宣通玄府汤联合舌丛刺运动针法治疗中风后失语临床研究

目的：观察宣通玄府汤联合舌丛刺运动针法对中风后失语患者表达能力、远隔损害及中枢损伤修复的作用。方法：选择90 例中风后失语症患者，按随机数字表法分为针刺组和研究组各45 例。2 组均给予基础治疗，针刺组在基础治疗同时给予舌丛刺运动针法治疗，研究组在针刺组治疗基础上给予宣通玄府汤治疗。评价2 组临床疗效，采用功能性语言沟通能力量表（CFCP）、中国康复研究中心失语症检查表（CRRCAE） 评价患者语言表达能力，统计中医证候评分，比较2 组治疗前后S100 钙结合蛋白B（S100B）、降钙素基因相关肽（CCRP）、神经生长因子（NGF）、血沉方程K 指数、血浆黏度、红细胞聚集指数、红细胞压积水平，检测2 组梗死灶、双侧大脑脚各向异性分数（FA） 值的变化。结果：研究组总有效率为97.78%，高于针刺组82.22%（P＜0.05）。治疗后，2 组CFCP、CRRCAE 评分较治疗前升高（P＜0.05）；且研究组CFCP、CRRCAE评分高于针刺组（P＜0.05）。治疗后，2 组各项中医证候评分较治疗前降低（P＜0.05）；且研究组各项中医证候评分低于针刺组（P＜0.05）。治疗后，2 组S100B 水平较治疗前降低，研究组S100B 水平低于针刺组（P＜0.05）；2 组CCRP、NGF 水平较治疗前升高，研究组CCRP、NGF 水平高于针刺组（P＜0.05）。治疗后，2 组血沉方程K 指数、血浆黏度、红细胞聚集指数、红细胞压积较治疗前降低（P＜0.05）；且研究组血沉方程K指数、血浆黏度、红细胞聚集指数、红细胞压积低于针刺组（P＜0.05）。治疗后，2 组梗死灶FA 值、梗死灶同侧大脑脚FA 值较治疗前降低（P＜0.05）；但研究组梗死灶FA 值、梗死灶同侧大脑脚FA 值高于针刺组（P＜0.05）。结论：宣通玄府汤联合舌丛刺运动针法治疗中风后失语症患者，可促进中枢损伤修复，改善血液流变学，减少远隔损害，改善患者失语表达能力，提升临床疗效。

Clinical Study on Xuantong Xuanfu Decoction Combined with Tongue Cluster NeedlingMovement Acupuncture Method for Post-stroke Aphasia

Abstract： Objective： To observe the effects of Xuantong Xuanfu Decoction combined with tonguecluster needling movement acupuncture method on expression ability，remote lesions and repair of centralinjury in patients with post- stroke aphasia. Methods： A total of 90 cases of patients with post- strokeaphasia were selected and divided into the acupuncture group and the study group according to the randomnumber table method， with 45 cases in each group. Both groups were given basic treatment； theacupuncture group was additionally treated with tongue cluster needling movement acupuncture method，and the study group was additionally treated with Xuantong Xuanfu Decoction based on the treatment of theacupuncture group. The clinical effects in the two groups were evaluated； Chinese Functional Communication Profile (CFCP) and Chinese Rehabilitation Research Center Aphasia Examination (CRRCAE)were used to evaluate the language expression ability of the patients；traditional Chinese medicine (TCM)syndrome scores were counted； the levels of S100 calcin- binding protein B (S100B)， calcitonin generelatedpeptide (CCRP)， nerve growth factor (NGF)， K index of erythrocyte sedimentation equation，plasma viscosity， red blood cell aggregation indexes and hematocrit were compared before and aftertreatment between the two groups； the changes in FA values of infarct lesions and bilateral cerebralpeduncle in the two groups were detected. Results： The total effective rate was 97.78% in the studygroup， higher than that of 82.22% in the acupuncture group (P＜0.05). After treatment， the scores ofCFCP and CRRCAE in the two groups were increased when compared with those before treatment (P＜0.05)，and the scores in the study group were higher than those in the acupuncture group (P＜0.05). Aftertreatment， TCM syndrome scores in the two groups were decreased when compared with those beforetreatment (P＜0.05)， and TCM syndrome scores in the study group were lower than those in theacupuncture group (P＜0.05). After treatment， S100B levels in the two groups were decreased whencompared with those before treatment， and S100B level in the study group was lower than that in theacupuncture group (P＜0.05). The levels of CCRP and NGF in the two groups were increased whencompared with those before treatment，and the levels of CCRP and NGF in the study group were higherthan those in the acupuncture group (P＜0.05). After treatment， the K indexes of ESR equation， plasmaviscosity， erythrocyte aggregation indexes and hematocrit in the two groups were decreased whencompared with those before treatment (P＜0.05)， and the K index of ESR equation， plasma viscosity，erythrocyte aggregation index and hematocrit in the study group were lower than those in the acupuncturegroup (P＜0.05). After treatment，the FA values of infarct lesions and infarct ipsilateral cerebral peduncle inthe two groups were decreased when compared with those before treatment (P＜0.05)；but the FA valuesof infarct lesions and infarct ipsilateral cerebral peduncle in the study group were higher than those in theacupuncture group (P＜0.05). Conclusion： Xuantong Xuanfu Decoction combined with tongue clusterneedling movement acupuncture method for patients with post- stroke aphasia can promote the repair ofcentral injury，improve hemorheology，reduce remote lesions，improve the expression ability of patients，and enhance clinical effects.