中医综合疗法治疗缺血性脑卒中后肢体功能障碍临床研究

Clinical study of comprehensive Traditional Chinese Medicine treatment for limb dysfunction after ischemic stroke

目的评价中医综合疗法治疗缺血性脑卒中后肢体功能障碍的临床疗效。方法将符合入选标准的2017年6月-2019年1月多中心联盟医院收治的160例缺血性脑卒中后肢体功能障碍患者采用随机数字表法分为2组,每组80例。对照组采用西医基础治疗与康复训练,观察组在对照组基础上联合中医综合疗法(中药内服+中药熏洗+耳穴贴压)治疗。2组均治疗4周,随访2个月。分别于治疗前后进行中医症状评分,采用Fugl-Meyer量表评估肢体功能障碍程度,采用美国国立卫生研究院卒中量表(national institudes of health stroke scale,NIHSS)评估神经功能受损程度,采用Barthel指数评估日常生活活动能力,依据Brunnstrom运动功能评定法进行临床疗效评价。结果治疗后,观察组肢体强痉拘急[(1.57±0.36)分比(1.98±0.53)分,t=5.724]、偏身麻木[(1.37±0.31)分比(1.80±0.36)分,t=8.096]、屈伸不利[(1.31±0.25)分比(1.84±0.46)分,t=9.055]评分均低于对照组(P<0.01);Fugl-Meyer活动和平衡评分均高于对照组(t值分别为2.739、4.705,P<0.05或P<0.01),NIHSS评分低于对照组(t=9.645,P<0.01),Barthel指数高于对照组(t=7.870,P<0.01)。观察组总有效率为97.5%(78/80)、对照组为88.8%(71/80),2组比较差异有统计学意义(χ^(2)=4.783,P=0.028)。结论中医综合疗法可有效改善缺血性脑卒中患者中医症状及肢体功能,促进神经功能恢复,提高日常生活能力及临床疗效。

Objective To evaluate the clinical effect of Limb dysfunction after the comprehensive treatment of ischemic stroke by Traditional Chinese Medicine(TCM).Methods A total of 160 patients with limb dysfunction after ischemic stroke.Who in line with the inclusion criteria,were randomly divided into 2 groups by random number table,80 cases each.These patients were treated in Multicenter Union Hospital from June 2017 to Janunry 2019.The patients in the control group were given basic Western medicine treatment and rehabilitation training,while the patients in the observation group were given a comprehensive treatment combined with traditional Chinese medicine based on the control group(Chinese herbs,herbal fumigation and ear point press).Both groups were treated for 4 weeks and follow-up for 2 months.The Fugl-Meyerscale were used to evaluate the degree of limb dysfunction and balance dysfunction,the National Institutes of Health Stroke Scale were used for assessing the damage extent of nerve function,the Barthel index for evaluating the mobility of daily life.The clinical efficacy was evaluated according to the method of Brunnstrom assessment.Results After treatment,the Limb strong spasm(1.57±0.36 vs.1.98±0.53,t=5.724),Hemianesthesia(1.37±0.31 vs.1.80±0.36,t=8.096),Inhibited bending and stretching(1.31±0.25 vs.1.84±0.46,t=9.055)in the observation group were significantly lower than those in the control group(P<0.01).The Fugl-Meyer activity and balance rating in the observation group were significantly higher than those in the control group(t values were 2.739,4.705,respectively,P<0.05 or P<0.01).The total effective rate of observation group was 93.3%(78/80),the control group was 73.3%(71/80),and there exist statistical significance(χ^(2)=4.783,P=0.028)in the two group’s comparative difference.Conclusion The comprehensive TCM treatment can improve the hemiplegia syndrome of ischemic stroke patients and their limb activity and balance function,promote their neural functional recovery,enhance the activity of their daily life and clinical efficacy.