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Article(id=1322923444748289001, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923011518628427, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.03.049, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339127956, onlineDateStr=2026-10-30, pubDate=1741536000000, pubDateStr=2025-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339127956, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339127956, creator=13701087609, updateTime=1793339127956, updator=13701087609, issue=Issue{id=1322923011518628427, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='3', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1741536000000', pubDateStr='2025-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339024666, creator='13701087609', updateTime=1793340602374, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929628976906432, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923011518628427, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929628981100737, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923011518628427, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=247, endPage=250, ext={EN=ArticleExt(id=1322923445998191594, articleId=1322923444748289001, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Tongli Huayu Xingnao Decoction（通里化瘀醒脑汤）Combined with Lower Extremity Acupoint Acupuncture on Stroke, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the effect of Tongli Huayu Xingnao Decoction（通里化瘀醒脑汤）combined with lower extremity acupoint acupuncture on quality of life of stroke patients.

Methods

The study included 113 stroke patients，all of whom were admitted to the hospital from January 2021 to December 2022，and were divided into observation group and control group by random number table method. The patients in the control group（56 cases）received routine clinical treatment，and those in the observation group（57 cases）received combined treatment with Tongli Huayu Xingnao Decoction and lower limb acupoint acupuncture on the basis of treatment in the control group. The effects，complications，changes of TCM syndrome scores（dizziness and delirium，skew of mouth，hemiplegia，palpitation and shortness of breath，pale complexion，etc.）and neurological impairment scores were compared between the two groups. The changes in National Institute of Health stroke scale（NIHSS），Brunel Balance Assessment（BBA）score，Fugl-Meyer motor function assessment（FMA），quality of life score（Barthel index）and patient satisfaction with treatment of the two groups were compared.

Results

Compared with that of the control group（71.43%），the effective rate of the observation group（87.72%）was higher（P<0.05）. The complication rate of the observation group and the control group was significant（1.75% vs 12.50%）（P<0.05）. The TCM syndrome scores（dizziness and delirium，skew of mouth，hemiplegia，palpitation and shortness of breath，pale complexion，etc.），NIHSSscore，BBA score，FMA score and Barthel index score before treatment in the observation group and the control group were similar（P>0.05）. After treatment，TCM syndrome scores（dizziness and delirium，skew of mouth，hemiplegia，palpitation and shortness of breath，pale complexion，etc.），NIHSS score，BBA score，FMA score and Barthel index were all improved in each group. And the indexes above in the observation group were better than those in the control group（P<0.05）. The treatment satisfaction rate of the observation group（96.49%）was higher than that of the control group（82.14%）（P<0.05）.

Conclusion

Tongli Huayu Xingnao Decoction combined with lower extremity acupoint acupuncture can significantly improve the clinical efficacy，quality of life and motor function of stroke patients，and reduce the complication rate，with good recovery and high satisfaction rate.

, authors=Bing WANG, Qiuju CHEN, Mengwei ZHANG, authorsList=Bing WANG, Qiuju CHEN, Mengwei ZHANG, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923451920548854, articleId=1322923444748289001, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=通里化瘀醒脑汤联合下肢穴位针刺治疗脑卒中效果分析, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

探究通里化瘀醒脑汤联合下肢穴位针刺提升脑卒中患者生存质量效果。

方法

研究纳入113例脑卒中患者，均由医院2021年1月—2022年12月收治，并以随机数字表法分为观察组与对照组，对照组患者（56例）常规临床治疗，观察组患者（57例）在对照组治疗基础上联合通里化瘀醒脑汤及下肢穴位针刺治疗，比较两组患者疗效、并发症、治疗前及治疗后患者中医证候积分（神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华等）变化及神经功能缺损评分（National Institute of Health stroke scale，NIHSS）变化、Brunel平衡量表（Brunel Balance Assessment，BBA）评分变化、运动功能评分（Fugl-Meyer motor function assessment，FMA）变化、生活质量评分（Barthel index，Barthel）、患者治疗满意度。

