标题：头针联合补阳还五汤对脑梗塞颈动脉粥样斑块患者IMT/r值、血清LP(α)水平及肢体功能的影响

      作者：侯治强，曹锋，边永喜，孙起世    志丹县中医医院针灸科，陕西 延安 717500

      卷次： 2019年30卷10期

      【摘要】 目的 探讨头针联合补阳还五汤对脑梗塞颈动脉粥样斑块患者颈动脉内膜中层厚度/血管内径(IMT/r)值、血清脂蛋白(α) [LP(α)]水平及肢体功能的影响。方法 选取2017年7月至2018年7月志丹县中医医院针灸科收治的120例脑梗塞伴颈动脉粥样斑块患者作为研究对象，按随机数表法将患者分为观察组和对照组，每组60例，对照组给予补阳还五汤治疗，观察组在对照组基础上联合头针针灸治疗，1次/d，10次为一个疗程，两组患者均治疗 3个疗程，治疗结束后 1周，比较两组患者的临床疗效以及治疗前后的血脂、颈动脉和肢体功能变化情况。结果 观察组患者的临床治疗总有效率为95.00%，明显高于对照组的83.33%，差异有统计学意义(P<0.05)；两组患者治疗后的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)水平均降低，高密度脂蛋白(HDL-C)水平升高，且治疗后观察组患者的 TC、LDL-C水平分别为(3.81±1.06) mmol/L、(2.95±0.34) mmol/L，明显低于对照组的(4.53±1.13) mmol/L、(3.26±0.39) mmol/L，HDL-C水平为(1.39±0.40) mmol/L，明显高于对照组的(1.24±0.41) mmol/L，差异均有统计学意义(P<0.05)；两组患者治疗后 IMT、r、IMT/r和血清LP(α)水平均降低，且观察组 IMT、r、IMT/r和血清LP(α)水平分别为(1.08±0.23) mm、(7.09±0.18) mm、(15.23±2.11)%、(17.12±4.28) ng/L，明显低于对照组的(1.28±0.29) mm、(7.20±0.20) mm、(17.78±2.15)%、(20.09±4.96) ng/L，差异均有统计学意义(P<0.05)；两组患者治疗后ADL评分均升高，且观察组ADL评分为(91.35±8.28)分，明显高于对照组的(87.92±9.96)分，差异有统计学意义(P<0.05)。结论 头针联合补阳还五汤治疗脑梗塞颈动脉粥样斑块可降血脂，稳定及消除颈动脉粥样斑块，促进患者肢体功能恢复，临床疗效显著。
      【关键词】 脑梗塞；颈动脉粥样斑块；补阳还五汤；头针；颈动脉内膜中层厚度；脂蛋白(α)；疗效
      【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1003—6350（2019）10—1262—04

Effects of scalp acupuncture combined with Buyang Huanwu Decoction on carotid intima-media thickness/vascular internal radius (IMT/r) value, serum LP(α) level, and limb function in cerebral infarction patients withcarotid atherosclerotic plaque.
HOU Zhi-qiang, CAO Feng, BIAN Yong-xi, SUN Qi-shi. Department of Acupuncture andMoxibustion, Zhidan Hospital of Traditional Chinese Medicine, Yan'an 717500, Shaanxi, CHINA
【Abstract】 Objective To investigate the effects of scalp acupuncture combined with Buyang Huanwu Decoc-tion on carotid intima-media thickness/vascular internal radius (IMT/r), serum lipoprotein (α) [LP(α)] level, and limbfunction in cerebral infarction patients with carotid atherosclerotic plaque. Methods A total of 120 cerebral infarctionpatients with carotid atherosclerotic plaque admitted to Department of Acupuncture and Moxibustion, Zhidan Hospital ofTraditional Chinese Medicine from July 2017 to July 2018 were selected as the study subjects. The patients were dividedinto observation group and control group according to random number table method, with 60 cases in each group. Thecontrol group was treated with Buyang Huanwu Decoction for 1 month, while the observation group was treated withscalp acupuncture for 3 month on the basis of the control group. One week after the end of treatment, the clinical effectsof the two groups were observed, and the changes of blood lipid, carotid artery level, limb function before and after treat-ment were compared. Results The total clinical effective rate of the treatment group was 95.00%, which was signifi-cantly higher than 83.33% of the control group (P<0.05). The levels of total cholesterol (TC), triglyceride (TG), low densitylipoprotein (LDL-C) decreased and high density lipoprotein (HDL-C) increased before and after treatment in both groups.After treatment, the levels of TC and LDL-C in the observation group were (3.81±1.06) mmol/L, (2.95±0.34) mmol/L, sig-nificantly lower than (4.53±1.13) mmol/L, (3.26±0.39) mmol/L in the control group, and the level of HDL-C were (1.39±0.40) mmol/L, significantly higher than (1.24±0.41) mmol/L in the control group (P<0.05). The levels of IMT, r, IMT/r,and serum LP(α) in the two groups were decreased before and after treatment (P<0.05). The levels of IMT, r, IMT/r, andserum LP(α) in the observation group were (1.08±0.23) mm, (7.09±0.18) mm, (15.23±2.11)%, (17.12±4.28) ng/L, signif-icantly lower than (1.28±0.29) mm, (7.20±0.20) mm, (17.78±2.15)%, (20.09±4.96) ng/L in the control group (P<0.05).The ADL scores of the two groups before and after treatment increased, and the ADL score of the observation group was91.35±8.28, significantly higher than 87.92±9.96 in the control group (P<0.05). Conclusion Scalp acupuncture com-bined with Buyang Huanwu Decoction is effective in treating cerebral infarction patients with carotid atherosclerotic