摘要
目的:探究补阳还五汤治疗中风后肢体痉挛的临床效果,研究作用机制、提高疗效、改善患者生命质量。方法:选取2015年8月至2018年7月南宁市中医医院收治的中风后肢体痉挛患者112例作为研究对象,按照入组先后顺序分成对照组和观察组,每组56例。2组均营养脑细胞、控制血压、调节血脂治疗,对照组辅助康复治疗,观察组加用补阳还五汤治疗,均治疗4周,观察治疗前、完成治疗后Fugl-Meyer功能量表、日常生活能力积分(ADL)、神经功能缺损程度(NDS)、改良Ashworth量表、肌电图、血液流变学(包括全血黏度、血浆黏度、纤维蛋白原、血小板聚集指数、红细胞变形指数)、神经元指标甘氨酸(Gly)、γ-氨基丁酸(GABA)变化并比较,完成治疗后总结疗效情况。结果:1)完成治疗后2组Hmax、Mmax、H/Mmax较治疗前均显著下降(P<0.05),完成治疗后观察组以上指标均显著低于对照组(P<0.05)。2)完成治疗后2组Fugl-Meyer功能量表、ADL较治疗前均显著升高,NDS、改良Ashworth量表较治疗前显著下降(P<0.05),完成治疗后观察组NDS评分、改良Ashworth量表显著低于对照组,余显著高于对照组(P<0.05)。3)完成治疗后2组全血黏度、血浆黏度、纤维蛋白原、血小板聚集指数、红细胞聚集指数较治疗前均显著下降(P<0.05),完成治疗后观察组以上指标均显著低于对照组(P<0.05)。4)完成治疗后2组Gly、GABA较治疗前均显著下降(P<0.05),完成治疗后观察组以上指标均显著低于对照组(P<0.05)。5)完成治疗后观察组治愈率、总有效率显著高于对照组(P<0.05)。结论:补阳还五汤能提高中风肢体痉挛神经元生长水平,促进血液循环,从而缓解痉挛症状,提高生命质量。
Objective:To explore the clinical effect of Buyang Huanwu Decoction(BYHWD)in the treatment of limb spasm after stroke,and to explore its mechanism of action,so as to improve the curative effect and the quality of life of patients.Methods:A total of 112 patients with post-stroke limb spasm admitted to Nanning Chinese Medicine Hospital from August 2015 to July 2018 were selected as the research objects and were divided into a control group and an observation group according to the order of enrollment,with 56 cases in each group.Both groups were treated with brain cell nutrition,blood pressure control and blood lipid regulation.The control group was assisted with rehabilitation treatment.The observation group was treated with Buyang Huanwu Decoction for 4 weeks.Fugl-Meyer Function Scale,ADL,NDS,modified Ashworth Scale,electromyogram and hemorheology(including whole blood viscosity,plasma viscosity,fibrinogen,platelet aggregation index,red blood cell deformity index),changes of neuronal indicators glycine(Gly)andγ-aminobutyric acid(GABA)were compared before and after treatment and the curative effect was summarized after treatment.Results:1)After treatment,Hmax,Mmax and H/Mmax in the 2 groups were significantly lower than those before treatment(P<0.05),and the above indexes in the observation group were significantly lower than those in the control group(P<0.05).2)After treatment,the Fugl-Meyer Function Scale and ADL in the 2 groups were significantly higher than those before treatment,while the NDS and the modified Ashworth Scale were significantly lower than those before treatment(P<0.05).After treatment,the NDS score and the modified Ashworth Scale in the observation group were significantly lower than those in the control group,and the rest were significantly higher than those in the control group(P<0.05).3)After treatment,the whole blood viscosity,plasma viscosity,fibrinogen,platelet aggregation index and erythrocyte aggregation index of the 2 groups were significantly lower than those of the control group(P<0.05),and the above indexes of the observation group were significantly lower than those of the control group(P<0.05).4)Gly and GABA in the 2 groups decreased significantly after treatment(P<0.05),and the above indexes in the observation group were significantly lower than those in the control group(P<0.05).5)After treatment,the curative rate and total effective rate in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Buyang Huanwu Decoction can improve the growth level of spastic neurons in apoplectic limbs,promote blood circulation,alleviate the symptoms of spasm and improve the quality of life.
作者
罗穗
潘凤仙
银春莉
LUO Sui;FAN Fengxian;YIN Chunli(The Second Department of Encephalology,Nanning Chinese Medicine Hospital,Nanjing 530001,China)
出处
《世界中医药》
CAS
2021年第3期472-476,共5页
World Chinese Medicine
基金
2015年度广西壮族自治区卫生厅医药卫生重点科研课题(20150052)。
关键词
补阳还五汤
中风后肢体痉挛
疗效
肌电图
血液流变学
痉挛量表
甘氨酸
Γ-氨基丁酸
Buyang Huanwu Decoction
Limb spasm after stroke
Curative effect
Electromyography
Hemorheology
Spasm scale
Glycine
Gamma-aminobutyric acid