结果

较对照组（71.43%），观察组患者有效率（87.72%）更高，P<0.05；观察组与对照组患者并发症率比较（1.75%vs 12.50%），P<0.05；观察组与对照组治疗前中医证候积分（神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华等）及NIHSS评分、BBA评分、FMA评分及Barthel指数评分相当，P>0.05，治疗后各组患者中医证候积分（神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华等）及NIHSS评分、BBA评分、FMA评分及Barthel指数评分均改善，观察组患者治疗后中医证候积分（神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华等）及NIHSS评分、BBA评分、FMA评分及Barthel指数评分均优于对照组，P<0.05；观察组患者治疗满意率（96.49%）高于对照组（82.14%），P<0.05。

结论

通里化瘀醒脑汤联合下肢穴位针刺可显著提升脑卒中患者临床疗效及生活质量、运动功能，患者并发症率降低，恢复好，满意率高。

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王冰（1990-），女，河北衡水人，主治医师，硕士，研究方向：中医康复。

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articleTitle=针刺联合康复训练治疗缺血性脑卒中上肢运动功能障碍的Meta分析, refAbstract=null), Reference(id=1322923484589981774, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923444748289001, doi=null, pmid=null, pmcid=null, year=2022, volume=39, issue=5, pageStart=1215, pageEnd=1220, url=null, language=null, rfNumber=［30］, rfOrder=29, authorNames=王振丰, 朱利霞, 徐振华, journalName=广州中医药大学学报, refType=null, unstructuredReference=王振丰，朱利霞，徐振华. 针刺治疗脑卒中后感觉障碍疗效的Meta分析［J］. 广州中医药大学学报，2022，39（5）：1215-1220., articleTitle=针刺治疗脑卒中后感觉障碍疗效的Meta分析, refAbstract=null), Reference(id=1322923488041893968, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923444748289001, doi=null, pmid=null, pmcid=null, year=2022, volume=44, issue=5, pageStart=446, pageEnd=449, url=null, language=null, rfNumber=［31］, rfOrder=30, authorNames=于子夫, 马甜甜, 毕鸿雁, journalName=中华物理医学与康复杂志, refType=null, unstructuredReference=于子夫，马甜甜，毕鸿雁，等. 针刺运动疗法对脑卒中患者运动功能及日常生活活动能力影响的Meta分析［J］. 中华物理医学与康复杂志，2022，44（5）：446-449., 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组别例数治愈好转未愈总有效
对照组5610（17.86）30（53.57）16（28.57）40（71.43）
观察组5717（29.82）33（57.89）7（12.28）50（87.72）
χ2值----4.6244
P值----0.0315
), ArticleFig(id=1322923457679327260, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923444748289001, language=CN, label=表1, caption=

两组脑卒中患者疗效比较

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组别例数治愈好转未愈总有效
对照组5610（17.86）30（53.57）16（28.57）40（71.43）
观察组5717（29.82）33（57.89）7（12.28）50（87.72）
χ2值----4.6244
P值----0.0315
), ArticleFig(id=1322923457759019037, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923444748289001, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数血栓癫痫感染总并发症
对照组563（5.36）1（1.79）3（5.36）7（12.50）
观察组570（0.00）0（0.00）1（1.75）1（1.75）
χ2值----4.9582
P值----0.0260
), ArticleFig(id=1322923457826127902, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923444748289001, language=CN, label=表2, caption=

两组脑卒中患者并发症率比较

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组别例数血栓癫痫感染总并发症
对照组563（5.36）1（1.79）3（5.36）7（12.50）
观察组570（0.00）0（0.00）1（1.75）1（1.75）
χ2值----4.9582
P值----0.0260
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组别例数治疗时间神昏谵语口舌歪斜半身不遂心悸气短面色无华
对照组56治疗前2.66±0.162.59±0.212.16±0.432.12±0.332.05±0.40
治疗后0.85±0.12a0.79±0.14a0.75±0.12a0.75±0.11a0.78±0.15a
观察组57治疗前2.70±0.142.60±0.192.13±0.402.09±0.352.07±0.39
治疗后0.28±0.07ab0.24±0.04ab0.19±0.04ab0.18±0.05ab0.20±0.06ab
), ArticleFig(id=1322923458195226656, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923444748289001, language=CN, label=表3, caption=

