化痰祛瘀汤联合电刺激治疗对老年脑梗死患者血流动力学、MoCA评分及肢体功能的影响
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摘要
目的探讨化痰祛瘀汤、神经肌肉电刺激联合治疗对老年脑梗死患者血流动力学、蒙特利尔认知评估量表(MoCA)评分及肢体功能的影响。方法选取2016年5月至2018年5月西安北方医院收治的130例老年脑梗死患者作为受试对象,按照入院先后顺序将其分为对照组63例和观察组67例。对照组患者在常规治疗基础上给予神经肌肉电刺激治疗,5 d为一个疗程,第一疗程结束后间隔2 d进行下个疗程;观察组患者在对照组基础上另给予化痰祛瘀汤治疗,7 d为一个疗程,两组均治疗三个疗程。比较两组患者治疗前后的局部大脑血流量、大脑中动脉平均血流速度、MoCA评分、Fugl-Meyer评分量表(FMA)评分和美国国立卫生研究院卒中量表(NIHSS)评分,并评价其治疗效果。结果治疗后观察组患者的局部大脑血流量和大脑中动脉平均血流速度分别为(58.49±11.72) mL/(100 g·min)、(74.18±15.06) cm/s,均明显高于对照组的(42.17±10.65) mL/(100 g·min)、(59.10±12.73) cm/s,差异均有统计学意义(P<0.05);治疗后观察组患者的MoCA评分和FMA评分分别为(23.86±4.69)分、(64.19±15.27)分,均明显高于对照组的(19.77±4.15)分、(50.28±12.43)分,差异均有统计学意义(P<0.05);治疗后观察组患者的NIHSS评分为(10.67±2.51)分,明显低于对照组的(14.89±2.98)分,差异有统计学意义(P<0.05);观察组患者的治疗总有效率为85.07%,明显高于对照组的68.25%,差异均有统计学意义(P<0.05)。结论化痰祛瘀汤联合神经肌肉电刺激治疗能有效改善老年脑梗死患者脑部血流供应情况,提高患者认知和肢体功能,治疗效果好。
Objective To investigate the effects of Huatan Quyu Decoction combined with neuromuscular electrical stimulation on hemodynamics, Montreal Cognitive Assessment Scale(MoCA) score, and limb function in elderly patients with cerebral infarction. Methods A total of 130 elderly patients with cerebral infarction admitted to Xi'an North Hospital from May 2016 to May 2018 were selected as subjects. They were divided into control group(63 cases)and observation group(67 cases) according to the order of admission. Patients in the control group were given neuromuscular electrical stimulation therapy on the basis of routine treatment, with 5 days as a course of treatment and an interval of 2 days between each two courses of treatment. Patients in the observation group were given Huatan Quyu Decoction on the basis of the control group, with 7 days as a course of treatment. The two groups were both treated for 3 courses.Local cerebral blood flow, mean blood flow velocity of middle cerebral artery, MOCA score, Fugl-Meyer scale(FMA)score, and NIHSS score were observed before and after treatment, and the therapeutic effect was evaluated. Results After treatment, the local cerebral blood flow and the mean blood flow velocity of middle cerebral artery in the observation group were(58.49±11.72) m L/(100 g·min) and(74.18±15.06) cm/s, respectively, which were significantly higher than(42.17±10.65) mL/(100 g·min) and(59.10±12.73) cm/s in the control group(P<0.05). After treatment, the scores of MOCA and FMA in the observation group were 23.86±4.69 and 64.19±15.27, respectively, which were significantly higher than 19.77±4.15 and 50.28±12.43 in the control group(P<0.05). After treatment, the NIHSS score of the patients in the observation group was 10.67±2.51, which was significantly lower than 14.89±2.98 in the control group(P<0.05). The total effective rate of the patients in the observation group was 85.07%, which was significantly higher than 68.25% of the control group(P<0.05). Conclusion Huatan Quyu Decoction combined with neuromuscular electrical stimulation therapy can effectively improve the cerebral blood flow supply of elderly patients with cerebral infarction, improve patients' cognitive and limb functions, and has a good therapeutic effect.
Objective To investigate the effects of Huatan Quyu Decoction combined with neuromuscular electrical stimulation on hemodynamics, Montreal Cognitive Assessment Scale(MoCA) score, and limb function in elderly patients with cerebral infarction. Methods A total of 130 elderly patients with cerebral infarction admitted to Xi'an North Hospital from May 2016 to May 2018 were selected as subjects. They were divided into control group(63 cases)and observation group(67 cases) according to the order of admission. Patients in the control group were given neuromuscular electrical stimulation therapy on the basis of routine treatment, with 5 days as a course of treatment and an interval of 2 days between each two courses of treatment. Patients in the observation group were given Huatan Quyu Decoction on the basis of the control group, with 7 days as a course of treatment. The two groups were both treated for 3 courses.Local cerebral blood flow, mean blood flow velocity of middle cerebral artery, MOCA score, Fugl-Meyer scale(FMA)score, and NIHSS score were observed before and after treatment, and the therapeutic effect was evaluated. Results After treatment, the local cerebral blood flow and the mean blood flow velocity of middle cerebral artery in the observation group were(58.49±11.72) m L/(100 g·min) and(74.18±15.06) cm/s, respectively, which were significantly higher than(42.17±10.65) mL/(100 g·min) and(59.10±12.73) cm/s in the control group(P<0.05). After treatment, the scores of MOCA and FMA in the observation group were 23.86±4.69 and 64.19±15.27, respectively, which were significantly higher than 19.77±4.15 and 50.28±12.43 in the control group(P<0.05). After treatment, the NIHSS score of the patients in the observation group was 10.67±2.51, which was significantly lower than 14.89±2.98 in the control group(P<0.05). The total effective rate of the patients in the observation group was 85.07%, which was significantly higher than 68.25% of the control group(P<0.05). Conclusion Huatan Quyu Decoction combined with neuromuscular electrical stimulation therapy can effectively improve the cerebral blood flow supply of elderly patients with cerebral infarction, improve patients' cognitive and limb functions, and has a good therapeutic effect.
