中药熏蒸联合血府逐瘀汤对中风后痉挛性瘫痪患者肢体功能和生活能力的影响
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摘要
目的探讨中药熏蒸联合血府逐瘀汤对中风后痉挛性瘫痪患者肢体功能和生活能力的影响。方法选择2012-06—2015-08在我院住院治疗的84例中风后痉挛性瘫痪患者为研究对象,随机分为对照组和研究组各42例,2组均常规治疗,包括控制血压、血糖、血脂,抗凝血,降低颅内压,维持水、电解质平衡,并结合康复训练。在常规治疗的基础上,对照组加服巴氯芬片,研究组加服加减血府逐瘀汤及中药熏蒸,2组治疗周期均为12周。观察2组治疗后的肌张力恢复疗效,并对比2组治疗前、治疗4周、治疗12周的肢体运动功能(Fugl-Meyer评分)和日常生活能力(Barthel指数评分)。结果治疗4周后,研究组总有效率45.24%,对照组为35.71%,差异无统计学意义(χ~2=0.791,P=0.374>0.05);治疗12周后,研究组总有效率88.10%,对照组为69.05%,差异有统计学意义(χ~2=4.525,P=0.033<0.05)。2组治疗后4周Fugl-Meyer评分、Barthel指数评分及神经功能缺损程度评分均明显优于治疗前(P<0.05),但治疗后4周Fugl-Meyer评分、Barthel指数评分及神经功能缺损程度评分组间比较差异无统计学意义(P>0.05),研究组治疗12周后Fugl-Meyer评分、Barthel指数评分及神经功能缺损程度评分明显优于对照组,差异有统计学意义(P<0.05)。治疗过程中,2组均出现轻微不良反应,对症治疗后恢复正常,不影响治疗。对照组不良反应发生率11.90%,研究组为4.76%,差异无统计学意义(χ~2=1.403,P=0.236>0.05)。结论中药熏蒸联合血府逐瘀汤治疗中风后痉挛性瘫痪效果显著,能改善患者肌张力,促进肢体运动功能恢复,提高日常生活能力。
Objective To study the effects of traditional Chinese medicine fumigation combined with Xuefu Zhuyu decoction on limb function and life ability of spastic paralysis after stroke.Methods The clinical data of 84 cases of hospitalized patients with spastic paralysis after stroke from June 2012 to August 2015 in our hospital were selected,and were randomly divided into control group and research group,42 cases of each group.All patients were treated with conventional treatment,including control of blood pressure,blood sugar,blood fat,and reduce intracranial pressure,and maintain water and electrolyte balance and rehabilitation training.On the basis of routine therapy,control group were treated with baclofen,research group were treated with traditional Chinese medicine fumigation combined with Xuefu Zhuyu decoction,and treatment cycle of two groups were 12 weeks.The muscle tone recovery effects of two groups after treatment were observed,and limb motor function(Fugl-Meyer score)and daily life ability score(Barthel index)before treatment,after treatment of 4weeks,12 weeks were compared.Results After treatment of 4weeks,the total effective rate in research group was 45.24%,total effective rate in control group was 35.71%,there was no statistically significant difference between two groups(χ~2=0.791,P=0.374>0.05).After treatment of 12 weeks,total effective rate in research group was 88.10%,total effective rate in control group was 69.05%,the difference between two groups was statistically significant(χ~2=4.525,P=0.033<0.05).After treatment of 4weeks,Fugl-Meyer score,Barthel index score and degree of nerve function defect score of two groups were significantly higher than those before treatment(P<0.05),but there was no statistically significant difference for Fugl-Meyer score,Barthel index score and degree of nerve function defect score after treatment of 4weeks between two groups(P>0.05),Fugl-Meyer score,Barthel index score and degree of nerve function defect score after treatment of12 weeks in research group were significantly higher than those in control group,the differences were statistical significant(P<0.05).In the process of treatment,adverse reactions of two groups were mild,after symptomatic treatment,they returned to normal,did not affect the treatment.The incidence of adverse reactions in control group was 11.90%,which was 4.76%in research group,there was no statistically significant difference between two groups(χ~2=1.403,P=0.236>0.05).Conclusion The effect of traditional Chinese medicine fumigation combined with Xuefu Zhuyu decoction in treatment of spastic paralysis after stroke is significantly,it can improve muscle tension,promote the limb motor function recovery,and improve the ability of daily life.
