Objective To explore the clinical efficacy of acupuncture and moxibustion combined with Buyang Huanwu decoction on the treatment of apoplectic sequelae with syndrome of qi deficiency and blood stasis.Methods From February 2015 to December 2017, one hundred and twenty patients of apoplectic sequelae with syndrome of qi deficiency and blood stasis were selected and randomly divided into observation group and control group with 60 cases in each group.The patients in the control group were treated with routine rehabilitation combined with acupuncture and moxibustion, and the patients in the observation group were treated with Buyang Huanwu decoction on the basis of the control group.After one month of treatment, the curative effect was evaluated, and the change of the TCM syndrome score, the MMT and the Barthel index before and after the treatment of the two patients were observed, and the t-PA and PAI-1 in the peripheral blood were measured.Results The levels of serum PAI-1 in both groups were significantly lower than those before treatment, and the levels of serum t-PA in both groups were significantly higher than those before treatment, and the degree of improvement in the observation group was significantly better than that in the control group (P＜0.05).The scores of Barthel index and MMT in both groups were significantly higher than those before treatment, and the degree of improvement in the observation group was significantly better than that in the control group (P＜0.05).The scores of TCM syndrome in both groups were significantly lower than those before treatment, and the degree of improvement in the observation group was significantly better than that in the control group (P＜0.05).The total effective rate of clinical treatment in the observation group was 80.00％, which was significantly higher than that of the control group (P＜0.05).Conclusion The application of acupuncture and moxibustion combined with Buyang Huanwu decoction on the treatment of apoplectic sequelae with syndrome of qi deficiency and blood stasis can obviously improve the clinical efficacy, reduce the score of TCM syndrome, and improve the function of limbs.In clinical work, the levels of serum PAI-1 and t-PA can be combined to predict the severity of apoplectic sequelae with syndrome of qi deficiency and blood stasis and its therapeutic effect.It is worth popularizing and applying in clinical diagnosis and treatment.%目的 探究针灸联合补阳还五汤治疗气虚血瘀型中风后遗症患者的临床疗效.方法 选取2015年2月—2017年12月本院神经内科收治的气虚血瘀型中风后遗症患者120例, 按照随机数字表法分为观察组和对照组, 每组60例.对照组患者予以常规康复联合针灸治疗, 观察组患者在对照组治疗基础上加用补阳还五汤治疗.治疗1个月后进行疗效评估, 观察2组患者治疗前后的中医证候积分、徒手肌力测定 (MMT) 和日常生活活动评分 (Barthel指数) 的变化, 检测患者外周血中组织型纤溶酶原激活物 (t-PA) 、快速抑制酶-1 (PAI-1) 的水平变化.结果 2组患者血清PAI-1水平均较治疗前明显下降, 血清t-PA水平均较治疗前明显提高, 且观察组改善程度显著优于对照组 (P＜0.05);2组患者Barthel指数及MMT评分均较治疗前明显升高, 且观察组改善程度显著优于对照组 (P＜0.05);2组患者中医证候积分均较治疗前明显下降, 且观察组改善程度显著优于对照组 (P＜0.05);观察组临床治疗总有效率为80.00％, 显著高于对照组的55.00％.结论 运用针灸联合补阳还五汤治疗气虚血瘀型中风后遗症患者可明显提高临床疗效, 降低中医证候积分, 改善肢体功能;临床工作中可通过联合检测血清中PAI-1及t-PA的水平变化来预测气虚血瘀型中风后遗症的病情严重程度与治疗效果, 值得在临床诊疗中推广应用.
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