拘挛方热敷联合康复训练治疗脑卒中上肢痉挛疗效观察

Effect of Juluan Formula Hot Compress Combined with Rehabilitation Training on Upper Limb Spasm in Stroke

目的:探讨拘挛方热敷联合康复训练治疗同水平上肢痉挛脑卒中的临床疗效。方法:将100例同水平上肢痉挛脑卒中患者以随机数字表法分为对照组和研究组各50例,对照组给予常规康复训练,研究组在此基础上加用拘挛方热敷,4周为1个疗程,共治疗2个疗程,比较两组治疗效果,采用改良Ashworth量表(MAS)评定治疗前、疗程结束后两组上肢肌张力分级、痉挛程度的变化;以简化Fugl-Meyer运动功能评分表(FMA)、改良Barthel指数评定量表(MBI)及脑卒中专用生活质量量表(SS-QOL)评定治疗前、治疗3个月两组运动能力、日常生活能力及生活质量的变化。结果:研究组治疗疗效分级、肌张力分级及痉挛程度分级均优于对照组,差异具有统计学意义(P<0.05);治疗3个月后,研究组FMA评分、MBI评分、SS-QOL评分均高于对照组,差异具有统计学意义(P<0.05)。结论:拘挛方热敷联合康复训练治疗同水平上肢痉挛脑卒中疗效优于单独康复训练治疗,可改善患者肌张力及肌痉挛程度,提升运动能力、日常生活能力,改善生活质量。

Objective:To investigate the effect of Juluan Formula(拘挛方)hot compress combined with rehabilitation training on upper limb spasm at the same level in stroke.Methods:One hundred of patients with upper limb spasm at the same level in stroke were numbered according to the sequence of admission,and were divided into control group and experimental group by a random number table,50 patients in each group.The control group was given conventional rehabilitation training,and the experimental group was given Juluan Formula hot compresses besides the treatment in the control group.Four weeks were a treatment course,and the treatment lasted for 2 treatment courses.The treatment effects of the two groups were compared.The modified Ashworth scale(MAS)was applied to evaluate the changes of the upper limb muscle tone classification and the spasm degree before and after the treatment.Before and 3 months after the treatment,simplified Fugl-Meyer motor function rating scale(FMA),and modified Barthel index rating scale(MBI)and the stroke-specific quality of life scale(SS-QOL)were used to evaluate the changes in exercise capacity,activity of daily living and quality of life in the two groups.Results:The treatment effect classification,muscle tone classification and spasm degree classification in the experiment group were better than those in the control group,with statistical difference(P<0.05);after 3 months of treatment,FMA score,MBI score,and SS-QOL score in the experimental group were all higher than those in the control group,with statistical difference(P<0.05).Conclusion:The curative effect of Juluan Formula hot compress combined with rehabilitation training is better than that of rehabilitation training alone in the treatment of upper limb spasm at the same level in stroke.It can improve the muscle tone and the degree of muscle spasm,improve exercise capability,activity of daily living,and the life quality in patients.