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[目的]观察中成药、针刺、推拿、康复训练、药物熏洗联合西药治疗急性脑出血疗效。[方法]使用随机平行对照方法,将80例住院患者按抛硬币法简单随机分为两组。对照组40例血糖控制、调整血压、降低颅内压、抗脑水肿、预防并发症,按出血量、出血部位、意识状态结合全身状况、年龄、发病时间选择微创手术治疗。治疗组40例中成药:痰热腑实证,20m L醒脑静+250m L生理盐水,1次/d,静滴;其他类型予20m L丹参注射液+250m L生理盐水,1次/d,静滴;针刺:石氏醒脑开窍针刺法,主穴为双侧内关、人中及患侧三阴交,副穴为患侧尺泽、极泉水、委中;眩晕加双侧天柱穴,吞咽障碍加双侧凤池、完骨、翳风穴;先刺双侧内关穴,刺入0.5~1寸,提插捻转泻法,持续1min,后刺人中,鼻中隔方向斜刺入0.3~0.5寸,雀啄手法,以眼球湿润或流泪为宜,后刺三阴交,沿胫骨内侧缘和皮肤保持45°斜刺,刺入0.5~1寸,提插补法进行;30min/次,1次/d;推拿,急性期改良陆氏推拿,以拇指按摩头部,5次;手揉拿上肢,5次;手指于肌腱部做弹指法,1~2次;按揉、活动关节;拇指按摩足背面趾间数次;30min/次,1次/d;药物熏洗,偏瘫活络方(桑枝、牛膝、两面针、红花、伸筋草、透骨草各12g),水煎3000m L,熏洗患处,1剂/次,30min/次,1次/d;西药治疗同对照组。连续治疗28d为1疗程。观测临床症状、FMA评分、NFD评分、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组痊愈21例,显效14例,有效3例,无效2例,总有效率95.00%。对照组痊愈17例,显效10例,有效5例,无效8例,总有效率80.00%。治疗组疗效优于对照组(P<0.05)。评分指标两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]中成药、针刺、推拿、康复训练、药物熏洗联合西药治疗急性脑出血疗效满意,无严重不良反应,值得推广。
[Objective] To observe the effect of Chinese patent medicines, acupuncture, massage, rehabilitation training, drug fumigation and western medicine in treating acute cerebral hemorrhage. [Methods] Using randomized parallel control method, 80 inpatients were randomly divided into two groups according to the coin-tossing method. Control group, 40 cases of blood glucose control, blood pressure, reduce intracranial pressure, anti-brain edema, prevent complications, according to the amount of bleeding, bleeding sites, combined with general condition of consciousness, age, onset time minimally invasive surgery. Treatment group 40 cases of proprietary Chinese medicine: phlegm heat organs, 20m L Xingnaojing + 250m L normal saline, 1 / d, intravenous infusion; other types to 20m L Salvia injection + 250m L normal saline, 1 / d, Intravenous infusion; acupuncture: recuperation Kai-shek acupuncture acupuncture, the main point of bilateral internal customs, people and the affected side Sanyinjiao, Vice hole ipsilateral foot Ze, very spring water, appoint; dizziness plus bilateral Tianzhu , Swallowing disorders plus bilateral Fengchi, bone, 翳 wind point; first puncture bilateral Neiguan acupuncture, piercing 0.5 to 1 inch, mention plug twist method, for 1min, after stabbing people, oblique direction of the nasal septum Into the 0.3 to 0.5 inch, bird pecking practices, eye wet or tearing, acupuncture Sanyinjiao, along the medial tibia and the skin to maintain 45 ° oblique, puncture 0.5 to 1 inch, to mention interpolation method; 30min / times , 1 time / d; massage, acute improvement of Lu massage, thumb massage head, 5 times; hand rubbing the upper limbs, 5 times; finger tendon in the fingers, 1 or 2 times; kneading, articulation ; Thumb massage back toe several times between the back; 30min / times, 1 / d; drug fumigation, hemiplegia live side (mulberry, Achyranthes, Acupuncture, safflower, Decoction 3000m L, fumigation affected area, 1 / time, 30min / time, 1 / d; western medicine treatment with the control group. Continuous treatment 28d for a course of treatment. Clinical symptoms, FMA score, NFD score and adverse reactions were observed. Continuous treatment of 3 courses to determine the efficacy. [Results] The treatment group cured 21 cases, 14 cases markedly effective, 3 cases effective, 2 cases ineffective, the total effective rate was 95.00%. The control group cured 17 cases, 10 cases markedly effective in 5 cases, 8 cases, the total effective rate 80.00%. The treatment group was better than the control group (P <0.05). Scoring index improved in both groups (P <0.01), the treatment group improved better than the control group (P <0.01). [Conclusion] Chinese medicine, acupuncture, massage, rehabilitation training, drug fumigation combined with Western medicine in the treatment of acute cerebral hemorrhage satisfactory results, no serious adverse reactions, it is worth promoting.