镇肝熄风汤配合镜像疗法对阴虚风动型脑卒中患者上肢功能恢复的疗效观察  

Effect of Zhen′gan Xifeng decoction combined with mirror therapy on the recovery of upper limb function of stroke patients with syndrome of Yin deficiency and wind stirring

作　　者：潘蓉蓉[1] 支英豪[1] 周龙寿[1] Pan Rongrong;Zhi Yinghao;Zhou Longshou(Department of Geriatrics, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou, Zhejiang 325000, China)

机构地区：[1]温州市中医院老年病科,浙江省325000

出　　处：《中国基层医药》2019年第10期1194-1198,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省温州市科技计划项目(Y20160288).

摘　　要：目的观察镇肝熄风汤配合镜像疗法对阴虚风动证脑卒中患者上肢功能恢复的疗效。方法选取温州市中医院康复科2015年1月至2017年10月收治的阴虚风动型脑卒中伴有上肢偏瘫患者90例,采用随机数字表将患者分成三组,每组30例。所有患者给予常规西医治疗,同时辅以肢体功能康复训练;在此基础上,联合治疗组给予中医药治疗联合镜像疗法康复治疗,镜像组给予镜像治疗法,对照组仅常规处理,三组患者治疗的疗程均为8周。采上肢功能评分法(FMA)、手臂动作测试评分法(ARAT)、功能独立量表(FIM)评估日常生活能力,以评价镇肝熄风汤配合镜像疗法对患者上肢功能康复的疗效,同时比较三组患者治疗前后中医证候评分的变化。结果治疗后,三组患者的上肢FMA评分、ARAT评分、FIM评分较治疗前均有提升(均P<0.01)。联合治疗组患者的上肢FMA评分[(33.80±7.17)分]、ARAT评分[(13.57±4.62)分]、FIM评分[(69.54±19.23)分]明显高于镜像组[(25.90±6.47)分、(11.57±3.84)分和(59.89±22.56)分,P=0.001、0.036、0.001]和对照组[(21.90±4.87)分、(10.32±3.21)分和(49.80±23.51)分,P=0.001、0.025、0.000]。联合治疗组在Ashworth上肢痉挛评分[(1.23±0.34)分]明显低于镜像组[(1.91±0.46)分,P=0.048]和对照组[(1.72±0.51)分,P=0.043],镜像组和对照组与治疗前比较,差异均无统计学意义(t=0.58,P=0.290,t=1.21,P=0.079)。中医症候疗效积分评定联合治疗组有效为24例,镜像组有效为18例,对照组有效为6例。结论镇肝熄风汤配合镜像疗法能更好地改善阴虚风动型脑卒中患者的上肢功能,改善患者的日常生活能力,对于上肢痉挛的改善更加有效,值得临床推广。Objective To observe the effect of Zhen′gan Xifeng decoction combined with mirror therapy on the recovery of upper limb function of stroke patients with syndrome of Yin deficiency and wind stirring. Methods From January 2015 to October 2017, 90 stroke patients with syndrome of Yin deficiency and wind stirring complicated with hemiplegia of upper limbs in Wenzhou Hospital of Traditional Chinese Medicine were randomly divided into the combined treatment group, the mirror treatment group and the control group according to the digital table, with 30 cases in each group.All patients were treated with conventional western medicine, combined with limb function rehabilitation training;on this basis, the combined treatment group was given mirror therapy in conjunction with Zhen′gan Xifeng decoction, the mirror group was given mirror treatment, the control group only received routine treatment.The three groups were treated for 8 weeks.The recovery of upper limb function score(FMA), arm action test score(ARAT), functional independent measurement(FIM) were used to evaluate the curative effect, and the TCM syndrome scores of the patients before and after treatment were compared in the three groups. Results After treatment, the FMA scores, ARAT scores and FIM scores of the three groups were higher than those before treatment(all P<0.01). The upper limb FMA score[(33.80±7.17)points], ARAT score[(13.57±4.62)points], FIM score[(69.54±19.23)points] in the combined treatment group were significantly higher than those in the mirror group[(25.90±6.47)points,(11.57±3.84)points and (59.89±22.56)points, P=0.001, 0.036, 0.001] and the control group[(21.90±4.87)points,(10.32±3.21)points,(49.80±23.51)points, P=0.001, 0.025, 0.000]. The Ashworth upper limb spasticity score in the combined treatment group[(1.23±0.34) points] was significantly lower than that in the mirror group[(1.91±0.46)points, P=0.048]and the control group[(1.72±0.51)points, P=0.043], compared with before treatment, the scores in the mirror group and the c

关 键 词：卒中 脑 上肢 功能恢复 医学 中国传统 治疗结果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]