Objective To study the effects of traditional Chinese medicine fumigation combined with Xuefu Zhuyu decoction on limb function and life ability of spastic paralysis after stroke.Methods The clinical data of 84 cases of hospitalized patients with spastic paralysis after stroke from June 2012 to August 2015 in our hospital were selected,and were randomly divided into control group and research group,42 cases of each group.All patients were treated with conventional treatment,including control of blood pressure,blood sugar,blood fat,and reduce intracranial pressure,and maintain water and electrolyte balance and rehabilitation training.On the basis of routine therapy,control group were treated with baclofen,research group were treated with traditional Chinese medicine fumigation combined with Xuefu Zhuyu decoction,and treatment cycle of two groups were 12 weeks.The muscle tone recovery effects of two groups after treatment were observed,and limb motor function(Fugl-Meyer score)and daily life ability score(Barthel index)before treatment,after treatment of 4weeks,12 weeks were compared.Results After treatment of 4weeks,the total effective rate in research group was 45.24%,total effective rate in control group was 35.71%,there was no statistically significant difference between two groups(χ~2=0.791,P=0.374>0.05).After treatment of 12 weeks,total effective rate in research group was 88.10%,total effective rate in control group was 69.05%,the difference between two groups was statistically significant(χ~2=4.525,P=0.033<0.05).After treatment of 4weeks,Fugl-Meyer score,Barthel index score and degree of nerve function defect score of two groups were significantly higher than those before treatment(P<0.05),but there was no statistically significant difference for Fugl-Meyer score,Barthel index score and degree of nerve function defect score after treatment of 4weeks between two groups(P>0.05),Fugl-Meyer score,Barthel index score and degree of nerve function defect score after treatment of12 weeks in research group were significantly higher than those in control group,the differences were statistical significant(P<0.05).In the process of treatment,adverse reactions of two groups were mild,after symptomatic treatment,they returned to normal,did not affect the treatment.The incidence of adverse reactions in control group was 11.90%,which was 4.76%in research group,there was no statistically significant difference between two groups(χ~2=1.403,P=0.236>0.05).Conclusion The effect of traditional Chinese medicine fumigation combined with Xuefu Zhuyu decoction in treatment of spastic paralysis after stroke is significantly,it can improve muscle tension,promote the limb motor function recovery,and improve the ability of daily life.
引文
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[10]郑鹏,徐晓红,张为民,等.推拿手法治疗中风后肘关节屈曲痉挛的临床观察[J].世界科学技术-中医药现代化,2013,15(5):1 029-1 031.
[11]李旗,田福玲,刘国荣,等.阴-阳对刺呼吸补泻法改善脑中风偏瘫患者下肢功能的临床研究[J].世界科学技术-中医药现代化,2014,16(7):1 633-1 636.
[12]谢惠云,林华型,林国华.火针配合活络固本汤治疗中风后偏瘫44例[J].世界科学技术-中医药现代化,2013,15(2):281-285.
[13]周喜燕,王雁慧.针药结合治疗中风后痉挛性瘫痪的临床观察[J].时珍国医国药,2009,20(4):1 010-1 011.
[14]毕颖,邵晓梅,李丽萍,等.针灸治疗中风后痉挛性瘫痪的临床研究进展[J].浙江中医杂志,2012,47(1):69-72.
[15]苏巧珍,蔡业峰,黄培新,等.中风后痉挛性瘫痪中西医治疗研究进展[J].中国中医急症,2002,11(5):394-395.
[16]余致伟.芍药甘草汤合血府逐瘀汤加减治疗中风后痉挛性瘫痪的观察[J].中医临床研究,2014,6(23):83-84.
[17]张秋香.芍药甘草汤合血府逐瘀汤加减治疗中风后痉挛性瘫痪35例临床观察[J].河北中医,2012,34(5):690-692.
[2]Takiyama Y.Hereditary spastic paraplegia:up to date[J].Rinsho Shinkeigaku,2014,54(12):1 009-1 011.
[3]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,43(2):146-153.
[4]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:24-25.
[5]张祥建.脑血管病[M].石家庄:河北科学技术出版社,2006:60.
[6]中华人民共和国卫生部医政司主编.中国康复医学诊疗规范[M].北京:华夏出版社,1998:184.
[7]全国第四届脑血管病学术会议委员会.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):62-64.
[8]盛国滨,卢凤娟,刘长燕,等.针刺经筋结点结合康复疗法治疗中风后痉挛性瘫痪[J].针灸临床杂志,2011,27(5):25-26.
[9]张秋香.芍药甘草汤合血府逐瘀汤加减治疗中风后痉挛性瘫痪35例临床观察[J].河北中医,2012,34(5):690-692.
[10]郑鹏,徐晓红,张为民,等.推拿手法治疗中风后肘关节屈曲痉挛的临床观察[J].世界科学技术-中医药现代化,2013,15(5):1 029-1 031.
[11]李旗,田福玲,刘国荣,等.阴-阳对刺呼吸补泻法改善脑中风偏瘫患者下肢功能的临床研究[J].世界科学技术-中医药现代化,2014,16(7):1 633-1 636.
[12]谢惠云,林华型,林国华.火针配合活络固本汤治疗中风后偏瘫44例[J].世界科学技术-中医药现代化,2013,15(2):281-285.
[13]周喜燕,王雁慧.针药结合治疗中风后痉挛性瘫痪的临床观察[J].时珍国医国药,2009,20(4):1 010-1 011.
[14]毕颖,邵晓梅,李丽萍,等.针灸治疗中风后痉挛性瘫痪的临床研究进展[J].浙江中医杂志,2012,47(1):69-72.
[15]苏巧珍,蔡业峰,黄培新,等.中风后痉挛性瘫痪中西医治疗研究进展[J].中国中医急症,2002,11(5):394-395.
[16]余致伟.芍药甘草汤合血府逐瘀汤加减治疗中风后痉挛性瘫痪的观察[J].中医临床研究,2014,6(23):83-84.
[17]张秋香.芍药甘草汤合血府逐瘀汤加减治疗中风后痉挛性瘫痪35例临床观察[J].河北中医,2012,34(5):690-692.