中医综合康复方案治疗不同程度中风后偏瘫痉挛的疗效研究  

A Stratified study on the efficacy of comprehensive rehabilitation program of traditional Chinese medicine for hemiplegia spasms caused by ischemic stroke

作　　者：耿花蕾 王雅惠 王月 陆梦馨 陈琛 吴康 邹忆怀[1] Geng Hualei;Wang Yahui;Wang Yue;Lu Mengxin;Chen Chen;Wu Kang;Zou Yihuai(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《现代中医临床》2021年第3期17-21,共5页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金面上项目(No.8187325);北京市科技计划课题(No.Z141107002514145)。

摘　　要：目的以西医现代康复技术为阳性对照,以神经功能缺损程度为分层依据,探讨中医综合康复方案对卒中后偏瘫痉挛的疗效。方法纳入符合标准的患者147例,根据随机对照表以2∶1随机分为试验组和对照组,分别应用中医综合康复方案、现代康复技术,2组均予基础治疗。应用改良的Ashworth评定量表(Modified Ashworth Scale, MAS)、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS),在第1天、第21天进行评价。依据NIHSS评分进行病情轻重分层,并进行疗效对比。结果治疗3周后,试验组与对照组MAS评分改善较治疗前均有统计学差异(P<0.05),且试验组有效率均高于对照组。分层后较重组中,试验组MAS较治疗前改善差异具有统计学意义(P=0.019),对照组较治疗前差异无统计学意义(P=0.092),组间疗效差异无统计学意义(P=0.814)。结论中医综合康复方案对缓解中风后患者肢体偏瘫痉挛有效。对于神经功能缺损程度较重的患者而言,中医综合康复方案比现代康复技术表现出更好的改善趋势。Objective To explore the efficacy of the comprehensive rehabilitation program of traditional Chinese medicine(TCM) in improving spastic state of ischemic stroke hemiplegia with modern rehabilitation techniques as controls and with different degrees of neurological deficit as a hierarchical basis. Methods A total of 147 cases with spastic hemiplegia of ischemic stroke were included and randomly divided into the experimental group and the control group according to the random comparison table with a ratio of 2∶1. The TCM comprehensive rehabilitation program and modern rehabilitation techniques were applied respectively, and the 2 groups were both given basic treatment. Evaluations were performed on Day 1 and Day 21 by using the Modified Ashworth Scale(MAS) and the National Institute of Health Stroke Scale(NIHSS). The severity of the disease was stratified and the curative effects were compared. Results After 3 weeks of treatment, the MAS scores were both improved of the experimental group and the control group(P<0.05), with the effective rate higher in the experimental group than in the control group. After stratification, the MAS of the experimental group with severe disease was significantly improved compared with that before the treatment(P=0.019), and there was no statistical difference in the control group of the same stratification(P=0.092). However, there was no statistical difference between the experimental group and the control group(P=0.814). Conclusions The TCM comprehensive rehabilitation program can improve the spasm degree after ischemic stroke. For patients with worse neurological deficits, TCM comprehensive rehabilitation program shows a better improvement trend than modern rehabilitation techniques.

关 键 词：中医康复 卒中后痉挛状态 MAS评分 NIHSS评分 

分 类 号：R247.9[医药卫生—中医临床基础]