乌头桂枝汤加味方熏洗对脑卒中上肢痉挛患者临床疗效及BDNF、NGF和炎性因子水平影响  

Clinical Observation on Fumigation Therapy for Post-stroke Upper Limb Spasticity with Modified Wutou Guizhi Decoction (乌头桂枝汤加味) and Its Effect on BDNF,NGF and Inflammatory Factors

作　　者：丁潇 韩宪伟[2] 张虎 邹忆怀[3] 刘贵军[4] DING Xiao;HAN Xianwei;ZHANG Hu;ZOU Yihuai;LIU Guijun(Shunyi Branch Hospital of Beijing Chinese Medicine Hospital,Beijing 101300,China;Shenyang 7th People's Hospital,Shenyang 110003,Liaoning,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;The Fourth Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150001,Heilongjiang,China)

机构地区：[1]北京中医医院顺义医院,北京101300 [2]沈阳市第七人民医院,辽宁沈阳110003 [3]北京中医药大学东直门医院,北京100700 [4]黑龙江中医药大学附属第四医院,黑龙江哈尔滨150001

出　　处：《辽宁中医药大学学报》2022年第11期141-144,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：北京市医管局培育项目(PZ2018008)。

摘　　要：目的 研究乌头桂枝汤加味方熏洗对脑卒中后上肢痉挛患者的治疗效果,探讨上肢痉挛的恢复与血清中生长因子及炎症因子水平变化间联系。方法 选取100例脑卒中上肢痉挛患者随机分为对照组和治疗组,每组各50例,均进行常规康复训练,治疗组在此基础上采用乌头桂枝汤加味方熏洗进行治疗,疗程均为4周。观察治疗前和治疗后患者上肢肌张力水平(MAS)、运动功能(FMA)和日常生活活动能力(ADL)的改变;比较治疗前后血清中BDNF、NGF、IL-6和TNF-α水平。结果 与治疗前相比较,两组患者治疗后MAS评分、IL-6和TNF-α水平均明显降低(P<0.05),FMA、ADL评分及BDNF、NGF水平均明显升高(P<0.05);与对照组相比较,治疗组MAS评分、IL-6和TNF-α水平均明显降低(P<0.05),FMA、ADL评分及BDNF、NGF水平均明显升高(P<0.05)。结论 乌头桂枝汤加味熏洗联合康复训练能够使脑卒中上肢痉挛患者肌张力得到明显降低,上肢运动功能得到极大提高,日常生活质量得到明显改善,其机制可能与抑制炎性反应和调节BDNF、NGF水平有关。Objective To observe the fumigation treatment of upper limb spasticity post-stroke with Modified Wutou Guizhi Decoction(乌头桂枝汤加味)was carried on.And to explore its effect on BDNF,NGF and inflammatory factors.Methods The patients were randomly divided into two groups,and two groups were treated with rehabilitation training as the basis.The treatment group added Modified Wutou Guizhi Decoction fumigation treatment.The treatment time was 4 weeks.Before and after treatment,the modified Barthel index score(MBI)was used to compare their daily living ability(ADL),the modified Ashworth spasticity scale score(MAS)was used to compare the muscle tone status of the affected limb,and the FuglMeyer motor function score(FMA)compare the motor function,and to compare the clinical efficacy between the groups.The BDNF,NGF,IL-6 and TNF-αbefore and after treatment were compared between the groups.Results After treatment,the MAS score and the level of IL-6 and TNF-αwere decreased in both groups(P<0.05).In the comparison between the groups after treatment,the MAS score and the level of IL-6 and TNF-αin the treatment group were lower than those in the control group(P<0.05).After treatment,the FMA and ADL scores and the level of BDNF and NGF were increased in both groups(P<0.05).In the comparison between the groups after treatment,the FMA and ADL scores and the level of BDNF and NGF in the treatment group were higher than those in the control group(P<0.05).Conclusion Effect of fumigation therapy for post-stroke upper limb spasticity with Modified Wutou Guizhi Decoction is exact.The possible mechanism might be related to BDNF,NGF and inflammatory factors.

关 键 词：熏洗治疗 乌头桂枝汤加味 脑卒中 上肢痉挛 

分 类 号：R743[医药卫生—神经病学与精神病学]