两组脑卒中患者中医证候积分比较（）

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组别例数治疗时间神昏谵语口舌歪斜半身不遂心悸气短面色无华
对照组56治疗前2.66±0.162.59±0.212.16±0.432.12±0.332.05±0.40
治疗后0.85±0.12a0.79±0.14a0.75±0.12a0.75±0.11a0.78±0.15a
观察组57治疗前2.70±0.142.60±0.192.13±0.402.09±0.352.07±0.39
治疗后0.28±0.07ab0.24±0.04ab0.19±0.04ab0.18±0.05ab0.20±0.06ab
), ArticleFig(id=1322923458274918433, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923444748289001, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间NIHSS评分BBA评分FMA评分
对照组56治疗前16.23±2.124.10±0.5515.62±2.62
治疗后12.06±1.23a6.79±0.39a20.34±3.21a
观察组57治疗前16.20±2.084.08±0.5316.67±2.57
治疗后10.03±0.78ab9.14±0.48ab27.23±1.76ab
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两组脑卒中患者治疗前后NIHSS评分、BBA及FMA评分比较（）

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组别例数治疗时间NIHSS评分BBA评分FMA评分
对照组56治疗前16.23±2.124.10±0.5515.62±2.62
治疗后12.06±1.23a6.79±0.39a20.34±3.21a
观察组57治疗前16.20±2.084.08±0.5316.67±2.57
治疗后10.03±0.78ab9.14±0.48ab27.23±1.76ab
), ArticleFig(id=1322923459008921636, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923444748289001, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组5645.23±5.2360.34±2.1220.03650.0000
观察组5745.73±5.7669.53±4.5124.56210.0000
t值-0.483313.9003--
P值-0.63080.0000--
), ArticleFig(id=1322923461496143910, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923444748289001, language=CN, label=表5, caption=

两组脑卒中患者Barthel评分比较（）

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组别例数治疗前治疗后t值P值
对照组5645.23±5.2360.34±2.1220.03650.0000
观察组5745.73±5.7669.53±4.5124.56210.0000
t值-0.483313.9003--
P值-0.63080.0000--
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通里化瘀醒脑汤联合下肢穴位针刺治疗脑卒中效果分析
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王冰 , 陈秋菊 , 张梦伟
中华中医药学刊 | 省级项目平台 2025,43(3): 247-250
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中华中医药学刊 |省级项目平台 2025 , 43 (3) : 247 -250
通里化瘀醒脑汤联合下肢穴位针刺治疗脑卒中效果分析
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王冰, 陈秋菊, 张梦伟
作者信息
  • 衡水市人民医院，河北 衡水 053099
作者简介:

王冰（1990-），女，河北衡水人，主治医师，硕士，研究方向：中医康复。

Effect of Tongli Huayu Xingnao Decoction（通里化瘀醒脑汤）Combined with Lower Extremity Acupoint Acupuncture on Stroke
Bing WANG, Qiuju CHEN, Mengwei ZHANG
Affiliations
  • Rehabilitation Medicine Department of Hengshui People's Hospital，Hengshui 053099，Hebei，China
出版时间: 2025-03-10 doi: 10.13193/j.issn.1673-7717.2025.03.049
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摘要
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目的

探究通里化瘀醒脑汤联合下肢穴位针刺提升脑卒中患者生存质量效果。

方法

研究纳入113例脑卒中患者，均由医院2021年1月—2022年12月收治，并以随机数字表法分为观察组与对照组，对照组患者（56例）常规临床治疗，观察组患者（57例）在对照组治疗基础上联合通里化瘀醒脑汤及下肢穴位针刺治疗，比较两组患者疗效、并发症、治疗前及治疗后患者中医证候积分（神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华等）变化及神经功能缺损评分（National Institute of Health stroke scale，NIHSS）变化、Brunel平衡量表（Brunel Balance Assessment，BBA）评分变化、运动功能评分（Fugl-Meyer motor function assessment，FMA）变化、生活质量评分（Barthel index，Barthel）、患者治疗满意度。

