摘要
背景急性脑梗死(ACI)后痉挛型偏瘫发生率不断增加,且约90%的患者可在发生偏瘫后21 d内出现肢体痉挛。但常规康复治疗难以达到理想的效果,且部分患者容易失去坚持治疗的信心,而中西医结合治疗已成为ACI后痉挛型偏瘫患者治疗的新趋势。目的探讨醒脑开窍针刺法联合熄风化痰通络扶正汤治疗ACI后痉挛型偏瘫的效果。方法选取天水市中西医结合医院2018年8月—2020年5月收治的ACI后痉挛型偏瘫患者216例为研究对象。采用随机数字表法将患者分为A组、B组、C组和D组,每组54例。A组给予常规康复治疗,B组给予常规康复+醒脑开窍针刺法治疗,C组给予常规康复+熄风化痰通络扶正汤内服治疗,D组给予常规康复+醒脑开窍针刺法+熄风化痰通络扶正汤内服治疗,均连续治疗1个月。比较四组患者临床疗效和治疗前后美国国立卫生研究院卒中量表(NIHSS)、Fugl-Meyer评定量表(FMA)、改良巴氏指数评定量表(MBI)评分及不良反应发生情况。结果D组患者临床疗效优于A组、B组、C组(P<0.05)。B组、C组、D组患者治疗后NIHSS评分低于A组(P<0.05);D组患者治疗后NIHSS评分低于B组、C组(P<0.05)。A组、B组、C组、D组患者治疗后NIHSS评分分别低于本组治疗前(P<0.05)。B组、C组、D组患者治疗后FMA、MBI评分高于A组(P<0.05);D组患者治疗后FMA、MBI评分高于B组、C组(P<0.05)。A组、B组、C组、D组患者治疗后FMA、MBI评分分别高于本组治疗前(P<0.05)。四组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论醒脑开窍针刺法联合熄风化痰通络扶正汤内服治疗可提高ACI后痉挛型偏瘫患者的临床疗效,有效恢复患者的神经功能,提高其肢体运动功能及日常生活活动能力,且安全可靠。
Background The incidence of spastic hemiplegia after acute cerebral infarction(ACI)is increasing,and about 90%of patients can have limb spasm within 21 days after the onset of hemiplegia.However,conventional rehabilitation treatment is difficult to achieve the desired effect,and some patients are easy to lose the confidence to adhere to the treatment,and the combination of Chinese and western medicine has become a new trend in the treatment of spastic hemiplegia after ACI.Objective To explore the effect of Xingnao Kaiqiao acupuncture combined with Xifeng Huatan Tongluo Fuzheng decoction internal treatment on spastic hemiplegia after ACI.Methods A total of 216 patients with spastic hemiplegia after ACI admitted to Tianshui Hospital of Integrated Traditional Chinese and Western Medicine from August 2018 to May 2020 were selected as the research objects and divided into group A,group B,group C and group D by random number table method,with 54 patients in each group.Group A was given conventional rehabilitation treatment,group B was given conventional rehabilitation+X ingnao Kaiqiao acupuncture treatment,group C was given conventional rehabilitation+Xifeng Huatan Tongluo Fuzheng decoction internal treatment,and group D was given conventional rehabilitation+X ingnao Kaiqiao acupuncture andX ifeng Huatan Tongluo Fuzheng decoction internal treatment,all the four groups were treated for 1 month.The clinical efficacy,scores of National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA)and modified Barthel Index(MBI)before and after treatment,adverse reactions were compared among the four groups.Results The clinical effect of group D was better than that of group A,group B and group C(P<0.05).NIHSS score of group B,group C and group D was lower than that of group A after treatment(P<0.05).The NIHSS score of group D was lower than that of group B and group C(P<0.05).The NIHSS scores of group A,group B,group C and group D after treatment were lower than those before treatment,respectively(P<0.05).The FMA,MBI scores of group B,group C and group D were higher than those of group A after treatment(P<0.05).The FMA,MBI scores of group D were higher than those of group B and group C after treatment(P<0.05).The FMA,MBI scores of group A,group B,group C and group D after treatment were higher than those before treatment,respectively(P<0.05).There was no significant difference in the incidence of adverse reactions among the four groups(P>0.05).Conclusion Xingnao Kaiqiao acupuncture combined with Xifeng Huatan Tongluo Fuzheng decoction internal treatment can enhance the clinical effect of patients with spastic hemiplegia after ACI,effectively recover the nerve function of patients,improve their limb motor function and daily life ability,and it is safe and reliable.
作者
胡建琴
何健
HU Jianqin;HE Jian(Department of Neurology,Tianshui Hospital of Integrated Traditional Chinese and Western Medicine,Tianshui 741020,China;Department of Rehabilitation,Tianshui Hospital of Integrated Traditional Chinese and Western Medicine,Tianshui 741020,China)
出处
《实用心脑肺血管病杂志》
2021年第8期89-94,共6页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
脑梗死
偏瘫
痉挛
针刺
醒脑开窍
熄风化痰通络扶正汤
治疗结果
Brain infarction
Hemiplegia
Spasm
Acupuncture
Xingnao Kaiqiao
Xifeng Huatan Tongluo Fuzheng decoction
Treatment outcome
