小续命汤联合常规疗法治疗中风(风痰阻络证)后上肢肌痉挛的临床研究  

Clinical study on Xiaoxuming Decoction combined with conventional therapy in treating post-stroke upper limb spasticity(wind-phlegm obstructing collaterals syndrome)

作　　者：刘薇[1] 叶晓红 朱文宗[1] 杨迎民[1] 金永喜[1] 宋成城 LIU Wei;YE Xiaohong;ZHU Wenzong;YANG Yingming;JIN Yongxi;SONG Chengcheng(Department of Rehabilitation,Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院康复科,浙江温州325000

出　　处：《上海中医药杂志》2021年第8期63-66,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：浙江省自然科学基金委员会基础公益研究计划项目(LY18H270001);温州市卫计委中医药科研项目(2018ZB004)。

摘　　要：目的观察小续命汤联合常规疗法治疗中风(风痰阻络证)后上肢肌痉挛的临床疗效。方法将90例中风(风痰阻络证)后上肢肌痉挛患者随机分为对照组和试验组,每组45例。对照组予常规内科治疗及康复训练,试验组在对照组治疗措施的基础上加用小续命汤。两组疗程均为12周,比较上肢表面肌电信号、改良Ashworth量表评定分级、Fugl-Meyer评分、改良Barthel量表评分的变化情况,同时进行安全性评价。结果(1)试验组脱落3例、对照组脱落1例,最终完成试验者86例,其中试验组42例、对照组44例。(2)治疗前后组内比较,两组肱二头肌、肱三头肌肌电积分(IEMG)、均方根(RMS)值均降低(P<0.05);组间治疗后比较,肱二头肌、肱三头肌RMS值差异有统计学意义(P<0.05)。(3)治疗前后组内比较,两组改良Ashworth量表评定分级均有所改善(P<0.05);组间治疗后比较,改良Ashworth量表评定分级差异有统计学意义(P<0.05)。(4)治疗6周、治疗后与治疗前组内比较,两组Fugl-Meyer评分、改良Barthel量表评分均升高(P<0.05);组间治疗6周后比较,改良Barthel量表评分差异有统计学意义(P<0.05);组间治疗后比较,Fugl-Meyer评分、改良Barthel量表评分差异有统计学意义(P<0.05)。(5)治疗期间,两组均未发生明显的不良反应。结论小续命汤联合常规疗法治疗中风(风痰阻络证)后上肢肌痉挛疗效满意,能有效降低患者的上肢肌张力,缓解中风后肌痉挛症状,改善日常生活能力和运动功能。Objective To investigate the clinical effect of Xiaoxuming Decoction combined with conventional therapy on post-stroke upper limb spasticity(wind-phlegm obstructing collaterals syndrome).Methods Ninety patients with post-stroke upper limb spasticity(wind-phlegm obstructing collaterals syndrome)were randomly divided into control group(n=45)and test group(n=45).The control group was administered with conventional secondary prophylaxis combined with rehabilitation training,while the test group was administered with Xiaoxuming Decoction besides the treatment measures of the control group.The treatment duration was 12 weeks.The pre-and post-treatment clinical indicators,including surface electromyography(EMG)signals,Modified Ashworth Scale(MAS)scores,Fugl-Meyer Assessment(FMA)scores and Modified Barthel Index(MBI)scores,were compared between the two groups,and the safety was evaluated.Results(1)There were 3 drop-out cases in the test group and 1 drop-out case in the control group,and 86 cases completed the trial,including 42 cases in the test group and 44 cases in the control group.(2)Intra-group comparison before and after treatment showed that the integrated EMG(IEMG)and root mean square(RMS)values of biceps and triceps decreased in both groups(P<0.05);After treatment,RMS values of biceps and triceps were significantly different between the two groups(P<0.05).(3)According to the intra-group comparison of the two groups before and after treatment,the MAS scores of the two groups improved(P<0.05);After treatment,there was a significant difference in the MAS scores between the two groups(P<0.05).(4)The scores of FMA and MBI increased after 6 weeks of treatment and after treatment in both groups compared to those before treatment(P<0.05);According to the inter-group comparison after 6 weeks of treatment,the difference in scores of MBI was significant between the groups(P<0.05);After treatment,the scores of FMA and MBI were significantly different between the two groups(P<0.05).(5)During the trial,no significant adverse

关 键 词：中风 脑卒中 肌痉挛 小续命汤 表面肌电图 中药研究 

分 类 号：R743.3[医药卫生—神经病学与精神病学]