针刺疗法联合化痰通络解痉汤及中药熏蒸对卒中后痉挛性瘫痪康复的效果评估

Effect evaluation of acupuncture combined with Huatan Tongluo Jiejing decoction and Chinese medicine fumigation on rehabilitation of spastic paralysis after stroke

目的 观察针刺疗法联合化痰通络解痉汤及中药熏蒸治疗卒中后痉挛性瘫痪的临床疗效。方法 将118例卒中后痉挛性瘫痪患者按随机数字表法分为2组。2组均给予卒中后常规康复训练,对照组59例加用化痰通络解痉汤及中药熏蒸治疗;治疗组59例在对照组基础上联合针刺疗法治疗。2组均治疗1个月后统计疗效,比较2组治疗前后中医症状(包括半身不遂、言语謇涩、神识昏蒙及口舌?斜)评分、改良Ashworth量表(MAS)评分、Fugl-Meyer运动功能量表(FMA)评分、Barthel指数(BI)评分及患者报告的临床结局(PRO)评分变化情况,并对患者治疗期间的满意度进行调查比较。结果 治疗组总有效率98.31%,总满意率98.31%,对照组总有效率88.14%,总满意率86.44%,治疗组总有效率及总满意率均高于对照组(P<0.05)。2组治疗后半身不遂、言语謇涩、神识昏蒙及口舌?斜评分与本组治疗前比较均降低(P<0.05),且治疗组治疗后各中医症状评分均低于对照组(P<0.05)。2组治疗后与本组治疗前比较,MAS评分及PRO评分均降低(P<0.05),FMA评分及BI评分均升高(P<0.05),且治疗组治疗后各项评分改善均优于对照组(P<0.05)。结论 针刺疗法联合化痰通络解痉汤及中药熏蒸治疗卒中后痉挛性瘫痪临床疗效确切,可明显改善患者中医症状,缓解肌张力,促进机体功能恢复,提高生活能力,改善生活质量,提高临床疗效,且患者满意率高。

Objective To observe the clinical efficacy of acupuncture combined with Huatan Tongluo Jiejing decoction and Chinese medicine fumigation on rehabilitation of spastic paralysis after stroke. Methods 118 patients with spastic paralysis after stroke were randomly divided into two groups according to random number table method. Both groups were given routine rehabilitation training after stroke. 59 cases in control group were treated by Huatan Tongluo Jiejing decoction and Chinese medicine fumigation. 59 cases in treatment group were treated by acupuncture on the basis of the control group. Both groups were treated for 1 month, and the clinical efficacy was counted. The changes of TCM symptoms (including hemiplegia, speech astringency, dizziness and mouth-tongue askew), modified Ashworth scale (MAS), Fugl-Meyer motor function scale (FMA), Barthel index (BI) and clinical outcome (PRO) score were compared between the two groups before and after treatment. The satisfaction during treatment was investigated and compared. Results The total effective rate was 98.31% in treatment group and 88.14% in control group. The total satisfaction rate was 98.31% in treatment group and 86.44% in control group. The total effective rate and total satisfaction rate of the treatment group was higher than that of the control group ( P <0.05). After treatment, the scores of hemiplegia, speech astringency, dizziness and mouth-tongue askew in the two groups were lower than those in the group before treatment ( P <0.05), and the scores of TCM symptoms in the treatment group were lower than those in the control group ( P <0.05). After treatment, the MAS score and PRO score of the two groups were decreased ( P <0.05), FMA score and BI score were increased ( P <0.05), and the improvement of each score in the treatment group was better than that in the control group ( P <0.05). Conclusion Acupuncture combined with Huatan Tongluo Jiejing decoction and Chinese medicine fumigation has definite clinical efficacy in treating post-stroke spastic paralysis. It can significantly improve the symptoms of patients with traditional Chinese medicine, relieve muscle tension, promote the recovery of body function, improve living ability, improve the quality of life, improve clinical efficacy, and the satisfaction rate of patients is high.