栝楼桂枝汤加减治疗中风肢体痉挛的临床疗效及对脑动脉血流动力学指标的影响  

Clinical Effect Observation of Trichosanthes Kirilowii (Gualou Guizhi) Decoction in the Treatment ofApoplectic Limb Spasm and its Influence on Cerebral Hemodynamic Indexes

作　　者：史轲 范秀凤 岳静 SHI Ke;FAN Xiu-feng;YUE Jing(Department of Internal Medicine f Changhn District Hospital of Traditional Chinese Medicine,Xi'an 710100,Shaanxi Province)

机构地区：[1]西安市长安区中医医院内科,陕西西安710100 [2]陕西省西安市第五医院心血管科,陕西西安710082

出　　处：《医学临床研究》2020年第11期1657-1660,共4页Journal of Clinical Research

摘　　要：【目的】探讨栝楼桂枝汤加减治疗中风肢体痉挛的临床效果观察及对脑血流动力学指标的影响。【方法】选取2017年1月至2019年7月本院收治的108例中风肢体痉挛患者,根据治疗方法将其分为观察组和对照组,每组各54例。对照组给予内科常规治疗联合康复训练,观察组在对照组基础上给予栝楼桂枝汤治疗。记录两组治疗前后脑血流动力学指标、患侧肌电活动、简化Fugl-Meyer评分、改良Ashworth痉挛量表(MAS)、改良Barthel指数量表(BI)及血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、神经元特异性醇化酶(NSE)、同型半胱氨酸(Hcy)水平变化,并统计两组患者临床治疗总有效率。【结果:】观察组总有效率为94.44%(51/54),显著高于对照组81.48%(44/54),差异有统计学意义(χ^2=4.285,P=0.038<0.05)。治疗后,两组ACA、MCA、PCA平均血流速度较治疗前上升,观察组显著高于对照组,差异有统计学意义(P<0.05)。两组患者血清IL-1β、TNF-、NSE、Hcy水平均低于治疗前,观察组显著低于对照组,差异均有统计学意义(P<0.05),两组患侧肱二头肌、股四头肌RMS值较治疗前下降,观察组患侧肱二头肌、股四头肌RMS值低于对照组,差异有统计学意义(P<0.05)。两组患者简化Fugl-Meyer评分、BI评分较治疗前上升,MAS评分较治疗前下降,观察组简化Fugl-Meyer评分、BI评分高于对照组,MAS评分低于对照组,差异均有统计学意义(P<0.05)。【结论】栝楼桂枝汤加减治疗中风肢体痉挛可调节相关炎症因子的表达,改善脑血流动力学,有利于促进患侧肢体康复。【Objective】To investigate the clinical effect of Trichosanthes kirilowii(Gualou Guizhi)decoction in the treat-ment of apoplectic limb spasm and its influence on cerebral hemodynamic indexes.【Methods】From January 2017 to July 2019,108 cases of apoplectic limb spasm in our hospital were selected and divided into observation group and control group according to the treatment method,with 54 cases in each group.The control group was given routine medical treatment combined with rehabilitation training,and the observation group was given the Trichosanthes kirilowii decoction on the basis of the control group.The changes of cerebral hemodynamic indexes,myoelectric activity of affected side,simplified Fugl Meyer score,modified Ashworth spasticity scale(MAS),modified Barthel Index(BI)and serum levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)>neuron specific alcoholase(NSE)and homocysteine(Hcy)were recorded before and after treatment,and the total effective rate of the two groups was statistically analyzed.【Results】The total effective rate of the observation group was 94.44%(51/54),which was significantly higher than that of the control group(81.48%)(Х^2=4.285,P=0.038<0.05).After treatment,the average blood flow velocity of ACA,MCA and PCA in the two groups increased compared with that before treatment,and the observation group was significantly higher than the control group,the difference was statistically significant(P<0.05).The serum levels of IL-1β,TNF-α,NSE and Hcy in the two groups were lower than those before treatment,and those in the observation group were significantly lower than those in the control group(P<0.05).The RMS values of biceps brachii and quadriceps femoris in the two groups were lower than those before treatment.The RMS values of biceps brachii and quadriceps femoris in the observation group were lower than those in the control group(P<0.05).The simplified Fugl Meyer score and Bi score of the two groups were higher than those before treatment,while the MAS score was l

关 键 词：中风/并发症 四肢麻痹/并发症 中风/中药疗法 四肢麻痹/中药疗法 血液动力学 

分 类 号：R255.2[医药卫生—中医内科学]