中药涂擦及蜡疗联合牵伸康复训练降低中风偏瘫患者肢体肌张力的应用价值  

Application Value of Traditional Chinese Medicine Inunction and Kerotherapy combined with Drafting Rehabilitation Training on Reducing Limb Muscle Tension in Patients with Stroke Hemiplegia

作　　者：丁少敏 王伟[1] 汪瑛[1] 程和青 刘思佳 孙培养[1] DING Shaomin;WANG Wei;WANG Ying;CHENG Heqing;LIU Sijia;SUN Peiyang(The Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei Anhui 230061,China)

机构地区：[1]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《中医药导报》2024年第3期96-100,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：第五批全国中医临床优秀人才研修项目(国中医药人教函〔2022〕1号);第七批全国老中医药专家学术经验继承工作项目(国中医药人教函〔2022〕76号);安徽省重大疑难疾病中西医协同攻关项目(皖中医药发展秘〔2021〕70号);黄学勇安徽省名中医工作室(中发展〔2022〕5号)。

摘　　要：目的:探讨中药涂擦及蜡疗联合牵伸康复训练降低中风偏瘫患者肢体肌张力的应用价值。方法:将我院2022年1月至2023年1月收治的80例中风偏瘫患者作为研究对象,以随机数字表法分为A组(中药涂擦与蜡疗联合牵伸康复训练,n=20)、B组(中药涂擦联合牵伸康复训练,n=20)、C组(蜡疗联合牵伸康复训练,n=20)与D组(采用牵伸康复训练,n=20)。比较治疗前后各组肌张力、脑血管微循环状态、肢体平衡和步行能力、临床疗效。结果:治疗1个月后,各组肌张力均较治疗前改善,0级占比上升,2级占比降低(P<0.05),A组0级比例高于B、C、D组(P<0.05)。治疗后,四组患者基底动脉(BA)、椎动脉(VA)、颈内动脉(ICA)平均血流速度均较治疗前上升,A组BA、VA、ICA平均血流速度均高于B、C、D组(P<0.05)。治疗后,四组患者脑卒中患者姿势评定量表(PASS)、功能性步行量表(FAC)评分均高于同组治疗前(P<0.05),A组PASS、FAC评分均高于B、C、D组(P<0.05)。中药涂擦与蜡疗在提高BA、VA、ICA平均血流速度,PASS、FAC评分方面均存在交互效应(P<0.05)。治疗后,A组疗效等级优于B、C、D组(P<0.05),A组总有效率高于B、C、D组(P<0.05),B、C、D组组间比较,差异无统计学意义(P>0.05)。结论:中药涂擦及蜡疗联合牵伸康复训练在治疗中风偏瘫患者中疗效确切,能够降低患者肌张力,改善脑血管微循环状态,改善患者平衡和步行能力。Objective:To explore the application value of traditional Chinese medicine inunction and kerotherapy combined with drafting rehabilitation training on reducing limb muscle tension in patients with stroke hemiplegia.Methods:80 patients with stroke hemiplegia who met the criteria from January 2022 to January 2023 were selected as research subjects.The patients were numbered according to the admission sequence and were divided into group A(traditional Chinese medicine inunction and kerotherapy combined with drafting rehabilitation training,n=20),group B(traditional Chinese medicine inunction combined with drafting rehabilitation training,n=20),group C(kerotherapy combined with drafting rehabilitation training,n=20)and group D(drafting rehabilitation training,n=20)by the random number table method.Muscle tension,cerebrovascular microcirculation status,limb balance,walking ability and clinical efficacy were observed.Results:After 1 month of treatment,the muscle tension in the four groups were improved compared with that before treatment,and the proportion of grade 0 muscle tension increased while the proportion of grade 2 decreased(P<0.05),and the proportion of grade 0 in group A was higher than that in groups B,C and D(P<0.05).After treatment,the BA,VA and ICA in the four groups were enhanced compared with those before treatment,and the above indicators in group A were higher than those in groups B,C and D(P<0.05).After treatment,PASS score and FAC score in the four groups were higher than those before treatment(P<0.05),and the scores in group A were higher than those in the other three groups(P<0.05).There was an interaction between Chinese medicine inunction and kerotherapy in improving the average blood flow velocity of BA,VA,ICA,PASS and FAC scores(P<0.05).After treatment,the efficacy grading in group A was better than that in groups B,C and D(P<0.05),and the total markedly effective rate in group A was higher than that in groups B,C and D(P<0.05),but there were no statistical differences among groups B,C and D(P

关 键 词：中风偏瘫 中药涂擦 蜡疗 牵伸康复训练 肌张力 临床研究 

分 类 号：R255.2[医药卫生—中医内科学]