四子散定向透药对脑卒中偏瘫患者上肢运动功能影响的随机对照研究  

Effect of Sizi Powder (四子散) Orientation Osmotherapy on Upper Limb Motor Function in Stroke Patients with Hemiplegia:A Randomized Controlled Study

作　　者：李壮苗[1] 李施恩 李霞[1] 池艳红 LI Zhuangmiao;LI Shien;LI Xia;CHI Yanhong(School of Nursing,Fujian University of Traditional Chinese Medicine,Fuzhou,350122;Fuzhou Second General Hospital;Longyan Hospital of Traditional Chinese Medicine,Fujian Province)

机构地区：[1]福建中医药大学护理学院,福建省福州市350122 [2]福建省福州市第二总医院 [3]福建省龙岩市中医院

出　　处：《中医杂志》2025年第2期157-164,共8页Journal of Traditional Chinese Medicine

基　　金：福建省自然科学基金(2023J01874)。

摘　　要：目的 观察四子散定向透药治疗脑卒中偏瘫患者的临床疗效和安全性。方法 将脑卒中偏瘫患者94例随机分为对照组和治疗组各47例。对照组进行常规治疗、护理及康复训练,治疗组在对照组的基础上进行四子散定向透药治疗,每次20 min,每日1次,每周5次,2周为1个疗程,共治疗2个疗程。于治疗前、治疗2周后、治疗4周后采用Fugl-Meyer肢体运动功能评定量表的上肢部分(U-FMA)总分评价上肢运动功能,采用改良Ashworth痉挛量表(MAS)评定患者上肢痉挛程度,检测肩关节前屈、后伸、外展、内旋、外旋,肘关节屈曲,腕关节掌屈、背伸、尺屈、桡屈的关节活动度;治疗2周、4周后评价痉挛临床疗效;研究过程中观察患者实施部位皮肤情况如有无烫伤、过敏、水疱等不良反应。结果 最终治疗组44例、对照组45例完成试验。治疗2周、4周后两组患者U-FMA总分均较本组治疗前升高,且治疗组总分均高于对照组(P<0.05)。两组患者治疗4周后MAS等级分布较治疗前改善(P<0.05),但两组治疗2周、4周后MAS等级分布比较差异均无统计学意义(P>0.05)。治疗组治疗2周、4周后痉挛临床疗效总有效率分别为15.91%(7/44)、40.91%(18/44),对照组分别为11.11%(5/45)、22.22%(10/45),两组治疗2周后总有效率比较差异无统计学意义(P>0.05),治疗4周后治疗组总有效率高于对照组(P<0.05)。两组患者治疗2周、4周后上肢各关节活动度均大于本组治疗前(P<0.05);治疗2周后治疗组肩前屈、肩后伸、肩外展的活动度均大于对照组,治疗4周后治疗组肩前屈、肩后伸、肩外展、肩内旋、肩外旋、肘屈活动度均大于对照组(P<0.05)。治疗过程中,治疗组1例患者出现轻度皮肤过敏,其余患者均未发生剧烈疼痛、瘙痒、严重水疱、感染等不良反应。结论 四子散定向透药能够有效改善脑卒中偏瘫患者上肢运动功能和关节活动度,治疗4周可改善上肢痉挛�Objective To observe the clinical efficacy and safety of Sizi Powder(四子散,SP)orientation osmotherapy in the treatment of stroke patients with hemiplegia.Methods In this study,94 patients with post-stroke hemiplegia were randomly divided into a control group and a treatment group with 47 patients in each group.The control group received conventional treatment,nursing and rehabilitation training,while the treatment group was treated with SP orientation osmotherapy in addition to the treatments in the control group.The treatment consisted of 20 minutes per session,once daily,5 times a week,2 weeks per course,with a total of 2 courses.Before the intervention,after 2 weeks intervention and after 4 weeks intervention,the upper limb motor function was evaluated by using the Fugl-Meyer Assessment(U-FMA).The modified Ashworth Scale(MAS)was used to assess upper limb spasticity,and joint range of motion was measured for shoulder flexion,extension,abduction,internal rotation,external rotation,elbow flexion,wrist palmar flexion,dorsiflexion,ulnar deviation,and radial deviation.Clinical efficacy for spasticity was evaluated after 2 and 4 weeks of treatment.Skin conditions,including burns,allergic reactions,and blisters,were monitored during the treatment process.Results A total of 44 patients in the treatment group and 45 patients in the control group completed the study.The results showed that after 2 and 4 weeks of intervention,the U-FMA scores of both groups increased,with the treatment group showing higher scores than the control group(P<0.05).After 4 weeks of treatment,the MAS score distribution improved significantly in both groups(P<0.05),although no significant difference was found between the groups after 2 and 4 weeks treatment(P>0.05).The total effective rate of spasticity clinical efficacy in the treatment group after 2 and 4 weeks was 15.91%(7/44)and 40.91%(18/44),respectively,while in the control group,it was 11.11%(5/45)and 22.22%(10/45).There was no significant difference after 2 weeks treatment(P>0.05),bu

关 键 词：脑卒中 偏瘫 上肢运动功能 关节活动度 四子散 定向透药 

分 类 号：R47[医药卫生—护理学]