通腑化浊方对缺血性脑中风早期康复的影响

Effect of Tongfu Huazhuo Fang Decoction Rehabilitation with Ischemic Stroke Patients

目的:观察通腑化浊方对缺血性脑中风早期康复的影响。方法:90例患者随机按住院前后顺序分为对照组和观察组各45例。两组给予西医生命支持、药物治疗、健康教育等常规治疗,并采用中医康复综合治疗,包括推拿、针灸、药浴等。观察组加用通腑化浊方内服,1剂/d,两组疗程均为4周。采用美国国立卫生研究院卒中量表(NIHSS)评估神经功能缺损严重程度,采用Fugl-Meyer运动功能评价量表(FMI)评估肢体运动功能,采用日常生活活动能力量表(BI)评价日常生活活动能力,采用改良Ashworth痉挛评定量表评价肢体痉挛程度,采用修订Rankin量表(MRS)评价致残率/病死率,测量血清S100B蛋白含量。结果:治疗第7,14,28天,观察组NIHSS评分均低于对照组(P<0.01);治疗后第14,28天,观察组FMI,BI评分高于对照组(P<0.01);治疗后第14,28天,观察组改良Ashworth评分低于对照组(P<0.01);治疗后第3,7,14天观察组血清S100B蛋白含量均低于对照组(P<0.01);随访3个月后观察组MRS评分低于对照组(P<0.01)。结论:在综合康复方案中,通腑化浊方能改善神经功能,提高运动功能,增强生活活动能力,降低血清S100B蛋白含量,降低致残率/病死率,在缺血性中风早期康复中起着重要的作用。

Objective： To observe the clinical curative effect of Tongfu Huazhuo dcoction in the treatment of early rehabilitation of ischemic stroke. Method： Ninety patients were randomly divided into control group and observation group according to the Before and after hospitalization sequence, each 45 cases. The two group were treated with western medicine on life support, medical treatment, health education routine treatment, and use traditional Chinese medicine comprehensive rehabilitation treatment, including massage, acupuncture, medicated bath. Observation group was added with Tongfu Huazhuo decoction, oral, 1 dosage/day, two groups were treated for 4 weeks. Assessed the nerve function defect severity by the United States National Institutes of Health Stroke Scale （NIHSS）; assessed the limb motor function by Evaluation of Fugl-Meyer motor function scale （FMI）; Assessed the activities of daily living by Daily life activities ability scale （BI） ; assessed the limb spasticity by the modified Ashworth spasticity scale; assessed the morbidity/mortality by the revised the Rankin scale （MRS） , to measure the content of S100B protein serum. Result： Treatment of 7, 14, 28 days, the observation group NIHSS scores we rcelower than the control group （P 〈 0.01 ） ; 14, 28 days, the observation group FMI, BI were higher than that＇ of the control group （P 〈 0.01 ） , and the observation group modified Ashworth score was lower than that of the control group （P 〈 0.01） ; after 3, 7 and 14 days treatment the observation group were lower than control group （P 〈 0.01 ） for S100B protein serum. After 3 months of follow-up the observation group MRS were lower than control group （P 〈 0.01 ）. Conclusion： In the comprehensive rehabilitation scheme, Tongfu Huazhuo dcoction improves nerve function and the motor function, enhances the capacity of life activity, reduces S100B protein serum and lowers morbidity/mortality. Tongfu Huazhuo Fang plays an important role in the early rehabilitation of stroke.