摘要
目的:观察益气活血通络汤联合针刺和肉毒毒素治疗卒中后肌肉痉挛患者的效果。方法:选取108例卒中后肌肉痉挛患者为研究对象,按照随机数字表法分为观察组与对照组各54例。对照组予以肉毒毒素治疗,观察组在对照组基础上采用益气活血通络汤联合针刺治疗,比较两组临床疗效、改良Ashworth肌张力(MAS)评分、神经电生理指标[尺神经、正中神经H反射最大波幅/M波最大波幅(Hmax/Mmax)和H反射潜伏期]水平、视觉模拟评分法(VAS)评分和不良反应发生率。结果:观察组治疗总有效率为94.44%,明显高于对照组的77.78%,差异有统计学意义(P<0.05);治疗后,观察组MAS评分、VAS评分和尺神经、正中神经Hmax/Mmax均低于对照组,尺神经、正中神经H反射潜伏期高于对照组,差异有统计学意义(P<0.05);两组治疗期间均未见明显不良反应。结论:益气活血通络汤联合针刺和肉毒毒素治疗卒中后肌肉痉挛患者可提高治疗总有效率和尺神经、正中神经H反射潜伏期,降低尺神经、正中神经Hmax/Mmax、MAS评分和VAS评分,效果优于单纯肉毒毒素治疗。
Objective: To observe effects of Yiqi Huoxue Tongluo decoction combined with acupuncture and Botulinum toxin in treatment of post-stroke muscle spasm. Methods: 108 patients with post-stroke muscle spasm were selected as the research objects, and were divided into observation group and control group according to the random number table method, 54 cases in each group. The control group was treated with Botulinum toxin, while the observation group was treated with Yiqi Huoxue Tongluo decoction combined with acupuncture on the basis of that of the control group. The clinical effects, the modified Ashworth muscle strength(MAS) score, the nerve electrophysiology index levels [ulnar nerve and median nerve H-reflex maximum amplitude/M-wave maximum amplitude(Hmax/Mmax) and H-reflex latencies], the visual analogue scale(VAS)score and the incidence of adverse reactions were compared between the two groups. Results: The total effective rate of the observation group was 94.44%, which was significantly higher than 77.78% of the control group, and the difference was statistically significant(P<0.05). After the treatment,the MAS score, the VAS score, the ulnar nerve and median nerve Hmax/Mmax in the observation group were lower than those in the control group;the ulnar nerve and median nerve H-reflex latencies were higher than those in the control group;and the differences were statistically significant(P<0.05). However, there were no obvious adverse reactions in the two groups during the treatment. Conclusions: Yiqi Huoxue Tongluo decoction combined with acupuncture and Botulinum toxin in the treatment of post-stroke muscle spasm can improve the total effective rate and the ulnar nerve and median nerve H-reflex latencies, and reduce the ulnar nerve and median nerve Hmax/Mmax, the MAS score and the VAS score. Moreover, it is superior to single Botulinum toxin treatment.
作者
刘广晨
王馨
LIU Guangchen;WANG Xin(Department of Encephalopathy of Jiamusi Hospital of Traditional Chinese Medicine,Jiamusi 154002 Heilongjiang,China)
出处
《中国民康医学》
2022年第11期98-100,104,共4页
Medical Journal of Chinese People’s Health
关键词
卒中
肌肉痉挛
益气活血通络汤
针刺
肉毒毒素
肌张力
神经电生理
Stroke
Muscle spasm
Yiqi Huoxue Tongluo decoction
Acupuncture
Botulinum toxin
Muscle tension
Nerve electrophysiology
