黄芪桂枝五物汤联合康复训练治疗脑卒中后肩手综合征临床研究  

Clinical Study on Astragalus and Cinnamon Twig Five Substances Decoction Combined with Rehabilitation Training for Post-Stroke Shoulder-Hand Syndrome

作　　者：张海军 ZHANG Haijun(Jinan Hospital of Integrated Traditional Chinese and Western Medicine,Jinan,Shandong,China,271100)

机构地区：[1]济南市中西医结合医院,山东济南271100

出　　处：《河南中医》2025年第5期661-666,共6页Henan Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划项目(2020-065)。

摘　　要：目的:观察黄芪桂枝五物汤联合康复训练治疗脑卒中后肩手综合征的临床疗效。方法:选取2021年6月至2023年6月济南市中西医结合医院收治的126例脑卒中后肩手综合征患者为研究对象,按照随机数字表法分为研究组和对照组,每组各63例。对照组实施常规康复训练治疗,研究组在对照组治疗的基础上给予黄芪桂枝五物汤,比较两组患者的临床疗效及治疗前后中医证候积分、肩手功能损伤评分、舒适度评分和血清学指标[降钙素基因相关肽(calcitonin gene-related peptide,CGRP)、血清缓激肽(bradykinin,BK)、P物质(substance P,SP)]变化情况。结果:研究组有效率为93.65%,高于对照组的76.19%,差异具有统计学意义(P<0.05)。两组患者治疗后手指肿胀、肢体疼痛、感觉减弱、舌淡苔薄、半身不遂和脉弦滑等中医证候积分低于本组治疗前,且治疗后研究组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后感觉、自主神经、运动等肩手功能损伤评分低于本组治疗前,且治疗后研究组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后生理、心理精神、环境、社会文化等舒适度评分高于本组治疗前,且治疗后研究组高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后CGRP水平高于本组,BK和SP水平低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。结论:黄芪桂枝五物汤联合康复训练治疗脑卒中后肩手综合征,能够有效改善临床症状及肩手功能损伤程度,并提高生活舒适度。Objective:To observe the clinical efficacy of Astragalus and Cinnamon Twig Five Substances Decoction combined with rehabilitation training for post-stroke shoulder-hand syndrome(SHS).Methods:A total of 126 patients with post-stroke shoulder-hand syndrome admitted to Jinan Hospital of Integrated Traditional Chinese and Western Medicine from June 2021 to June 2023 were selected and randomly divided into the study group and the control group using the random number table method,with 63 cases in each group.The control group received conventional rehabilitation training,while the study group received Astragalus and Cinnamon Twig Five Substances Decoction in addition to the control group′s treatment.The therapeutic efficacy,TCM syndrome scores(finger swelling,limb pain,sensory impairment,pale tongue with thin coating,hemiplegia,wiry and slippery pulse),shoulder-hand function impairment scores(sensory,autonomic,motor),comfort scores(physical,psychological,environmental,sociocultural),and serological indicators[calcitonin gene-related peptide(CGRP),bradykinin(BK),substance P(SP)]before and after treatment were compared.Results:The effective rate was 93.65%in the study group,significantly higher than 76.19%in the control group,with a statistically significant difference(P<0.05).After treatment,TCM syndrome scores(such as finger swelling,limb pain,sensory impairment,etc.)and shoulder-hand function impairment scores decreased in both groups compared to pre-treatment,with the study group showing significantly lower scores than those of the control group,and all the differences were statistically significant(P<0.05).The scores of shoulder-hand function impairment such as sensation,autonomic nerve and movement of the two groups of patients were lower than those before treatment in the same group,and the scores of the study group were lower than those of the control group,with statistically significant differences(P<0.05).The comfort levels of the two groups in terms of physiology,psychology,spirit,environment and social cult

关 键 词：脑卒中后肩手综合征 黄芪桂枝五物汤 康复训练 《金匮要略》 张仲景 

分 类 号：R277.743.3[医药卫生—中医学]