结果

较对照组（71.43%），观察组患者有效率（87.72%）更高，P<0.05；观察组与对照组患者并发症率比较（1.75%vs 12.50%），P<0.05；观察组与对照组治疗前中医证候积分（神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华等）及NIHSS评分、BBA评分、FMA评分及Barthel指数评分相当，P>0.05，治疗后各组患者中医证候积分（神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华等）及NIHSS评分、BBA评分、FMA评分及Barthel指数评分均改善，观察组患者治疗后中医证候积分（神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华等）及NIHSS评分、BBA评分、FMA评分及Barthel指数评分均优于对照组，P<0.05；观察组患者治疗满意率（96.49%）高于对照组（82.14%），P<0.05。

结论

通里化瘀醒脑汤联合下肢穴位针刺可显著提升脑卒中患者临床疗效及生活质量、运动功能，患者并发症率降低，恢复好，满意率高。

脑卒中  /  通里化瘀醒脑汤  /  下肢穴位针刺  /  中医证候积分  /  并发症  /  运动功能
Objective

To explore the effect of Tongli Huayu Xingnao Decoction（通里化瘀醒脑汤）combined with lower extremity acupoint acupuncture on quality of life of stroke patients.

Methods

The study included 113 stroke patients，all of whom were admitted to the hospital from January 2021 to December 2022，and were divided into observation group and control group by random number table method. The patients in the control group（56 cases）received routine clinical treatment，and those in the observation group（57 cases）received combined treatment with Tongli Huayu Xingnao Decoction and lower limb acupoint acupuncture on the basis of treatment in the control group. The effects，complications，changes of TCM syndrome scores（dizziness and delirium，skew of mouth，hemiplegia，palpitation and shortness of breath，pale complexion，etc.）and neurological impairment scores were compared between the two groups. The changes in National Institute of Health stroke scale（NIHSS），Brunel Balance Assessment（BBA）score，Fugl-Meyer motor function assessment（FMA），quality of life score（Barthel index）and patient satisfaction with treatment of the two groups were compared.

Results

Compared with that of the control group（71.43%），the effective rate of the observation group（87.72%）was higher（P<0.05）. The complication rate of the observation group and the control group was significant（1.75% vs 12.50%）（P<0.05）. The TCM syndrome scores（dizziness and delirium，skew of mouth，hemiplegia，palpitation and shortness of breath，pale complexion，etc.），NIHSSscore，BBA score，FMA score and Barthel index score before treatment in the observation group and the control group were similar（P>0.05）. After treatment，TCM syndrome scores（dizziness and delirium，skew of mouth，hemiplegia，palpitation and shortness of breath，pale complexion，etc.），NIHSS score，BBA score，FMA score and Barthel index were all improved in each group. And the indexes above in the observation group were better than those in the control group（P<0.05）. The treatment satisfaction rate of the observation group（96.49%）was higher than that of the control group（82.14%）（P<0.05）.

Conclusion

Tongli Huayu Xingnao Decoction combined with lower extremity acupoint acupuncture can significantly improve the clinical efficacy，quality of life and motor function of stroke patients，and reduce the complication rate，with good recovery and high satisfaction rate.

