黄芪桂枝五物汤联合四物汤加减对外伤性周围神经损伤康复的影响  

Effect of Huangqi Guizhi Wuwu Tang Combined with Siwu Tang on Recovery of Traumatic Peripheral Nerve Injury

作　　者：李万辉[1] 位娜娜[1] 王海龙[1] 

机构地区：[1]郑州大学附属洛阳中心医院,河南洛阳471009

出　　处：《中国实验方剂学杂志》2016年第21期162-166,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省科技计划项目(20140613-1025)

摘　　要：目的:观察黄芪桂枝五物汤合四物汤加减对外伤性周围神经损伤无张力外膜吻合术后患者周围神经功能康复的促进作用。方法:将143例患者采用按SAS软件生成的随机数字表法,以就诊先后分为对照组71例和观察组72例。对照组采用甲钴胺片+电针+康复训练的综合康复方案,观察组在对照组治疗的基础上加用黄芪桂枝五物汤合四物汤加减内服,1剂/d。两组疗程均为8周。采用英国医学研究会标准评价感觉功能恢复情况和肌肉功能恢复情况;进行肌电图检查;采用肌电图仪检测治疗前后正中神经、尺神经、桡神经、腓总神经和胫神经的运动神经传导速度(MCV)和感觉神经传导速度(SCV);进行治疗前后气血不足,兼瘀血阻络证评分。结果:治疗后观察组临床肌电图疗效总有效率为95.83%,对照组为84.51%,观察组高于对照组(P<0.05);经Ridit分析,观察组神经功能恢复情况和肌电图改善情况均好于对照组(P<0.05);治疗后观察组正中神经、尺神经、桡神经、腓总神经和胫神经的MCV和SCV快于对照组(P<0.01);治疗后观察组中医证候疗效总有效率为94.44%,对照组为74.46%,观察组高于对照组(P<0.01)。结论:黄芪桂枝五物汤合四物汤加减内服治疗外伤性周围神经损伤能改善患者的神经电生理情况,进一步的促进神经功能的恢复,促进患者感觉功能和运功功能的恢复,改善中医证候症状。Objective： To observe the clinical efficacy of Huangqi Guizhi Wuwu Tang combined with Siwu Tang in promoting patients＇ neurological functional rehabilitation after outer membrane anastomosis. Method：One hundred and forty-three patients were randomly divided into control group（ 71 cases） and observation group（ 72 cases） by random number table. The patients in control group were treated with the comprehensive rehabilitation scheme of mecobalamin tablets ＋ electrical acupuncture ＋ rehabilitation training. In addition to the therapy of control group,the patients in observation group was also given Huangqi Guizhi Wuwu Tang combined with Siwu Tang,1 dose/day. The courses of treatment were 8 weeks. Recovery of sensory function and muscle function were evaluated according to the standards of British Medical Research Council. Before and after the treatment,electromyography was performed to detect motor nerve conduction velocity（ MCV） and sensory nerve conduction velocity（ SCV） of median nerve,ulnar nerve,musculospiral nerve,nervus peroneus communis and tibial nerve. And Qi and blood deficiency and blood-stasis obstruction were also scored. Result： After the treatment,the total effective rate of electromyography in observation group was 95. 83%,which was higher than84. 51% of in control group（ P〈0. 05）. According to Ridit analysis,recovery of sensory function and improvement in electromyography in observation group were superior to those in control group（ P〈0. 05）. After the treatment,MCV and SCV of median nerve,ulnar nerve,musculospiral nerve and nervus peroneus communis of observation group were faster than those in control group（ P〈0. 01）. After the treatment,the total effective rate of traditional Chinese medicinel（ TCM） symptoms in observation group was 94. 44%,which was higher than 77. 46% in control group（ P〈0. 01）. Conclusion： Huangqi Guizhi Wuwu Tang combined with Siwu Tang can ameliorate patients＇ nerve electrophysiology and TCM symptoms,and further prom

关 键 词：神经损伤 外伤 黄芪桂枝五物汤 四物汤 康复 肌电图 神经电图 

分 类 号：R287[医药卫生—中药学]