加味补阳还五汤加减辅治脑卒中恢复期患者的临床效果  

Clinical effect of modified Buyang Huanwu decoction in adjuvant treatment of stroke patients in the recovery period

作　　者：喻宏剑 YU Hongjian(Rehabilitation Department,Fuding Hospital of Traditional Chinese Medicine,Fujian Province,Fuding 355200,China)

机构地区：[1]福建省福鼎市中医院康复科,355200

出　　处：《临床合理用药》2025年第9期10-13,17,共5页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察加味补阳还五汤加减辅治脑卒中恢复期患者的临床效果。方法选取2022年10月—2023年10月福鼎市中医院收治的脑卒中恢复期患者76例,采用随机单双号法将纳入样本分为试验组(n=38)和西药组(n=38)。西药组采取常规西医治疗,试验组在西药组基础上采用加味补阳还五汤加减治疗,2组均治疗4周。比较2组临床疗效,治疗前后中医证候积分、血清细胞因子[神经生长因子(NGF)、脑源性神经细胞营养因子(BDNF)]、血液流变学指标、疾病恢复相关评分,不良反应。结果试验组治疗总有效率为94.74%,高于西药组的78.95%(χ^(2)=4.146,P=0.042)。治疗4周后,西药组与试验组主症、次症积分较治疗前降低,且试验组低于西药组(P<0.01);西药组与试验组血清NGF、BDNF水平较治疗前升高,且试验组高于西药组(P<0.01);西药组与试验组血小板聚集指数、红细胞聚集指数、血浆纤维蛋白原及血浆黏度较治疗前降低,且试验组低于西药组(P<0.05或P<0.01);西药组与试验组美国国立卫生研究院卒中量表评分较治疗前下降,Fugl-Meyer运动功能评估量表评分、Barthel指数较治疗前升高,且试验组下降/升高幅度大于西药组(P<0.01)。试验组不良反应总发生率为5.26%,与西药组的7.89%比较无统计学差异(χ^(2)=0.214,P=0.644)。结论在常规西医治疗基础上,采用加味补阳还五汤加减治疗脑卒中恢复期患者,可显著提升治疗效果,更好地改善临床症状,同时可有效调节血清NGF、BDNF水平,改善血液流变学指标,促进预后恢复,且不良反应发生率低。Objective To observe the clinical effect of modified Buyang Huanwu decoction in adjuvant treatment of stroke patients in the recovery period.Methods A total of 76 stroke patients in the recovery period admitted to Fuding Hospital of Traditional Chinese Medicine from October 2022 to October 2023 were selected.The included samples were randomly divided into the experimental group(n=38)and the Western medicine group(n=38)using a single and even number method.The Western medicine group received conventional Western medicine treatment,while the experimental group received modified Buyang Huanwu decoction addition to the Western medicine group.Both groups were treated for 4 weeks.Clinical efficacy,changes in TCM syndrome scores,serum cytokines(NGF,BDNF),hemorheological indicators,disease recovery-related scores before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of the experimental group was 94.74%,which was higher than 78.95%of the Western medicine group(χ^(2)=4.146,P=0.042).After 4 weeks of treatment,the scores of the main and secondary symptoms in the Western medicine group and the experimental group were lower than before treatment,and the experimental group was lower than the Western medicine group(P<0.01);Levels of serum NGF and BDNF in the Western medicine group and the experimental group were higher than before treatment,and the experimental group was higher than the Western medicine group(P<0.01);The platelet aggregation index,red blood cell aggregation index,plasma fibrinogen,and plasma viscosity in the Western medicine group and the experimental group were lower than before treatment,and the experimental group was lower than the Western medicine group(P<0.05 or P<0.01);NIHSS scores in the Western medicine group and the experimental group were lower than before treatment,while the Fugl-Meyer motor function assessment score and Barthel index were higher than before treatment,and the decrease/increase in the experimental group was greater than

关 键 词：脑卒中 恢复期 加味补阳还五汤 中医证候 血液流变学 不良反应 

分 类 号：R74[医药卫生—神经病学与精神病学]