中药联合神经肌肉关节促进技术对老年脑卒中伴弛缓性瘫痪功能障碍患者预后的影响  

Effect of combined Chinese herbal medicine and rehabilitation techniques on elderly stroke patients with flaccid paralysis

作　　者：马国立 王建波 齐有莉 Ma Guoli;Wang Jianbo;Qi Youli(Department of Pharmacy,Hebei Provincial Veterans General Hospital,Xingtai 054000,Hebei Province,China)

机构地区：[1]河北省退役军人总医院药剂科,河北邢台054000

出　　处：《中华老年多器官疾病杂志》2024年第7期532-536,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：河北省邢台市重点研发计划项目(2022zz087)。

摘　　要：目的探讨补肾活血中药汤剂联合神经肌肉关节促进技术对老年脑卒中伴弛缓性瘫痪功能障碍患者预后的影响。方法选择2021年2月至2023年1月河北省退役军人总医院收治的老年脑卒中伴弛缓性瘫痪功能障碍患者112例,通过简单随机分组法分为2组,每组56例。对照组给予神经肌肉关节促进技术,观察组在对照组治疗基础上联合补肾活血中药汤剂治疗。比较两组患者临床疗效,治疗前后髋关节和膝关节最大屈曲角、最大伸展角,腓肠肌、胫前肌表面肌电信号,血液流变学指标[高切与低切全血比黏度(WBV)、血浆黏度(PV)、红细胞压积(HCT)]、Fugl-Meyer下肢运动功能评估表(FMA)及日常生活活动能力量表Barthel指数(ADL-Barthel)评分。采用SPSS 20.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ^(2)检验。结果观察组治疗显效率(67.86%)高于对照组(48.21%),差异有统计学意义(P<0.05);两组有效率比较,差异无统计学意义。治疗6周和治疗2个月后,观察组和对照组高切WBV、低切WBV、PV、HCT水平均低于治疗前水平,以及同一时间对照组水平;髋关节的最大屈曲角、最大伸展角,膝关节的最大屈曲角、最大伸展角均大于治疗前水平,以及同一时间对照组水平;腓肠肌的均方根值(RMS)、肌电积分值(IEMG),胫前肌的RMS、IEMG均高于治疗前水平,以及同一时间对照组水平;FMA、ADL-Barthel评分均高于治疗前水平,以及同一时间对照组水平,差异均有统计学意义(P<0.05)。治疗2个月后,观察组和对照组高切WBV、低切WBV、PV、HCT水平均低于治疗6周水平;髋关节的最大屈曲角、最大伸展角,膝关节的最大屈曲角、最大伸展角均大于治疗6周水平;腓肠肌的RMS、IEMG,胫前肌的RMS、IEMG均高于治疗6周水平;FMA、ADL-Barthel评分均高于治疗6周水平,差异均有统计学意义(P<0.05)。结论补肾活血中药汤剂联合神经肌肉关节促进�Objective To investigate the effect of Kidney-Tonifying and Blood-Activating decoction combined with neuromuscular joint facilitation(NJF)techniques on prognosis of elderly patients with stroke accompanied by flaccid-paralysis dysfunction.Methods A total of 112 elderly stroke patients with flaccid paralysis admitted in our hospital from February 2021 to January 2023 were recruited,and randomly divided into control group(n=56)and observation group(n=56).The control group was given NJF techniques for rehabilitation,and the observation group was given a traditional Chinese medical prescription(Kidney-Tonifying and Blood-Activating decoction)on the basis of the treatment of the control group.The clinical efficacy was compared between two groups,in terms of the pre-and post-treatment changes in maximum flexion angle and maximum extension angle of the hip and knee joints,surface electromyography(EMG)signals of gastrocnemius and anterior tibia muscle,and hemorheological indicators[such as high-and low-shear whole blood viscosity(WBV),plasma viscosity(PV),hematocrit(HCT)],as well as scores of Fugl-Meyer Assessment(FMA)for Lower Limb Motor Function and Barthel index for activity of daily life(ADL-Barthel).SPSS statistics 20.0 was used for statistical analysis.Data comparison between two groups was perfomed using t test orχ^(2)test depending on data type.Results The effective rate of treatment was significantly higher in the observation group than the control group(67.86%vs 48.21%,P<0.05),but there was no statistical difference in the efficiency between them.In six weeks and two months after treatment,the high-shear WBV value,low-shear WBV value,PV value and HCT level were decreased in both groups when compared with the levels before treatment,with those in the observation group more significant.At the same time points,the maximum flexion and extension angles of the hip and knee joints were increased than before treatment,and the observation group obtained better results than the control group.Similar results were observe

关 键 词：老年人 脑卒中 弛缓性瘫痪 补肾活血中药汤剂 神经肌肉关节促进技术 功能障碍 

分 类 号：R742.3[医药卫生—神经病学与精神病学] R592[医药卫生—临床医学]