黄芪桂枝五物汤加味结合神经肌肉电刺激治疗外伤性周围神经损伤气虚血瘀证的疗效观察

Effect of Modified Huangqi Guizhi Wuwu Decoction(黄笑桂枝五物汤)Combined with Neuromuscular Electrical Stimulation on Traumatic Peripheral Nerve Injury of Qi Deficiency and Blood Stasis Syndrome

目的:观察黄芪桂枝五物汤加味结合神经肌肉电刺激(NMES)治疗外伤性周围神经损伤气虚血瘀证的疗效及对神经传导速度的影响。方法:将60例下肢外伤性周围神经损伤气虚血瘀证患者按照随机数字表法随机分为治疗组与对照组,每组30例。对照组患者予基础治疗+NMES,治疗组患者在对照组基础上辅以黄芪桂枝五物汤加味内服,疗程均为4周;治疗前、治疗4周后分别采用Barthel指数(BI)评定患者日常生活活动能力,肌电图检测患者运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)变化,并比较两组临床疗效与安全性。结果:治疗组总有效率为86.67%(26/30),对照组总有效率为63.33%(19/30),治疗组优于对照组(P<0.05);治疗后,两组患者BI积分均较治疗前显著增高(P<0.05),且治疗组患者治疗后BI积分明显高于对照组(P<0.05);治疗后,两组患者MNCV、SNCV均较治疗前明显增快(P<0.05),且治疗组患者显著优于对照组(P<0.05);两组均未见明显不良反应。结论:黄芪桂枝五物汤加味联合NMES能进一步改善外伤性周围神经损伤气虚血瘀证患者日常生活能力,促进神经传导功能恢复。

Objective:To observe the effect of modified Huangqi Guizhi Wuwu Decoction combined with neuromuscular electrical stimulation(NMES)on traumatic peripheral nerve injury of Qi deficiency and blood stasis syndrome and its effect on nerve conduction velocity.Methods:Totally 60 patients with traumatic peripheral nerve injury of Qi deficiency and blood stasis syndrome were divided into treatment and control groups according to the random number table method,30 cases in each group.The patients received basic treatment and NMES in control group,and the patients in treatment group were supplemented with modified Huangqi Guizhi Wuwu Decoction orally on the basis of the control group,and the treatment course was 4 weeks.The Barthel index(BI)was used to assess the activities of daily living of patients,and the electromyogram(EEG)was used to measure the changes of motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV),before and after treatment for 4 weeks.The clinical efficacy and safety were also compared between the two groups.Results:The total effective rate was 86.67%(26/30)in treatment group and 63.33%(19/30)in control group,and the treatment group showed higher total effective rate than control group(P<0.05).After treatment,BI scores increased in the two groups(P<0.05)and the treatment group showed higher in BI scores than control group(P<0.05).After treatment,MNCV and SNCV in the two groups were significantly faster than before treatment(P<0.05),and the treatment group showed faster MNCV and SNCV than control group(P<0.05).There was no obvious adverse reactions in both groups.Conclusion:The combination of modified Huangqi Guizhi Wuwu Decoction and NMES can further improve the daily life ability of patients with traumatic peripheral nerve injury of Qi deficiency and blood stasis syndrome,and promote the recovery of nerve conduction velocity.