清脑通脉汤加味辅助治疗脑梗死恢复期偏瘫临床研究  

Clinical Study on Modified Qingnao Tongmai Decoction as Adjuvant Therapy for Hemiplegia During Convalescence Phase of Cerebral Infarction

作　　者：潘林花 吕甜甜 方蓉[3] PAN Linhua;LYU Tiantian;FANG Rong(Department of Rehabilitation,Xinchang County People's Hospital,Xinchang Zhejiang 312500,China;Department of Chinese Medicine,Qixing Branch of Xinchang County People's Hospital Medical Consortium,Xinchang Zhejiang 312500,China;Physical Examination Center,The Affiliated Hospital of Hangzhou Normal University,Hangzhou Zhejiang 310015,China)

机构地区：[1]新昌县人民医院康复科,浙江新昌312500 [2]新昌县人民医院医共体七星分院中医科,浙江新昌312500 [3]杭州师范大学附属医院体检中心,浙江杭州310015

出　　处：《新中医》2025年第7期94-98,共5页New Chinese Medicine

摘　　要：目的:观察清脑通脉汤加味辅助治疗脑梗死恢复期偏瘫患者的临床效果。方法:选择2020年1月—2023年6月新昌县人民医院收治的72例脑梗死恢复期偏瘫患者为研究对象,按照随机数字表法分为对照组和观察组各36例。对照组采用常规治疗措施,结合向心和离心运动,观察组在对照组的基础上联合清脑通脉汤加味治疗,2组均连续治疗3个月。比较2组临床疗效及不良反应,比较2组治疗前后中医证候积分,血清S100钙结合蛋白β(S100β)蛋白、脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)水平及Fugl-Meyer运动功能(FMA)评分、Barthel评分、Ashworth评分、美国国立卫生研究院神经功能缺损评分(NIHSS)。结果:观察组总有效率97.22%(35/36),高于对照组77.78%(28/36)(P<0.05)。治疗后,2组神志昏蒙、偏身麻木、头痛眩晕、舌苔白腻等中医证候积分均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,2组血清S100β蛋白、NSE水平均降低(P<0.05),且观察组低于对照组(P<0.05);2组BDNF水平升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,2组FMA评分、Barthel评分均升高(P<0.05),且观察组高于对照组(P<0.05);2组Ashworth评分、NIHSS评分均降低(P<0.05),且观察组低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:清脑通脉汤加味辅助治疗脑梗死恢复期偏瘫患者能明显提升疗效,改善患者中医症状、日常生活能力及神经功能。Objective:To observe the clinical effect of modified Qingnao Tongmai Decoction as adjuvant therapy for patients with hemiplegia during the convalescence phase of cerebral infarction.Methods:A total of 72 patients with hemiplegia during the convalescence phase of cerebral infarction admitted to Xinchang County People's Hospital from January 2020 to June 2023 were selected and randomly divided into the control group and the observation group by random number table method,with 36 patients in each group.The control group received conventional treatment combined with concentric and eccentric exercises,while the observation group received additional modified Qingnao Tongmai Decoction on the basis of the control group's treatment.Both groups were treated for three consecutive months.The clinical efficacy and adverse reactions were compared between the two groups.The traditional Chinese medicine syndrome scores,serum levels of S100 calcium-binding proteinβ(S100βprotein),brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE),and scores for Fugl-Meyer motor function(FMA),Barthel index,Ashworth scale,and National Institutes of Health Stroke Scale(NIHSS)were compared before and after treatment between the two groups.Results:The total effective rate in the observation group was 97.22%(35/36),which was higher than the 77.78%(28/36)in the control group(P<0.05).After treatment,the traditional Chinese medicine syndrome scores such as mental confusion,hemiplegia,headache and dizziness,and white and greasy tongue coating were decreased in both groups(P<0.05),and the observation group had lower scores than the control group(P<0.05).After treatment,the serum levels of S100βprotein and NSE were decreased in both groups(P<0.05),and the observation group had lower levels than the control group(P<0.05);the levels of BDNF were increased in both groups(P<0.05),and the observation group had higher levels than the control group(P<0.05).After treatment,the FMA scores and Barthel index scores were increased in both groups(P<0.

关 键 词：脑梗死 恢复期 偏瘫 清脑通脉汤 运动能力 日常生活能力 神经功能 中医证候积分 

分 类 号：R743.3[医药卫生—神经病学与精神病学]