血府逐瘀汤联合芍药甘草汤治疗脑卒中后痉挛性瘫痪患者的效果及对肢体功能的影响  

The Effect of Xuefu Zhuyu Decoction and Shaoyao Gancao Decoction in Treating Spastic Paralysis after Stroke and Its Influence on Limb Function

作　　者：赵文华 王锋 叶迎新 ZHAO Wenhua;WANG Feng;YE Yingxin(Brain Disease Department,Jinan Zhangqiu District Traditional Chinese Medicine Hospital,Jinan,Shandong,250200,China;Department of Traditional Chinese Medicine,Jinan Zhangqiu District Traditional Chinese Medicine Hospital,Jinan,Shandong,250200,China)

机构地区：[1]济南市章丘区中医医院脑病科,山东济南250200 [2]济南市章丘区中医医院中医科,山东济南250200

出　　处：《中外医疗》2025年第7期128-131,152,共5页China & Foreign Medical Treatment

摘　　要：目的分析在脑卒中后痉挛性瘫痪中合用芍药甘草汤、血府逐瘀汤治疗的效用及其对肢体功能的影响。方法方便选取2021年2月—2023年2月济南市章丘区中医医院收治的106例脑卒中后痉挛性瘫痪患者为研究对象,依据不同的治疗方法分为对照组、观察组,各53例。对照组口服巴氯芬片治疗,观察组合用血府逐瘀汤+芍药甘草汤治疗。对比两组的治疗总有效率、肢体功能、血清指标及不良事件发生情况。结果观察组治疗总有效率为96.23%(51/53),高于对照组的84.91%(45/53),差异有统计学意义(χ^(2)=3.975,P<0.05)。治疗前,两组患者的运动功能量表(Fugl-meyer Assessment,FMA)评分与姿势控制量表(Postural Assessment Scale for Stroke Patients,PASS)评分比较,差异均无统计学意义(P均>0.05);治疗后,两组患者的FMA评分与PASS评分均高于治疗前,且观察组FMA评分中上肢功能评分为(60.33±4.97)分,下肢功能评分为(30.16±3.72)分,PASS评分为(19.12±4.33)分,均高于对照组的(51.26±5.16)分、(24.29±4.21)分与(14.38±3.42)分,差异均有统计学意义(t=9.217,7.607,6.254;P均<0.05)。治疗前,两组患者的血清谷氨酸(glutamic acid,Glu)与γ-氨基丁酸(gamma-aminobutyric acid,GABA)水平比较,差异均无统计学意义(P均>0.05);治疗后,两组患者的Glu水平低于治疗前,GABA水平高于治疗前,且观察组Glu水平低于对照组,GABA水平高于对照组,差异均有统计学意义(P均<0.05)。对照组不良反应总发生率为15.09%(8/53),高于观察组的1.89%(1/53),差异有统计学意义(χ^(2)=4.371,P<0.05)。结论血府逐瘀汤联合芍药甘草汤治疗脑卒中后痉挛性瘫痪疗效显著,可有效提升运动功能评分,调节神经递质水平,且不良事件发生率低,且安全性较高。Objective To analyze the efficacy of combined use of Shaoyao Gancao decoction and Xuefu Zhuyu decoction in the treatment of spastic paralysis after stroke and its impact on limb function.Methods A total of 106 patients with spastic paralysis after stroke admitted to Jinan Zhangqiu District Traditional Chinese Medicine Hospital from February 2021 to February 2023 were conveniently selected as the research object and divided into a control group and an observation group according to different treatment methods,with 53 cases in each group.The control group was treated with oral baclofen tablets,while the observation group was treated with Xuefu Zhuyu decoction combined with Shaoyao Gancao decoction.The total treatment efficiency,limb function,serum indexes and occurrence of adverse events were compared between the two groups.Results The total treatment efficiency of the observation group was 96.23%(51/53),which was higher than that of the control group 84.91%(45/53),and the difference was statistically significant(χ^(2)=3.975,P<0.05).Before treatment,there were no statistically significant differences in the scores of Fugl-meyer Assessment(FMA)and Postural Assessment Scale for Stroke Patients(PASS)between the two groups(both P>0.05);after treatment,the FMA and PASS scores of both groups were higher than those before treatment,and the scores of upper limb function,lower limb function and PASS in the observation group were(60.33±4.97)points,(30.16±3.72)points and(19.12±4.33)points respectively,which were higher than those in the control group[(51.26±5.16)points,(24.29±4.21)points and(14.38±3.42)points],and the differences were statistically significant(t=9.217,7.607,6.254;all P<0.05).Before treatment,there were no statistically significant differences in the levels of serum glutamic acid(Glu)and gamma-aminobutyric acid(GABA)between the two groups(both P>0.05).After treatment,the Glu levels of both groups were lower than those before treatment,and the GABA levels were higher than those before treatment,moreover,

关 键 词：脑卒中 痉挛性瘫痪 血府逐瘀汤 芍药甘草汤 治疗效果 肢体功能 

分 类 号：R4[医药卫生—临床医学]