补阳还五汤加减方联合针刀松解治疗脑卒中后肢体痉挛临床研究  

Clinical Study on Modified Prescription of Buyang Huanwu Tang Combined with Acupotomy for Limb Spasm After Stroke

作　　者：沈方伦 方晓亮 谢建平 SHEN Fanglun;FANG Xiaoliang;XIE Jianping

机构地区：[1]桐乡市康复医院中医康复科,浙江桐乡314500 [2]桐乡市康复医院康复医学科,浙江桐乡314500

出　　处：《新中医》2021年第5期40-43,共4页New Chinese Medicine

摘　　要：目的:观察补阳还五汤加减方联合针刀松解治疗脑卒中后肢体痉挛的临床疗效。方法:将脑卒中后肢体痉挛患者80例,随机分为对照组和观察组,各40例。对照组采用针刀松解治疗,观察组在对照组基础上给予补阳还五汤加减治疗。2组疗程均为4周,于治疗前后采用美国国会卫生研究院卒中量表(NIHSS)评分、改良Ashworth量表(MAS)、改良Barthel指数(MBI)、Fugl-Meyer评分(FMA)、痉挛指数评分等评估偏瘫肢体痉挛状态和运动功能。结果:观察组总有效率为95.00%,对照组为77.50%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组NIHSS、MAS评分较治疗前降低(P<0.05),MBI、下肢FMA评分较治疗前升高(P<0.05);观察组NIHSS、MAS、MBI、下肢FMA评分改善均优于对照组(P<0.05)。治疗前,2组偏瘫肢体痉挛指数评分比较,差异无统计学意义(P>0.05);治疗后,观察组偏瘫肢体痉挛指数评分低于对照组(P<0.05),观察组指数差值高于对照组(P<0.05)。结论:补阳还五汤加减方联合针刀松解可有效缓解脑卒中后肢体痉挛,纠正异常运动模式,有效提高患者的日常生活能力。Objective: To observe the clinical effect of modified prescription of Buyang Huanwu tang combined with acupotomy for limb spasm after stroke. Methods:A total of 80 cases of patients with limb spasm after stroke were randomly divided into the control group and the observation group,40 cases in each group. The control group was given acupotomy,and the observation group was additionally given modified Buyang Huanwu tang based on the treatment of the control group.Both groups were treated for four weeks. Before and after treatment, scores of National Institutes of Health Stroke Scale(NIHSS), Modified Ashworth Scale(MAS), Modified Barthel Index(MBI), Fugl-Meyer Assessment(FMA), and score of spams index were applied to evaluating spasticity of hemiplegic limbs and motor function in the two groups. Results: The total effective rate was 95.00% in the observation group,and 77.50% in the control group,the difference being significant(P<0.05). After treatment,scores of NIHSS and MAS in the two groups were decreased when compared with those before treatment(P<0.05);scores of MBI and FMA scores of lower limbs were increased(P<0.05). After treatment,improvement of scores of NIHSS,MAS,MBI,and FMA of lower limbs in the observation group was better than that in the control group(P<0.05). Before treatment,there was no significant difference being found in the comparison of score of spasm index of hemiplegic limbs between the two groups(P>0.05). After treatment, the score of spasm index of hemiplegic limbs in the observation group was lower than that in the control group(P<0.05), and the difference value was higher(P<0.05).Conclusion:The therapy of modified prescription of Buyang Huanwu tang combined with acupotomy can effectively relieve limb spasm after stroke and enhance activities of daily living,as well as correct abnormal motor pattern.

关 键 词：脑卒中 肢体痉挛 补阳还五汤加减方 针刀疗法 痉挛指数 

分 类 号：R743.3[医药卫生—神经病学与精神病学]