乙哌立松联合肩宁汤治疗脑卒中后肩手综合征Ⅰ期患者临床疗效观察

Clinical efficacy of eperisone combined with Jianning decoction on stage-I shoulder-hand syndrome after stroke:an observation study

目的观察乙哌立松联合肩宁汤(自拟方)治疗脑卒中后肩手综合征(SHS)Ⅰ期患者的疗效。方法选取2018年1月至2020年7月在我院住院治疗的脑卒中后SHSⅠ期患者100例,随机分为对照组和研究组,每组50例。对照组患者给予乙哌立松治疗,研究组患者给予乙哌立松联合肩宁汤治疗,14 d为1疗程,共治疗2个疗程。比较两组患者的疗效;比较两组患者治疗前及治疗2个疗程后患侧的手部水肿积分、视觉模拟量表(VAS)评分、Barthel指数量表(BI)评分以及Fugl-Meyer量表(FMA)评分;比较两组患者治疗期间的不良反应发生情况。结果治疗2个疗程后,研究组患者的治疗总有效率(94.0%)显著高于对照组(80.0%),临床疗效明显优于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者患侧的手部水肿积分、VAS评分、BI评分、FMA评分比较差异无统计学意义(P>0.05)。治疗2个疗程后,两组患者患侧的手部水肿积分、VAS评分均显著降低,研究组患者的评分低于对照组;两组患者的BI、FMA评分均显著升高,研究组患者的评分显著高于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者的不良反应发生率比较差异无统计学意义(P>0.05)。结论乙哌立松联合肩宁汤治疗脑卒中后肩手综合征Ⅰ期患者临床效果显著,可有效减轻水肿及疼痛的严重程度,显著改善上肢运动功能,明显提高日常生活能力。

Objective To observe the curative effect of eperisone combined with Jianning decoction(the self-design prescription)in the treatment of stage-Ⅰ shoulder-hand syndrome(SHS)after stroke.Methods A total of 100 patients with stage-Ⅰ SHS after stroke who were hospitalized in our hospital from January 2018 to July 2020 were enrolled.They were randomly divided into control group and study group,with 50 cases in each group.The control group was treated with eperisone,while the study group was treated with eperisone combined with Jianning decoction,for 14 days as a course of treatment and 2 treatment courses in total.The curative effect was compared between the two groups.The scores of hand edema,Visual Analogue Scale(VAS),Barthel Index(BI),and Fugl-Meyer Assessment(FMA)of the affected side before and 2 treatment courses after treatment were compared between the two groups.The incidence of adverse reactions during treatment was compared between the two groups.Results After 2 courses of treatment,the study group yielded a significantly higher total effective rate(94.0%vs.80.0%),and a significantly superior clinical efficacy as compared with the control group,with statistically significant differences(P<0.05).Before treatment,there were no statistically significant differences in scores of hand edema,VAS,BI,and FMA of the affected side between the two groups(P>0.05).After 2 courses of treatment,the scores of hand edema and VAS of the affected side decreased significantly,and the scores of BI and FMA increased in both groups;to compare with the control group,the study group yielded lower scores of hand edema and VAS,whereas higher scores of BI and FMA,with statistically significant differences(P<0.05).During the treatment,there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Eperisone combined with Jianning decoction has a significantly clinical effect in the treatment of patients with stage-Ⅰ shoulder-hand syndrome after stroke,which can effectively alleviate the severity of edema and pain,significantly improve upper limb motor function,and significantly improve the ability of daily living.