推拿联合补阳还五汤加减治疗气虚血瘀型中风后痉挛性偏瘫临床研究

Clinical Study on Tuina Combined with Modified Buyang Huanwu Tang for PostStroke Spastic Hemiplegia of Qi Deficiency with Blood Stasis Type

目的:观察推拿联合补阳还五汤加减治疗气虚血瘀型中风后痉挛性偏瘫的临床疗效。方法:选取80例气虚血瘀型中风后痉挛性偏瘫患者,随机分为对照组和观察组各40例。对照组给予常规基础治疗和康复训练,观察组在对照组基础上给予推拿联合补阳还五汤加减治疗,2组均治疗2周。比较2组治疗前后的中医证候积分、改良Ashworth痉挛量表(MAS)评分、功能综合评定量表(FCA)评分、临床神经功能缺损程度评分(NDS)、四肢简化Fugl-Meyer运动功能(FMA)评分及临床痉挛指数(CSI),评价2组临床疗效。结果:治疗后,2组中医证候积分均较治疗前降低(P<0.01,P<0.05),观察组中医证候积分低于对照组(P<0.05)。治疗后,2组MAS评分均较治疗前改善,观察组MAS评分改善程度优于对照组,差异均有统计学意义(P<0.05)。治疗后,2组FCA、FMA评分均较治疗前升高(P<0.05),观察组FCA、FMA评分均高于对照组(P<0.05);2组NDS、CSI均较治疗前下降(P<0.05),观察组NDS、CSI均低于对照组(P<0.05)。观察组临床疗效优于对照组,差异有统计学意义(Z=-2.327,P=0.020<0.05)。结论:推拿联合补阳还五汤加减治疗气虚血瘀型中风后痉挛性偏瘫,能明显改善患者的痉挛程度、神经功能缺损症状及运动功能,降低中医证候积分,临床疗效优于常规基础治疗和康复训练。

Objective:To observe the clinical effect of tuina combined with modified Buyang Huanwu tang for post-stroke spastic hemiplegia of qi deficiency with blood stasis type.Methods:A total of 80 cases of patients with post-stroke spastic hemiplegia of qi deficiency with blood stasis type were randomly divided into the control group and the observation group,40 cases in each group.The control group was given routine basic treatment and rehabilitation training,and the observation group was additionally treated with tuina combined with modified Buyang Huanwu tang based on the treatment of the control group.Both groups were treated for two weeks.The Chinese medicine syndrome scores,modified Ashworth Spasm Scale(MAS)score,the scores of Functional Comprehensive Assessment(FCA),clinical Neurological Deficit Scores(NDS),the scores of simplified Fugl-Meyer Assessment(FMA)of limbs and Clinical Spasticity Index(CSI)in the two groups were compared.Evaluate the clinical effect of two groups.Results:After treatment,Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.01,P<0.05),and the score in the observation group was lower than that in the control group(P<0.05).After treatment,the MAS scores in the two groups were improved when compared with those before treatment,and the improvement in the observation group was better than that in the control group,differences being significant(P<0.05).After treatment,the scores of FCA and FMA in the two groups were increased when compared with those before treatment(P<0.05),and the scores in the observation group were higher than those in the control group(P<0.05);the NDS and CSI in the two groups were decreased when compared with those before treatment(P<0.05),and the NDS and CSI in the observation group were lower than those in the control group(P<0.05).The clinical effect in the observation group was better than that in the control group,the difference being significant(Z=-2.327,P=0.020<0.05).Conclusion:The therapy of tuina combined with modified Buyang Huanwu tang for post-stroke spastic hemiplegia of qi deficiency with blood stasis type can significantly improve the degree of spasm,neurological impairment and motor function as well as reduce the Chinese medicine syndrome scores,whose clinical effect is better than that of routine basic treatment and rehabilitation training.