stroke  /  Tongli Huayu Xingnao Decoction（通里化瘀醒脑汤）  /  lower extremity acupoint acupuncture  /  TCM syndrome score  /  complications  /  motor function
王冰, 陈秋菊, 张梦伟. 通里化瘀醒脑汤联合下肢穴位针刺治疗脑卒中效果分析. 中华中医药学刊, 2025 , 43 (3) : 247 -250 . DOI: 10.13193/j.issn.1673-7717.2025.03.049
Bing WANG, Qiuju CHEN, Mengwei ZHANG. Effect of Tongli Huayu Xingnao Decoction（通里化瘀醒脑汤）Combined with Lower Extremity Acupoint Acupuncture on Stroke[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (3) : 247 -250 . DOI: 10.13193/j.issn.1673-7717.2025.03.049
正文
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脑卒中为临床常见危急重症，患者脑细胞缺血缺氧性坏死，神经功能出现障碍，对患者语言与躯体功能影响较大，需及时采取有效措施治疗，以降低致残率与病死率[1-3]。中国脑卒中发病率逐年升高，危害患者健康与安全，临床十分关注[4-5]。西医常规治疗脑卒中取得一定疗效，但临床疗效并不显著，且患者存在一定后遗症，故而需积极探究新的有效治疗方案[6-7]。中医治疗脑卒中具有较为丰富经验，相关报道较多[8-9]。通里化瘀醒脑汤、下肢穴位针刺均对脑卒中患者具有积极影响，可较好改善患者症状，提升临床疗效，值得深入研究，故而笔者选取院内收治的113例患者进行研究，现报道如下。
1　资料与方法
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1.1　一般资料
研究纳入113例脑卒中患者，均由医院2021年1月—2022年12月收治。伦理会批准研究进行，并采取随机数字表法[6]将其分为两组。对照组56例，男40例，女16例，年龄48～77岁，平均（58.23±5.23）岁；观察组57例，男41例，女16例，年龄49～80岁，平均（58.29±5.21）岁。各组资料比较差异具有统计学意义（P>0.05）。
1.2　诊断标准
脑卒中西医诊断以《中国脑卒中康复治疗指南》[10]为准：发病急，神经功能缺损，病情发展快速，结合影像学确诊。中医参照《中医内科学》[11]中脑卒中（气滞血瘀型）诊断：神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华、自汗、舌质黯淡、苔白腻、脉沉细等。
1.3　纳入排除标准
纳入标准：①确诊为脑卒中，且患者自愿加入研究。②患者可接受通里化瘀醒脑汤、下肢穴位针刺治疗。
排除标准：①患者非自愿参与研究。②患者病情危重，存在生命危险。
1.4　治疗方法
对照组患者西医常规治疗，规范降糖、降压、降脂等，稳定斑块，口服阿司匹林肠溶片，100 mg/d，口服阿托伐他汀钙片，10 mg/d，治疗1个月。观察组患者在对照组治疗基础上联合通里化瘀醒脑汤及下肢穴位针刺治疗，通里化瘀醒脑汤药用：石膏40 g，生大黄25 g，厚朴12 g，川芎12 g，知母12 g，枳实10 g，芒硝10 g，石菖蒲10 g，桃仁10 g，红花8 g，琥珀5 g，汤剂均由我院中药房专门煎煮装袋，1剂/d，每剂3袋，每袋100 mL，患者早中晚饭后温服，连续治疗1个月。下肢穴位针刺：取穴足三里、三阴交及涌泉穴，辅助以阳陵泉及阴陵泉、太冲、丘墟等穴位，患者取仰卧位，酒精消毒，根据患者情况选择毫针，常规针刺，得气留针30 min，间隔10 min运针一次，时间持续1～2 min，每周针刺3～5次，治疗1个月。
1.5　观察指标
①治疗效果[12]，显效：患者神经功能缺损评分（National Institute of Health stroke scale，NIHSS）显著下降，90%以上；有效：患者NIHSS评分得以改善，下降20%～90%之间；无效：患者NIHSS评分下降20%内。总有效率＝显效率+有效。②比较各组患者并发症。③比较各组患者中医证候积分[13]：神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华等证候，各项积分0～3分，分值越高表示患者的证候越严重。④比较各组患者治疗前后NIHSS评分、Brunel平衡量表（Brunel Balance Assessment，BBA）评分、运动功能评分（Fugl-Meyer motor function assessment，FMA）变化。NIHSS评分[14]：评分为0～42分，分值越高表明患者神经功能缺损越为严重。BBA评分[15]：评估患者的平衡功能，分值越高表明患者的平衡能力越佳。FMA评分[16]：评估患者的运动功能，肢体功能恢复情况，分值越高表示越佳。⑤比较各组患者生活质量评分（Barthel index，Barthel）变化。治疗前与治疗后采取Barthel指数[17]评估患者的日常生活能力，分值范围为0～100分，分值越高表示越佳。⑥以问卷调查各组患者治疗后的满意率情况。
