芍甘木瓜汤联合康复训练治疗脑卒中后下肢痉挛疗效观察及对痉挛指数、运动功能的影响

Curative Observation of Applying Shaogan Mugua Decoction Combined with Rehabilitation Training for Lower Limb Spasticity after Stroke and its Influence on Spasticity Index and Motor Function

目的:探讨芍甘木瓜汤联合康复训练治疗脑卒中后下肢痉挛的临床疗效及对痉挛指数、运动功能的影响。方法:对2018年5月~2021年5月我院收治的89例脑卒中后下肢痉挛患者临床资料进行回顾性分析,按照资料中治疗方法将其纳入对照组(44例)与治疗组(45例)。对照组给予康复训练治疗,治疗组在对照组基础上加芍甘木瓜汤治疗。对比两组治疗前后临床痉挛指数(CSI)评分、运动功能Fugel-Meyer评分(FMA)、中医症候积分、生活自理能力Barthel评分(BI)和中风痉挛生活质量评分(PRO),同时比较两组的临床疗效。结果:相比对照组,治疗组总有效率更高(95.56%vs 79.55%)(P<0.05)。治疗后2组腱反射、肌张力、阵挛评分均明显降低(P<0.05),且治疗组治疗后腱反射、肌张力、阵挛评分均低于对照组(P<0.05)。治疗后2组上肢、下肢FMA评分均明显升高(P<0.05),且治疗组治疗后上肢、下肢FMA评分明显高于对照组(P<0.05)。治疗后2组中医症候积分明显降低、BI评分和PRO评分明显升高(P<0.05),且治疗组治疗后中医症候积分低于对照组,BI评分和PRO评分均高于对照组(P<0.05)。结论:芍甘木瓜汤联合康复训练治疗脑卒中后下肢痉挛疗效显著,不但能改善痉挛程度和中医症状,还可提高运动功能、生活自理能力和生活质量。

Objective:To explore the clinical efficacy of applying Shaogan Mugua Decoction combined with rehabilitation training for lower limb spasticity after stroke and its influnce on spasticity index and motor function.Methods:The clinical data of 89 patients with lower extremity spasticity after stroke admitted to our hospital from May 2018 to May 2021 were retrospectively analyzed,and divedened them into a controlled group(44 cases)and a treatment group(45 cases)by treatment methods in the data.The controlled group was given rehabilitation training,and the treatment group was treated with Shaogan Mugua Decoction combined with rehabilitation training.The clinical spasticity index(CSI)score,motor function Fugel-Meyer score(FMA),TCM syndrome score,self-care ability Barthel score(BI)and stroke and spasm quality of life score(PRO)were compared in two groups.The clinical efficacy was aslo compared.Results:The total effective rate in the treatment group was higher compared with the controlled group(95.56%vs 79.55%)(P<0.05).After treatment,the scores of tendon reflex,muscle tone,and clonus were reduced in the two groups(P<0.05),and the scores of tendon reflex,muscle tone,and clonic in the treatment group were lower compared with the controlled group(P<0.05).After treatment,the FMA scores of the upper and lower limbs of the two groups were increased(P<0.05),and the FMA scores of the upper and lower limbs of the treatment group were higher compared with the controlled group(P<0.05).The TCM syndrome scores of the two groups were reduced after treatment,and the BI score and PRO score were increased(P<0.05),and the TCM syndrome scores of the treatment group after treatment were lower compared with the controlled group,and the BI score and PRO score were higher compared with the controlled group(P<0.05).Conclusion:Shaogan Mugua Decoction combined with rehabilitation training has a significant effect on lower limb spasticity after stroke,which can improve the degree of spasticity,motor function and TCM symptoms of patients,and improve their self-care ability and quality of life.