补阳还五汤加减联合脑-肢协同调控治疗卒中后肢体功能障碍临床研究  

Clinical Study on Modified Buyang Huanwu Decoction Combined with Brain-Limb Coordinated Regulation for Post-stroke Limb Dysfunction

作　　者：姚先丽 李坤彬 刘亚鸽 温小鹏 吴志远 焦冰 YAO Xianli;LI Kunbin;LIU Yage;WEN Xiaopeng;WU Zhiyuan;JIAO Bing(Department of Neurological Rehabilitation,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou Henan 450006,China)

机构地区：[1]郑州大学附属郑州中心医院神经康复科,河南郑州450006

出　　处：《新中医》2024年第7期36-41,共6页New Chinese Medicine

基　　金：河南省医学科技攻关计划项目(2018020808)。

摘　　要：目的:观察补阳还五汤加减联合脑-肢协同调控治疗脑卒中后肢体功能障碍的疗效。方法:选取96例卒中后肢体功能障碍患者为研究对象,按随机数字表法分为对照组及观察组各48例。对照组采取常规治疗加脑-肢协同调控,观察组在对照组基础上采用补阳还五汤加减治疗。比较2组临床疗效,比较2组治疗前后中医证候积分、血清指标[C-反应蛋白(CRP)、同型半胱氨酸(Hcy)]、血流变指标[纤维蛋白原(Fib)、血浆黏度、红细胞比容(HCT)]、Fugl-Meyer运动功能评分量表(FMA)、Berg平衡量表(BBS)、功能性步行量表(FAC)评分的变化。结果:治疗4周后,观察组临床疗效总有效率为95.83%,对照组为83.33%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候各积分均较治疗前下降(P<0.05),观察组中医证候各积分均低于对照组(P<0.05)。治疗后,2组CRP、Hcy指标值均较治疗前下降(P<0.05),观察组上述2项指标值均低于对照组(P<0.05)。治疗4周后,2组Fib、血浆黏度、HCT指标值均较治疗前下降(P<0.05),观察组上述3项指标值均低于对照组(P<0.05)。治疗4周后,2组FMA、BBS、FAC评分均较治疗前升高(P<0.05),观察组评分均高于对照组(P<0.05)。结论:补阳还五汤加减联合脑-肢协同调控治疗卒中后肢体功能障碍能提升临床疗效,改善肌力、肌张力下降等症状,减轻炎症,促进肢体运动能力的恢复。Objective:To observe the curative effect of modified Buyang Huanwu Decoction combined with brain-limb coordinated regulation on post-stroke limb dysfunction.Methods:A total of 96 cases of patients with post-stroke limb dysfunction were selected as the study subjects and divided into the control group and the observation group according to the random number table method,with 48 cases in each group.The control group was treated with routine treatment and brain-limb coordinated regulation,and the observation group was additionally treated with modified Buyang Huanwu Decoction based on the treatment of the control group.Clinical effects were compared between the two groups.Changes in traditional Chinese medicine(TCM)syndrome scores,serum indicators[C-reactive protein(CRP)and homocysteine(Hcy)],hemorheological indicators[fibrinogen(Fib),plasma viscosity,and hematocrit(HCT)],and scores of Fugl-Meyer Motor Function(FMA),Berg Balance Scale(BBS),and Functional Ambulation Categories(FAC)were compared between the two groups before and after treatment.Results:After 4 weeks of treatment,the total clinical effective rate was 95.83%in the observation group and 83.33%in the control group,the difference being significant(P<0.05).After treatment,each TCM syndrome score in the two groups was decreased when compared with that before treatment(P<0.05),and each TCM syndrome score in the observation group was lower than that in the control group(P<0.05).After treatment,CRP and Hcy in the two groups were decreased when compared with those before treatment(P<0.05),and the above two indicators in the observation group were lower than those in the control group(P<0.05).After 4 weeks of treatment,Fib,plasma viscosity,and HCT in the two groups were decreased when compared with those before treatment(P<0.05),and the above three indicators in the observation group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the scores of FMA,BBS,and FAC in the two groups were increased when compared with those before treatment

关 键 词：脑卒中 肢体功能障碍 补阳还五汤 脑-肢协同调控 Fugl-Meyer运动功能评分量表 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R277.7[医药卫生—临床医学]