中医推拿联合化痰通络解痉汤治疗脑卒中后痉挛性瘫痪的临床研究

Clinical study of traditional Chinese medicine massage combined with Huatan Tongluo Jiejing Decoction in the treatment of spastic paralysis after stroke

目的探讨中医推拿联合化痰通络解痉汤治疗脑卒中后痉挛性瘫痪的临床效果。方法选取2018年9月—2019年6月四川省简阳市人民医院收治的脑卒中后痉挛性瘫痪患者106例,按照随机数字表法将其分为对照组(n=53)和观察组(n=53)。两组均给予常规治疗,对照组使用康复及中医推拿治疗,观察组使用康复、中医推拿以及化痰通络解痉汤治疗。比较两组的临床疗效、血清谷氨酸(Glu)、γ-氨基丁酸(GABA)、改良Ashworth量表(MAS)、Fugl-Meyer运动功能量表(FMA)、Barthel指数(BI)评分及患者满意度。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05)。两组治疗后Glu水平较治疗前降低,GABA水平较治疗前升高,且观察组Glu水平低于对照组,GABA水平高于对照组(P<0.05)。两组治疗后MAS、FMA及BI评分均较治疗前升高,且观察组高于对照组(P<0.05)。观察组总满意度高于对照组,差异有统计学意义(P<0.05)。两组治疗期间均无不良反应发生。结论中医推拿联合化痰通络解痉汤治疗脑卒中后痉挛性瘫痪患者效果显著,可有效改善患者血清氨基酸类神经递质水平。

Objective To explore clinical effect of traditional Chinese medicine massage combined with Huatan Tongluo Jiejing Decoction in the treatment of spastic paralysis after stroke.Methods One hundred and six patients with spastic paralysis after stroke treated in People′s Hospital of Jianyang City from September 2018 to June 2019 were divided into control group(n=53)and observation group(n=53)by random number table method.Two groups were given routine treatment.Control group was treated with rehabilitation and massage therapy of traditional Chinese medicine.Observation group was treated with rehabilitation and massage therapy of traditional Chinese medicine and Huatan Tongluo Jiejing Decoction.Clinical efficacy,serum glutamate(Glu),gamma aminobutyric acid(GABA),modified Ashworth scale(MAS),fugl meyer motor function scale(FMA),Barthel index(BI)and patient satisfaction were compared between two groups.Results Total effective rate in observation group was higher than that in control group,the difference was statistically significant(P<0.05).After treatment,Glu level in two groups was lower than that before treatment,and GABA level in two groups was higher than that before treatment,Glu level in observation group was lower than that in control group,and GABA level in observation group was higher than that in control group(P<0.05).After treatment,the scores of MAS,FMA and BI in two groups were higher than those before treatment,and the scores in observation group were higher than those in control group(P<0.05).Total satisfaction of observation group was higher than that of control group(P<0.05).No adverse reactions occurred in two groups during the treatment.Conclusion Traditional Chinese medicine massage combined with Huatan Tongluo Jiejing Decoction has a significant effect in the treatment of spastic paralysis after stroke,which can effectively improve the level of serum amino acid neurotransmitters.