加味补阳还五汤联合镜像疗法对气虚血瘀型脑梗死后中重度上肢偏瘫患者脑侧支循环建立及肢体康复的影响分析  

Effect of Jiawei Buyang Huanwu Decoction(加味补阳还五汤)Combined with Mirror lmage Therapy on Establishment of Cerebral Collateral Circulation and Limb Rehabilitation in Patients with Moderate to Severe Upper Limb Hemiplegia after Cerebral infarction of Qi Deficiency and Blood Stasis Type

作　　者：林瑜[1] 许健[1] 周伟 LIN Yu;XU Jian;ZHOU Wei(Quzhou Peoples Hospital,Quzhou 324000,Zhejiang,China)

机构地区：[1]衢州市人民医院,浙江衢州324000

出　　处：《中华中医药学刊》2024年第12期237-240,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划项目(2019ZT003)。

摘　　要：目的探究加味补阳还五汤联合镜像疗法对气虚血瘀型脑梗死后中重度上肢偏瘫患者脑侧支循环建立及肢体康复的影响分析。方法选取气虚血瘀型脑梗死后中重度上肢偏瘫患者100例,随机分为两组,每组50例。对照组使用常规治疗,观察组在对照组基础上联合加味补阳还五汤及镜像疗法治疗,疗程为4周,对比两组患者临床治疗效果、美国国会卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、蒙特利尔认知评估量表(Montreal Cogni-tive Assessmen,MoCA)、基质细胞源性因子1(Stromal cell-derived factor 1,SDF1)、S100钙结合蛋白B(S100 calcium bind-ing proteinB,S100B)、血小板源性生长因子(Platelet-derived growth factor,PDGF)、福格-米勒运动功能评分量表(Fugl-Meyer motor function assessment,FMA)评分及巴塞尔指数(Barthel index,BI)评分。结果治疗后对照组总有效率为68.00%(34/50),显著低于观察组的90.00%(45/50)(P<0.05);治疗后两组NIHSS评分较治疗前显著降低(P<0.05),观察组评分显著低于对照组(P<0.05);治疗后两组MoCA评分均较治疗前提高(P<0.05),观察组评分显著高于对照组(P<0.05);治疗后两组PDG水平均显著升高,观察组显著高于对照组(P<0.05);SDF-1、S100B水平均显著降低,且观察组显著低于对照组(P<0.05);治疗后两组FMA评分及BI评分均较治疗前显著提升(P<0.05),观察组显著高于对照组(P<0.05)。结论加味补阳还五汤联合镜像疗法治疗气虚血瘀型脑梗死后中重度上肢偏瘫患者具有良好的临床治疗效果,显著改善患者神经功能及认知水平,促进脑血管新生和侧支循环形成,并改善患者肢体运动功能,全面提升患者生存质量。Objective To explore the effect of Jiawei Buyang Huanwu Decoction(加味补阳还五汤)combined with mirror im-age therapy on the establishment of cerebral collateral circulation and limb rehabilitation in patients with moderate to severe upper limb hemiplegia after cerebral infarction of Qi deficiency and blood stasis type.Methods A hundred patients with moderate to se-vere upper limb hemiplegia after cerebral infarction of Qi deficiency and blood stasis type were selected and randomly divided into two groups,50 cases in each group.The control group was treated with routine treatment,and the observation group was treated with Jiawei Buyang Huanwu Decoction and mirror image therapy on the basis of the control group.The course of treatment was 4 weeks.Health stroke scale(NIHSS)score,Montreal Cognitive Assessment(MoCA),stromal cell-derived factor 1(SDF1),S100 calcium binding protein B(S100B),platelet-derived growth factor(PDGF),Fugl-Meyer motor function assessment(FMA)score and Basel index(BI)rating of two groups were compared.Results After treatment,the total effective rate of the control group was 68.00%,which was significantly lower than that(90.00%)in the observation group(P<0.05).After treatment,the NIHSS scores of the two groups were significantly lower than those before treatment(P<0.05),and the scores of the observation group were significantly lower than those before treatment(P<0.05).After treatment,the MoCA scores of the two groups were higher than those before treatment(P<0.05),and the scores of the observation group were significantly higher than those of the control group(P<0.05).After treatment,the PDGF levels of the two groups were significantly increased.The PDGF level of the observation group was significantly higher than that of the control group(P<0.05).The levels of SDF-1 and S100B were sig-nificantly lower,and the levels of the observation group were significantly lower than those of the control group(P<0.05).After treatment,the FMA score and BI score of both groups were significantly improve

关 键 词：补阳还五汤 镜像疗法 气虚血瘀 脑梗死后偏瘫 脑侧支循环 

分 类 号：R255.2[医药卫生—中医内科学]