuncture on Hemorheology and Serum Levels of IL-6 and TNF-αin Patients with Ischemic Stroke in Convalescent Period（Qi Deficiency Syndrome）[J]. Chinese Archives of Traditional Chinese Medicine, 2026 , 44 (4) : 53 -57 . DOI: 10.13193/j.issn.1673-7717.2026.04.012

基金

收起

国家中医药管理局全国名老中医药家传承工作室建设项目(国中医药办人教函〔2022〕75号)

参考文献

收起

文献

收起

参考文献引证文献

排序方式：

[1]

WASSÉLIUS J, ARNBERG F, VON EULER M, et al. Endovascular thrombectomy for acute ischemic stroke[J]. J Intern Med, 2022, 291（3）: 303-316.

[2]

GROTTA J C. Fifty years of acute ischemic stroke treatment: a personal history[J]. Cerebrovasc Dis, 2021, 50（6）: 666-680.

[3]

LI X M, LIN S Y, CHEN X L, et al. The prognostic value of serum cytokines in patients with acute ischemic stroke[J]. Aging Dis, 2019, 10（3）: 544-556.

[4]

步霄，贾师捷，周叶，等.急性缺血性脑卒中患者血清CRP、TNF-α、IL-1 β、HIF-1 α、NSE、SAA对神经功能损伤的诊断价值[J].广东医学，2021，42（1）：90-95.

[5]

李静，刘睿，周婷，等.补阳还五汤加减联合针刺治疗缺血性脑卒中后肢体运动功能障碍临床观察[J].安徽中医药大学学报，2022，41（2）：39-43.

[6]

吴万丰，聂慧芳，胡立娟，等.补阳还五汤对缺血性脑卒中气虚血瘀证大鼠肠道菌群及其血浆代谢产物的影响[J].中草药，2021，52（1）：118-128.

[7]

胡莹莹，谢西梅，沈亚亭，等.醒脑开窍针法联合Bobath技术治疗脑卒中后肩手综合征Ⅰ期的临床研究[J].针灸临床杂志，2023，39（10）：23-27.

[8]

中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国各类主要脑血管病诊断要点2019[J].中华神经科杂志，2019，52（9）：711.

[9]

郑筱萸.中药新药临床研究指导原则[M].北京：中国医药科技出版社，2002：99-104.

[10]

RIGUAL R, FUENTES B, DÍEZ-TEJEDOR E. Management of acute ischemic stroke [J]. Med Clin（Barc）, 2023, 161（11）: 485-492.

[11]

ROMANO J G, RUNDEK T. Expanding treatment for acute ischemic stroke beyond revascularization[J]. N Engl J Med, 2023, 388（22）: 2095-2096.

[12]

SIENEL R I, MAMRAK U, BILLER J, et al. Inhaled nitric oxide suppresses neuroinflammation in experimental ischemic stroke[J]. J Neuroinflammation, 2023, 20（1）: 301.

[13]

谭春凤，郑全成，徐琼，等.补阳还五汤配合温阳针灸法治疗老年缺血性脑卒中恢复期气虚血瘀证的疗效观察[J].中华中医药学刊，2023，41（7）：230-234.

[14]

李章晗，黎华茂，艾年年.醒脑开窍针刺法联合呼吸训练治疗脑卒中后吞咽障碍临床研究[J].针刺研究，2021，46（10）：875-879，884.

[15]

李晓红，韩金娥.补阳还五汤对缺血性脑卒中恢复期气虚血瘀证患者踝背屈障碍的改善效果[J].贵州医药，2024，48（3）：380-382.

[16]

陈佳，陶红，陈小欢，等.醒脑开窍针对急性脑梗死的疗效及部分机制探讨[J].世界中医药，2020，15（3）：468-472.

[17]

黄志强，曹朝霞，崔晓娟，等.补阳还五汤治疗气虚血瘀证急性缺血性脑卒中的临床研究[J].中国中西医结合杂志，2022，42（1）：24-28.

[18]

冯春梅，黄荣荣，杨成，等.醒脑开窍针刺法联合穴位埋线对急性缺血性脑卒中患者吞咽功能障碍及肢体功能恢复情况的影响[J].中国中医急症，2020，29（10）：1855-1857.

[19]

徐可欣，李敏，石建爽.醒脑开窍针法联合艾司唑仑治疗脑梗死后失眠临床研究[J].新中医，2023，55（24）：134-138.

[20]

金倩倩，俞红，王哈妮.经颅磁刺激联合醒脑开窍针对脑卒中患者神经功能及认知功能的影响[J].中国中医急症，2024，33（3）：465-468.

[21]

方芫，苏春娇，胡家桥.三虫半夏白术天麻汤联合丹参注射液对风痰瘀阻型急性缺血性脑卒中患者血液流变学及血清炎症指标的影响[J].四川中医，2022，40（12）：133-136.

[22]

陈萍，侯仕荣.急性缺血性脑卒中患者血清血栓调节蛋白、凝血酶激活纤溶抑制物及相关炎性因子水平的变化及其临床意义[J].实用医院临床杂志，2020，17（3）：30-32.

[23]

马晓伟，冯文霞，王立哲，等.急性脑梗死不同分型病人血清IL-6、TNF-α、hs-CRP及MMP-9水平变化[J].中西医结合心脑血管病杂志，2023，21（15）：2870-2873.

[24]

林琳，张伟，王昌在，等.补阳还五汤联合双抗血小板聚集治疗缺血性脑卒中患者的临床疗效及对血清炎性因子的影响[J].世界中西医结合杂志，2022，17（7）：1416-1420.

[25]

田涛涛，王媛，马凤翘，等.“醒脑开窍”针刺法治疗早期缺血性脑卒中对远期致残率影响的临床研究[J].中华中医药学刊，2023，41（8）：93-96.

[26]

林琳，晏丽丽，王峥，等.补阳还五汤对急性缺血性脑卒中患者炎性因子、氧化应激指标及脑神经功能影响[J].现代中西医结合杂志，2022，31（10）：1391-1395.

2026年第44卷第4期

PDF下载

引用本文

BibTeX

文章信息

doi: 10.13193/j.issn.1673-7717.2026.04.012

首发时间：2026-10-14
出版时间：2026-04-10

补充材料

相关文章

文章信息

作者

出版历史

基金

国家中医药管理局全国名老中医药家传承工作室建设项目(国中医药办人教函〔2022〕75号)

作者信息

山西省人民医院，山西太原 030024

参考文献

分享链接

https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2026.04.012

分享至

全文二维码

扫描看全文

引用本文

BibTeX

本文的引用情况

2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

关闭全屏

BibTeX
EndNote
RefWorks
TxT