摘要
目的研究芍药甘草汤联合西药治疗卒中后肌痉挛的疗效。方法选取我院近年78例卒中后肌痉挛患者为研究对象,按随机数字表法分为观察组与对照组,两组均采取主被动训练的基础干预,对照组口服巴氯芬,观察组另加用芍药甘草汤治疗,两组均持续治疗1月,比较两组治疗前、后改良Ashworth肌张力分级情况,并检测治疗前、治疗后1周、治疗后1月脑内神经递质指标表达,包括肾上腺素(NE)、5-羟色胺(5-HT)、γ-氨基丁酸(GABA)、谷氨酸(Glu)、甘氨酸(Gly)、天门冬氨酸(ASP)差异。结果治疗后两组均有向低级别偏移趋势,与治疗前比较差异有统计学意义(P<0.05),组间比较观察组肌张力分级分布与对照组比较差异有统计学意义(P<0.05);观察组治疗后1周NE、Asp、Glu显著高于对照组(P<0.05或P<0.01);观察组治疗后1月5-HT、NE、Asp、Glu均显著高于对照组(P<0.05或P<0.01),Gly、GABA显著低于对照组(P<0.01)。结论芍药甘草汤联合西药治疗卒中后肌痉挛具有满意疗效,其疗效机制与调控脑内神经递质水平有关。
Objective To study the therapeutic mechanism of Shaoyao Gancao decoction combined with West-ern medicine in the treatment of myospasm after stroke. Methods Seventy -eight patients with myospasm after stroke in our hospital in recent years were selected as the study subjects and were randomly divided into the observation group and the control group. Both groups were give basic intervention of active -passive training. The control group was administrated with baclofen, while the observation group was additionally treated with Shaoyao Gancao decoction. Both groups were treated for 1 month. The status of modified Ashworth muscle tension grading was compared between the two groups before and after treatment. The expression of neurotransmitters in brain, including epinephrine （NE）, 5 -hydroxy tryptamine （5 -HT）, gamma aminobutyric acid （GABA）, glutamate （Glu）, glycine （Gly） and aspartic acid （ASP） was detected before treatment and at one week and one month after treatment. Results There was no significant difference between the two groups in modified Ash-worth muscle tension grading before treatment （P〉0.05）. After treatment, both groups showed a trend of shifting to low level. Compared with those before treatment, there were significant differences （P〈0.05）. There was significant difference in the distribution of muscle tension grading between the two groups （P〈0.05）, and there were no significant differences in the parameters of amino acid neurotransmitters between the two groups before treatment （P〉0.05）. The NE, Asp and Glu in the observation group were significantly higher than those in the control group at one week after treatment （P〈0.05）, there was no significant difference between other indicators （P〉0.05）. The 5-HT, NE, Asp and Glu were significantly higher in the observa-tion group than those in the control group after treatment of one month （P〈0.05）, Gly and GABA were significantly lower than those in the control group （P〈0.05）. Conclusion Shaoyao Gancao decoction combined with Western medicine show good effect in the treatment of myospasm after stroke, and its therapeutic mechanism may be related to regulation of the levels of neurotransmitters in brain.
作者
高亚军
薛娟
姚院芳
GAO Yajun XUE Juan YAO Yuanfang(Deportment of Neurology, Affiliated Hospital of Yan＇an University, Yan＇an, Shanxi 716000, China)
出处
《湖南中医药大学学报》
CAS
2017年第5期544-547,共4页
Journal of Hunan University of Chinese Medicine
基金
延安市科技项目(2016KS-03)
关键词
卒中后肌痉挛
芍药甘草汤
白芍
炙甘草
地龙
巴氯芬
myospasm after stroke
Shaoyao Gancao decoction
white peony root
prepared licorice
lumbricus
baclofen
