振痿方对脑卒中软瘫期肌张力及预后的影响

Influence of Zhenweifang on Muscle Tension in Flaccid Paralysis Period and Prognosis of Stroke

目的观察振痿方对脑卒中软瘫期肌张力及预后的影响。方法将180例患者随机分为基础组、补阳还五汤组、振痿方组,每组60例,基础组采用一般内科治疗并配合常规神经康复训练及针灸治疗,补阳还五汤组、振痿方组在基础组治疗的基础上,服用相应中药,补阳还五汤组、振痿方组均以肌张力达到Ashworth量表Ⅱ级标准时停服中药,继续基础治疗。3组均于治疗3周后、6周后对神经功能缺损程度、日常生活活动能力进行评定,依据临床疗效评定标准评价总预后。结果振痿方组肌张力上升至Ashworth分级Ⅱ级所需时间明显短于补阳还五汤组及基础组(P<0.01)。振痿方组治疗后神经功能缺损评分减少程度和临床疗效显著优于基础组(P<0.01),且振痿方组优于补阳还五汤组,具有统计学意义。结论振痿方治疗中风后软瘫期肢体肌张力消失或低下临床疗效显著,并可显著改善远期预后,减少致残率。

Objective To observe the influence of Zhenweifang on the muscle tension in flaccid paralysis period and prognosis of stroke. Methods One hundred and eighty patients were randomly divided into basic group, Buyanghuanwutang group and Zhenweifang group. Basic group was treated with usual medical treatment with nerve rehabitilation and acupuncture. Buyanghuanwutang group and Zhenweifang group were given the corresponding traditional Chinese medicine. Patients in Buyanghuanwutang group and Zhenweifang group stop taking the traditional Chinese medicine when their muscle tension reach the level of Ashworth Grade Ⅱ, and continued their basic treatment. The defect of neurological and daily life ability were evaluated after three-week and six-week treatment, and the prognosis was evaluated according to clinical efficacy. Results The time that patients muscle tension in Zhenweifang group need to reach Ashworth Grade Ⅱ was much shorter than that in Buyanghuanwutang group and basic group （P〈0.01）. The evaluation of the nervous function defection and their clinical efficacy in Zhenweifang group were much better than those in basic group （P〈0.01） and Buyanghuanwutang group, with statistical meaning. Conclusion The clinical efficacy of Zhenweifang group is remarkable on the muscle tension fading of stroke. This method can also greatly improve the forward prognosis and reduce the disability rate.