摘要
目的：观察加味补阳还五汤联合头针治疗脑卒中后单侧空间忽略（USN）的临床疗效及对血液流变学的影响。方法：将112例USN患者,按入院先后顺序,依据随机数字表法分为观察组和对照组各56例。两组患者均给予康复训练和重复经颅磁刺激疗法。对照组采用头针,1次/d,6次/周。观察组在对照组治疗的基础上服用加味补阳还五汤,1剂/d。两组均连续治疗8周。USN严重程度评分采用直线评分试验、线段删除试验和画钟试验;运动功能评定采用Fugl-Meyer量表,日常生活自理能力采用Barthel指数,认知功能采用简易精神状态评定量表（MMSE）,抑郁程度采用汉密尔顿抑郁量表（HAMD）和生活质量采用世界卫生组织生存质量测评量表（WHO-QOL-100）,均采用第三者评价,治疗前后各评价1次。并检测治疗前后血液流变学指标。结果：治疗后观察组直线评分试验、线段删除试验和画钟试验评分均低于对照组（P〈0.01）;治疗后观察组患者Fugl-Meyer量表上、下肢评分和总分均高于对照组（P〈0.01）;Barthel和MMSE评分均高于对照组,HAMD评分低于对照组（P〈0.01）;观察组患者认知功能和日常生活自理能力的改善均优于对照组（P〈0.05）;WHO-QOL-100量表的躯体功能、心理功能、独立性、社会关系、生活质量总分等5个维度评分均高于对照组（P〈0.01）;观察组血液流变学指标全血黏度（高切、低切）、全血还原黏度、血浆黏度、纤维蛋白原和血小板聚集率的改善均优于对照组（P〈0.01）。结论：采用加味补阳还五汤内服联合头针治疗脑卒中后USN,可有效的减轻病情程度,改善认知功能和血液流变性,减轻抑郁程度,提高患者的运动、生活自理能力和生活质量,针药结合方案有利于脑卒中后单侧空间忽略的康复。
Objective： To observe the clinical efficacy of modified Buyang Huanwutang combined with scalp acupuncture on unilateral spatial neglect（ USN） and its effect on hemorheology. Method： One hundred and twelve patients with USN were divided into control group（ 56 cases） and observation group（ 56 cases） according to the order of admission by random number table. Both groups＇ patients got rehabilitation training and repetitive transcranial magnetic stimulation therapy. Patients in control group got scalp acupuncture,1 time/day,6 times/week. In addition to the therapy for control group,patients in observation group were also given modified Buyang Huanwutang,1 dose/day. The treatment lasted for 8 weeks. The severity of USN was scored by linear scoring test,line deletion test and clock drawing test. Fugl-Meyer scale was used to detect the motor function. Barthel index was used for measuring the ability of daily living. Mini-mental state examination（ MMSE） was used for detecting the cognitive function. And Hamilton depression scale（ HAMD） and world health organization survival quality assessment scale（ WHO-QOL-100） scale were used for measuring depression symptom. Before and after treatment,hemodynamic indexes were detected. Result： After treatment,the scores of linear scoring test,line deletion test and clock drawing task in observation group were lower than those in control group（ P 〈0. 01）. The scores of upper and lower limbs and the total score of Fugl-Meyer scale in observation group were higher than those in control group（ P 〈0. 01）. The scores of Barthel and MMSE in observation group were higher than those in control group,but the score of HAMD was lower than that in control group（ P 〈0. 01）. The cognitive function and activities of daily living in observation group were improved more significantly than those in control group（ P 〈0. 05）. Five composite scores in WHO-QOL-100 scale,namely physical performance,mental function,independence,social relations,and quality of life,were higher than those in control group（ P 〈0. 01）. And indicators of hemorheology,such as whole blood viscosity（ high and low shearing）, whole blood reduced viscosity, plasma viscosity,fibrinogen,platelet aggregation rate,were all superior to those in control group（ P 〈0. 01）. Conclusion：Modified Buyang Huanwutang combined with scalp acupuncture can relieve illness degree,improve the cognitive function and hemorheological indicators,reduce depression symptom,improve exercise,self-help ability and quality of life,and thus is worth clinical application.
作者
王天磊
刘建浩
郑杨杨
徐琼
谭春凤
WANG Tian-lei;LIU Jian-hao;ZHENG Yang-yang;XU Qiong;TAN Chun-feng(Sanya Traditional Chinese Medicine （TCM） Hospital, Sanya 572000, China;Hainan Provincial Hospital of TCM , Haikou 570100, China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2018年第13期196-201,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
海南省自然科学基金项目(817399)
关键词
单侧空间忽略
脑卒中
补阳还五汤
头针
血液流变学
unilateral spatial neglect
stroke
Buyang Huawutang
scalp acupuncture
hemorheology
