益肾解痉汤联合常规康复疗法治疗脑卒中后肩-手综合征30例临床观察

Clinical Observation on Yishen Jiejing Decoction Combined With Routine Rehabilitation for 30 Cases of Shoulder-Hand Syndrome After Stroke

目的观察益肾解痉汤联合常规康复疗法治疗脑卒中后肩-手综合征(SHSAS)患者的临床疗效。方法将60例SHSAS患者随机分为对照组和治疗组各30例。对照组给予常规基础治疗、对症处理及常规康复训练,治疗组在对照组治疗的基础上加用益肾解痉汤口服,每日1剂。两组患者均治疗1个月。两组患者治疗前后分别进行神经功能缺损评分、中医证候评分、上肢运动功能评定(FMA)、日常生活活动能力评定(BMI)和疼痛评定(VAS),并判定临床疗效。结果治疗组临床疗效总有效率为90.00%,对照组为73.33%,治疗组疗效明显优于对照组(P<0.05)。两组患者治疗后神经功能缺损评分、中医证候评分和VAS均较治疗前显著降低(P<0.05或P<0.01),FMA和MBI均较治疗前显著提高(P<0.05),治疗组治疗后神经功能缺损评分、中医证候评分、FMA、MBI和VAS明显优于对照组(P<0.05或P<0.01)。结论益肾解痉汤联合常规康复疗法治疗SHSAS患者能明显提高临床疗效,改善临床症状和日常生活活动能力,安全可靠。

Objective To observe the therapeutic effect of Yishen Jiejing Decoction （decoction to boost the kidney and resolve tetany） combined with routine rehabilitation on shoulder-hand syndrome after stroke （SHSAS）. Methods Sixty cases of SHSAS were randomized into the treatment group and control group, with 30 in each. The control group was given basic treatment, symptomatic treatment and routine rehabilitation training. The treatment group was added with 50ml Yishen Jiejing Decoction twice daily. The treatment lasted for one month. The neurological deficit score, TCM pattern score, upper-limb motor subscale of the Fugl Meyer Assessment （FMA） score, activities of daily living （ADL） evaluated with Modified Barthel Index （MBI） score and visual analog scale （VAS） pain score were observed before and after treatment. The therapeutic effect was evaluated after treatment. Results The total effective rate of the treatment group and control group was 90.00% and 73.33% respectively, with a significant difference between groups （P〈0.05）. The neurological deficit score, TCM pattern score and VAS score were significantly decreased （P〈0. 05 or P〈0.01） but the FMA score and MBI score were significantly increased （P〈0. 05） in both groups after treatment, especially in the treatment group （P〈0.05 or P〈0. 01）. Conclusion The combo therapy of Yishen Jiejing Decoction and routine rehabilitation is effective and safe for SHSAS and it can obviously relieve clinical symptoms and increase the activities of daily living.