益气通脑方对脑卒中后下肢运动功能恢复的影响

Influence of Yiqi Tongnao Decoction on Lower Limb Motor Function's Recovery in Patients with Stroke

目的:探讨益气通脑方对脑卒中后下肢运动功能的促进作用及对血清同型半胱氨酸(HCY),超敏C-反应蛋白(hs-CRP),D-二聚体(D-D)的影响。方法:106例脑卒中恢复期患者采用随机按数字表法分为对照组和观察组各53例。两组均采用常规内科治疗和现代综合康复训练手段,对照组采用醒脑开窍针刺法,观察组在对照组治疗的基础上加用益气通脑方。两组疗程均为8周。进行下肢肌力、下肢运动功能(Fugl-Meyer),步行能力(BBS)量表、日常生活活动(BI指数)及痉挛程度(Ashworth法)评价,检测血清HCY,hs-CRP,D-D水平。结果:观察组在治疗后4,8周下肢肌力和步行能力评分均低于对照组(P<0.01);观察组在治疗后4,8周BI和下肢Fugl-Meyer评分均高于对照组(P<0.01);治疗后观察组下肢痉挛Ashworth评分低于对照组(P<0.01),Ashworth肌力分级改善优于对照组(P<0.05);治疗后观察组BBS评分高于对照组(P<0.01),观察组BBS分级改善优于对照组(P<0.05);治疗后观察组HCY,hs-CRP和D-D水平均低于对照组(P<0.01)。结论:在常规内科、康复治疗及针灸治疗的基础上,益气通脑方能改善脑卒中患者下肢肌张力,减轻肌肉痉挛程度,提高平衡能力,提高下肢的运动能力和生活能力。

Objective： To discuss the promoting effect on lower limb motor function in patients with stroke through Yiqi Tongnao decoction, and to discuss its influence on homocysteine （HCY） , allergic C-reactive protein （hs-CRP） and D-dirner （D-D）. Method： One hundred and six stroke patients during the recovery period were randomly divided into the control group （53 cases） and the observation group （53 cases） by a random number table. Patients in both groups received conventional medical treatment and modern comprehensive rehabilitation training therapy, Patients in the control group added Xingnao Kaiqiao acupuncture therapy. Based on the treatment of the control group, patients in the observation group added Bupi Tongnao decoction. All patients in both groups received 8 weeks of treatment. Lower limb muscle strength, lower extremity motor function Fugl-Meyer （leg） , walking ability, walking ability （BBS scale）, daily life activity （BI index） and convulsion degree （Ashworth method） were evaluated. Serum HCY, hs-CRP, D-D were detected. Result： Scores of lower limb muscle strength and walking ability in the observation group were lower （P 〈0.01 ）, scores of BI index and Fugl-Meyer （leg） were higher in the observation group than those in the control group at the fourth and eighth week after treatment （P 〈 0.01 ）. Besides, Ashworth score in the observation group was superior to that in the control group （P 〈 0.01 ）, while muscle strength grading improvement of Ashworth was better than that in the control group （P 〈 0.05）. After therapy, BBS score of the observation group was higher than that of the control group （P 〈 0.01 ）. Meanwhile, BBS classification improvement was superior to that in the control group （P 〈 0. 05）. Levels of HCY, hs-CRP and D-D in the observation group were lower than those in the control group （P 〈 0. 01 ）. Conclusion ： On the basis of conventional medical treatment, adding Yiqi Tongnao decoction could enhance lower limb muscle strength, reduce the convulsion degree, improve ability of balance, and raise lower extremity motor function and ability of life in stroke patients.