引文
[1] SAITO T, HAYASHI K, NAKAZAWA H, et al. Clinical characteristics and lesions responsible for swallowing hesitation after acute cerebral infarction[J]. Dysphagia, 2016, 31(4):567-573.
[2]顾玉宝,刘敬霞,王枫,等.中医药治疗脑梗死的临床研究进展[J].中华中医药学刊, 2017, 35(2):303-306.
[3]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志, 1996, 29(6):379-380.
[4]陈可冀.心脑血管疾病研究[M].上海:上海科学技术出版社, 2009:311.
[5]孙传兴.临床疾病诊断依据治愈好转标准[M]. 2版.北京:人民军医出版社, 1998:116-120.
[6] AYLING OG, IBRAHIM GM, ALOTAIBI NM, et al. Dissociation of early and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage[J]. Stroke, 2016, 47(12):2945-2951.
[7]夏楠,任彩丽,王红星,等.脑梗死急性期康复训练流程对患者运动功能和日常生活活动能力改善程度的影响[J].中国康复医学杂志,2017, 32(4):396-401.
[8]张翔,刘从国,张继红,等.益气活血中药联合西医治疗急性缺血性脑卒中的Meta分析[J].中国老年学杂志, 2017, 37(4):873-876.
[9]华彩红,尹山兰,郝尚辉,等.祛瘀化痰汤对多囊卵巢综合征患者卵巢多囊样改变、内分泌及代谢的影响[J].中国实验方剂学杂志,2017, 23(9):179-183.
[10]姬霞.补肾化痰祛瘀方对多囊卵巢综合征患者卵巢激素的影响[J].中药药理与临床, 2016, 32(2):216-217.
[11]桂树虹,黄东勉,李俊驹,等.针灸配合滋阴补肾兼化痰祛瘀法在海南省高碘饮食致结节性甲状腺肿中的防治作用[J].中国地方病防治杂志, 2016, 31(2):170-173.
[12]李怀山,刘建云,张颖丽.补阳还五汤联合依达拉奉治疗缺血性脑卒中疗效及对血液流变学影响[J].中华中医药学刊, 2016, 34(3):721-723.
[13]叶普法,应丹松,柯宁珠.清热凉血通瘀汤加减辅助治疗缺血性脑卒中急性期临床疗效[J].辽宁中医杂志, 2016, 43(3):536-538.
[14]魏丽萍,司君增,亓晓丽.经颅多普勒超声辅助动脉溶栓后联合活血化瘀汤治疗急性脑梗死临床疗效研究[J].中华中医药学刊,2017, 35(10):2685-2689.
[15]刘建涛,孙永康,郑树然,等.活血化瘀汤联合康复理疗对脑梗死后遗症患者脑循环动力学的影响[J].辽宁中医杂志, 2018, 45(1):83-85.
[2]顾玉宝,刘敬霞,王枫,等.中医药治疗脑梗死的临床研究进展[J].中华中医药学刊, 2017, 35(2):303-306.
[3]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志, 1996, 29(6):379-380.
[4]陈可冀.心脑血管疾病研究[M].上海:上海科学技术出版社, 2009:311.
[5]孙传兴.临床疾病诊断依据治愈好转标准[M]. 2版.北京:人民军医出版社, 1998:116-120.
[6] AYLING OG, IBRAHIM GM, ALOTAIBI NM, et al. Dissociation of early and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage[J]. Stroke, 2016, 47(12):2945-2951.
[7]夏楠,任彩丽,王红星,等.脑梗死急性期康复训练流程对患者运动功能和日常生活活动能力改善程度的影响[J].中国康复医学杂志,2017, 32(4):396-401.
[8]张翔,刘从国,张继红,等.益气活血中药联合西医治疗急性缺血性脑卒中的Meta分析[J].中国老年学杂志, 2017, 37(4):873-876.
[9]华彩红,尹山兰,郝尚辉,等.祛瘀化痰汤对多囊卵巢综合征患者卵巢多囊样改变、内分泌及代谢的影响[J].中国实验方剂学杂志,2017, 23(9):179-183.
[10]姬霞.补肾化痰祛瘀方对多囊卵巢综合征患者卵巢激素的影响[J].中药药理与临床, 2016, 32(2):216-217.
[11]桂树虹,黄东勉,李俊驹,等.针灸配合滋阴补肾兼化痰祛瘀法在海南省高碘饮食致结节性甲状腺肿中的防治作用[J].中国地方病防治杂志, 2016, 31(2):170-173.
[12]李怀山,刘建云,张颖丽.补阳还五汤联合依达拉奉治疗缺血性脑卒中疗效及对血液流变学影响[J].中华中医药学刊, 2016, 34(3):721-723.
[13]叶普法,应丹松,柯宁珠.清热凉血通瘀汤加减辅助治疗缺血性脑卒中急性期临床疗效[J].辽宁中医杂志, 2016, 43(3):536-538.
[14]魏丽萍,司君增,亓晓丽.经颅多普勒超声辅助动脉溶栓后联合活血化瘀汤治疗急性脑梗死临床疗效研究[J].中华中医药学刊,2017, 35(10):2685-2689.
[15]刘建涛,孙永康,郑树然,等.活血化瘀汤联合康复理疗对脑梗死后遗症患者脑循环动力学的影响[J].辽宁中医杂志, 2018, 45(1):83-85.