经筋刺法结合加味芍药甘草汤治疗脑卒中后肢体痉挛的效果  

Effect of Acupuncture at Muscle Tendon and Supplemented Peony-Licorice Decoction on Spasticity after Stroke

作　　者：刘未艾[1,2] 岳增辉[1] 付磊[2] 戴思佳[2] 陈建宏 贺新民 LIU Wei-ai;YUE Zeng-hui;FU Lei;DAI Si-jia;CHEN Jian-hong;HE Xin-min(Hunan University of Traditional Chinese Medicine, Changsha, Hunan 410208, China;the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan 410005, China;The Affiliated Hengyang Hospital of Hunan University of Traditional Chinese Medicine, Hengyang, Hunan 421001,China)

机构地区：[1]湖南中医药大学,湖南长沙市410208 [2]湖南中医药大学第二附属医院,湖南长沙市410005 [3]湖南中医药大学附属衡阳医院,湖南衡阳市421001

出　　处：《中国康复理论与实践》2018年第3期323-327,共5页Chinese Journal of Rehabilitation Theory and Practice

基　　金：国家自然科学基金面上项目(No.81673886);湖南省中医药科研计划项目(No.201862)~~

摘　　要：目的观察中医针药结合治疗脑卒中后肢体痉挛的临床疗效。方法 2016年4月至2017年10月,90例脑卒中后肢体痉挛患者随机分为基础康复组(n=30)、巴氯芬组(n=30)和针药结合组(n=30)。三组均予脑卒中内科常规治疗和康复训练,针药结合组加经筋针刺和加味芍药甘草汤口服,巴氯芬组加巴氯芬口服。治疗前和治疗4周后采用改良Ashworth量表(MAS)、简式Fugl-Meyer评定量表(FMA)和改良Barthel指数(MBI)进行评定,并比较三组临床疗效。结果基础康复组总有效率53.3%,巴氯芬组66.7%,针药结合组86.7%。三组治疗后MAS、FMA及MBI评分均较治疗前显著改善(t>6.500,P<0.001),针药结合组评分最优(F>12.332,P<0.001)。治疗过程中未见不良反应事件发生。结论结合中医针刺和中药能更好缓解脑卒中后偏瘫患者肌张力,改善运动功能,提高日常生活活动能力。Objective To observe the effect of traditional Chinese acupuncture-medcine on limb spasticity after stroke.Methods From April,2016to October,2017,90patients with limb spasticity after stroke were randomly divided into basic rehabilitation group(n=30),baclofen group(n=30)and acupuncture-medicine group(n=30).All the groups accepted basic medical therapy and rehabilitation training,while the acupuncture-medicine group accepted acupuncture at muscle tendon and Supplemented Peony-Licorice Decoction orally,and the baclofen group accepted baclofen orally.They were assessed with modified Ashworth Scale(MAS),simplified Fugl-Meyer Assessment(FMA)and modified Barthel index(MBI)before and four weeks after treatment,and the clinical effective rates were compared.Results The total effective rate of the basic rehabilitation group was53.3%,and it was66.7%in the baclofen group,and86.7%in the acupuncture-medicine group.The scores of MAS,FMA and MBI significantly improved in all the groups after treatment(t>6.500,P<0.001),and improved the most in the acupuncture-medicine group(F>12.332,P<0.001).No adverse event was found during the treatment.Conclusion The integration of acupuncture and Chinese medicine in rehabilitation can further relieve the spasticity in patientsafter stroke,and improve the motor function and activities of daily living.

关 键 词：脑卒中 痉挛 经筋刺法 加味芍药甘草汤 康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]