补中益气汤加减辅助康复训练治疗卒中后疲劳的疗效观察  

Effects of buzhong yiqi and rehabilitation training on post-stroke fatigue

作　　者：冯玲[1] 司马振奋[1] 何玲燕[1] 吴月峰[1] 钮易蓓[1] 平仁香[1] 范虹[1] 

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院)康复中心,绍兴312000

出　　处：《中华物理医学与康复杂志》2014年第6期421-424,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：浙江省中医药（中西医结合）重点学科资助项目（2012-XK-A33）、浙江省中医药科学研究基金项目（2010ZBl49）

摘　　要：目的观察补中益气汤加减辅助康复训练治疗卒中后疲劳的疗效。方法采用随机数字表法将115例卒中后疲劳患者分为单纯康复组及联合治疗组，2组患者均给予常规康复治疗及原发病治疗，联合治疗组在此基础上辅以补中益气汤加减治疗。于治疗前、治疗4周后分别对2组患者肌电疲劳信号、主观疲劳程度、主动康复运动时间、肢体运动功能及日常生活活动（ADL）能力等指标进行评定，其中肌电疲劳信号采用表面肌电图平均功率（MPF）斜率（KMPF）和中位频率（MF）斜率（KMF）测定，主观疲劳程度采用疲劳严重度量表（FSS）评定，主动康复运动时间则记录2组患者每天90min康复训练期间主动进行康复运动的时间，运动功能评定则采用简化Fugl—Meyer评定量表（FMA），ADL能力评定采用改良Barthel指数（MBI）评定量表。结果治疗前2组患者KMPF、KMF、FSS评分、主动康复运动时间、FMA及MBI评分组间差异均无统计学意义（P〉0．05）；分别经4周治疗后，发现2组患者上述指标均有一定程度改善（单纯康复组FSS评分除外），并且联合治疗组KMPF（-0．66±0．53）、KMF（-0．75±1．10）、FSS评分[（44．17±8．19）分]、主动康复运动时间[（52．05±16．38）min]、FMA评分[（48．28±10．97）分]及MBI评分[（64．5±13．19）分]亦显著优于单纯康复组，组间差异均具有统计学意义（P〈0．05）。结论在常规康复干预基础上辅以补中益气汤加减治疗卒中后疲劳患者具有协同疗效，能进一步缓解卒中后患者疲劳感，提高其参与主动康复运动能力，有助于患者肢体功能恢复及ADL能力改善。Objective To observe the effects of a decoction of buzhong yiqi in conjunction with rehabilitation training in relieving post-stroke fatigue. Methods A group of 115 stroke patients was enrolled and randomly divided into a simple rehabilitation group and a combination therapy group. Both groups received conventional rehabilitation treatment and appropriate treatment of any primary diseases. In addition, those in the combination therapy group were given a decoction of buzhong yiqi twice daily for a total of 4 weeks. EMG signals, subjective evaluations of fatigue severity, active rehabilitation exercise duration, motor function and ability in the activities of daily living （ADL） were assessed before treatment and after 4 weeks of treatment. The slope of the surface electromyogram＇s mean power frequency （KMPF） and median frequency （KMF） were used to quantify fatigue. Subjective fatigue severity was estimated using a fatigue severity scale （FSS）. The active rehabilitation exercise lasted, on average, 90 minutes daily. The Fugl-Meyer assessment （FMA） was used to evaluate motor function and the modified Barthcl index （MBI） ADL ability. Results There were no statistically significant differences between the groups before treatment. After 4 weeks of treatment all the outcomes in both groups had improved （ except the FSS scores of the simple rehabilitation group）. The KMPF, KMF, FSS, exercise duration, FMA scores and MBI scores in the combination therapy group were all significantly better than those in the simple rehabilitation group. Conclusion Taking buzhong yiqi can significantly improve the clinical effects of conventional rehabilitation training on post-stroke fatigue. It helps relieve fatigue, improve active participation in rehabilitation exercise, and also improve motor function and ADL ability.

关 键 词：补中益气汤 卒中后疲劳 肌电疲劳信号 主观疲劳程度 

分 类 号：R743.3[医药卫生—神经病学与精神病学]