舒筋解挛汤熏洗联合平衡舒筋手法治疗脑卒中后手痉挛临床研究  

Clinical study of fumigation with Shujin-Jieluan Decoction combined with Pingheng-Shujin Manipulation in the treatment of chirospasm after stroke

作　　者：戴润清[1] 孙建梅[2] 徐晶磊 卢艳丽[1] Dai Runqing;Sun Jianmei;Xu Jinglei;Lu Yanli(Physical Rehabilitation Center,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China;Department of Orthopedics,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院物理康复治疗中心,呼和浩特010050 [2]内蒙古医科大学附属医院骨科,呼和浩特010050

出　　处：《国际中医中药杂志》2020年第2期133-137,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的评价舒筋解挛汤熏洗联合平衡舒筋手法治疗脑卒中后手痉挛的疗效。方法选取内蒙古医科大学附属医院2016年7月-2018年6月符合入选标准的脑卒中后手痉挛患者104例,按随机数字表法分为2组,每组52例。对照组行常规康复训练,观察组在对照组基础上结合舒筋解挛汤熏洗联合平衡舒筋手法治疗。2组均连续治疗8周。采用改良Ashwonh痉挛量表(Modified Ashwonh Scale,MAS)进行手痉挛分级评定,采用肌电诱发仪记录正中神经F波出现次数、平均波幅、最短潜伏期;采用Fugl-Meyer运动功能评分量表评估手运动功能;采用改良Barthel指数评估生活能力,观察临床疗效。结果观察组愈显率为88.5%(46/52)、对照组为65.4%(34/52),2组比较差异有统计学意义(χ^2=7.800,P=0.005)。治疗后,观察组患侧F波出现次数[(15.11±2.06)次比(16.72±1.95)次,t=4.093]、平均波幅[(0.52±0.04)mV比(0.59±0.05)mV,t=7.883]及最短潜伏期[(24.37±2.85)ms比(25.88±2.43)ms,t=2.907]均低于对照组(P<0.01);Fugl-Meyer手功能评分[(6.51±1.45)分比(5.09±1.22)分,t=5.404]及改良Barthel指数评分[(60.87±5.16)分比(56.54±4.25)分,t=4.671]均高于对照组(P<0.01)。治疗后2组MAS分级均降低,且观察组低于对照组(Z=8.410,P=0.004)。结论舒筋解挛汤熏洗联合平衡舒筋手法可改善脑卒中后手痉挛患者的神经肌肉传导,有助于手功能及生活能力的恢复。Objective To evaluate the efficacy of fumigation with Shujin-Jieluan Decoction combined with Pingheng-Shujin Manipulation(manipulation of balance and muscle tendon relaxing)in the treatment of chirospasm after stroke.Methods A total of 104 patients with chirospasm after stroke who metthe inclusion criteria from July 2016 to June 2018 were selectedand divided into tow groups with the digital table methodwith 52 cases in each group.The control group was given routine rehabilitation training while the observation group was given fumigation with Shujin-Jieluan decoction combined with Pingheng-Shujin manipulation based oncontrol group,and the two groups both were treated for 8 weeks.The Modified Ashworth Scale(MAS)was used for chirospasm classification,and Key Point tabletop electromyography device was used to record the frequency,average amplitude and the shortest latency of F wave of median nerve.Fugl-Meyer motor function rating scale was used to evaluate hand motor function,and modified Barthel Index(BI)was used to evaluate life functionand clinical efficacy.Results The effective rate was 88.5%(46/52)in observation group and was 65.4%(34/52)in control group(χ^2=7.800,P=0.005).After treatment,the frequency(15.11±2.06 vs.16.72±1.95,t=4.093),average amplitude(0.52±0.04 mV vs.0.59±0.05 mV,t=7.883)and the shortest latency(24.37±2.85 ms vs.25.88±2.43 ms,t=2.907)of F wave in observation group were significantly lower than the control group(P<0.01).Fugl-Meyer hand function score(6.51±1.45 vs.5.09±1.22,t=5.404)and BI index score(60.87±5.16 vs.56.54±4.25,t=4.671)were significantly higher than the control group(P<0.01).The distribution of MAS classification in observation group was significantly lower than that of control group(Z=8.410,P=0.004).Conclusions Fumigation with Shujin-Jieluan Decoction combined with Pingheng-Shujin Manipulation can improve the neuromuscular transmission of patients with chirospasm after stroke,and facilitate the recovery of hand function and viability.

关 键 词：卒中 痉挛 中医康复 舒筋解挛汤 舒筋整复手法 熏洗疗法 

分 类 号：R277[医药卫生—中医学]