1.6　统计学处理
采取SPSS 25.0软件对各组数据进行χ2、t检验，P<0.05，差异具有统计学意义。
2　结果
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2.1　两组疗效比较
对照组与观察组疗效比较（71.43%vs87.72%），P<0.05。见表1。
2.2　两组并发症比较
对照组与观察组并发症率比较（12.50%vs1.75%），P<0.05。见表2。
2.3　两组治疗前后中医证候积分变化比较
与治疗前比较，各组患者治疗后中医证候积分（神昏谵语、口舌歪斜、半身不遂、心悸气短、面色无华等）均明显降低，而观察组各项积分治疗后比对照组更低，P<0.05。见表3。
2.4　两组NIHSS评分、BBA评分、FMA评分变化比较
较治疗前，各组患者治疗后NIHSS评分、BBA评分、FMA评分均改善，观察组各项评分均比对照组更佳，P<0.05。见表4。
2.5　两组治疗前及治疗1个月后生活质量情况比较
较治疗前，各组患者治疗后Barthel评分提升，观察组比对照组评分更高，P<0.05。见表5。
2.6　两组治疗满意度比较
观察组患者治疗满意例数55，满意率96.49%，高于对照组82.14%（46/56），满意率比较χ2＝6.126 9（P=0.013 3），P<0.05。
3　讨论
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中医将脑卒中归于“中风”范畴[18-20]。脑卒中病机复杂，其病变在脑，多与患者年迈经穴亏虚、气血与阴阳不足、外邪入侵机体，导致气血逆乱，痹阻脑络，导致患者脑髓清窍失养，故而可给予患者开窍醒脑、活血化瘀、通络之法治疗[21-24]。故而本次笔者给予脑卒中患者通里化瘀醒脑汤辅助治疗，探究其作用机制及疗效，取得一定成果。通里化瘀醒脑汤包括石膏、生大黄、厚朴及川芎、知母、枳实、芒硝及石菖蒲、桃仁、红花、琥珀等中药，其中石膏具有生用解肌清热，除烦止渴功效；生大黄可泻热毒，破积滞，行瘀血；厚朴可降压、镇静、下气宽中、燥湿消痰、健胃等；川芎行气开郁，祛除风燥湿，活血止痛；知母清热泻火，滋阴润燥；枳实破气消积，化痰除痞；芒硝清热解毒，活血化瘀，软坚散结；石菖蒲开窍豁痰，醒神益智；桃仁活血祛瘀；红花活血通经，去瘀止痛；琥珀镇惊安神、散瘀止血、利水通淋；患者气机逆乱、脏腑功能失调，血瘀滞脑，神志昏蒙，故而以该汤剂行活血化瘀、开窍醒脑功效，帮助患者更好恢复健康[25-28]。
下肢穴位针刺治疗可提升脑卒中患者疗效，故而引起临床重视。本次笔者取足三里、三阴交及涌泉等穴对患者进行针刺治疗，针刺涌泉穴可开窍醒脑、填精益髓、通经活络。针刺足三里可补中益气、调理脾胃、通经活络、疏风化湿、扶正祛邪；针刺三阴交可补肾滋阴、益肾生髓，针刺诸穴可缓解患者症状，帮助患者更好恢复健康[29-32]。本次研究数据显示对照组与观察组疗效比较（71.43%vs87.72%），P<0.05，提示通里化瘀醒脑汤联合下肢穴位针刺可提升脑卒中患者临床疗效；观察组与对照组患者并发症率比较（1.75%vs12.50%），P<0.05，提示通里化瘀醒脑汤联合下肢穴位针刺可降低脑卒中患者并发症发生率，安全性较高；治疗后，观察组患者的各项中医证候积分及NIHSS评分、BBA评分、FMA评分及Barthel指数评分明显优于对照组患者，P<0.05，提示通里化瘀醒脑汤联合下肢穴位针刺可改善脑卒中患者临床症状及神经功能、运动能力及生活能力。观察组患者治疗满意率（96.49%）高于对照组（82.14%），P<0.05，提示脑卒中患者对通里化瘀醒脑汤联合下肢穴位针刺治疗方案较为满意。
综上所述，脑卒中患者采取通里化瘀醒脑汤联合下肢穴位针刺治疗效果较好，患者生活质量改善，病症好转，还可降低患者并发症，促进患者神经功能恢复，改善患者运动功能以及生活能力，患者恢复较好，满意率高，可推广应用。
基金
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  • 河北省医学科学研究项目(20191775)
文献
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2025年第43卷第3期
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doi: 10.13193/j.issn.1673-7717.2025.03.049
  • 首发时间：2026-10-30
  • 出版时间：2025-03-10
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河北省医学科学研究项目(20191775)
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    衡水市人民医院，河北 衡水 053099
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2种不同金属材料的力学参数
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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
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