艾灸与中药熏洗联合常规医护措施干预高血压性脑出血术后偏瘫临床研究

Clinical Study on Moxibustion and Chinese Medicine Fumigation and Washing Combined with Routine Medical Measures for Hemiplegia After Operation for Hypertensive Intracerebral Hemorrhage

目的:观察在常规医护措施基础上加用艾灸与中药熏洗干预高血压性脑出血(HICH)术后偏瘫患者的临床效果。方法:将90例辨证属气虚血瘀证的HICH术后偏瘫患者按随机数字表法分为对照组和观察组各45例。2组均采用盐酸尼卡地平注射液控制血压、依达拉奉注射液营养神经、注射用七叶皂苷钠改善微循环,并给予心理护理、体位管理和偏瘫肢体锻炼等护理措施。观察组加予艾灸联合中药熏洗进行干预。2组均连续治疗4周。治疗前、治疗4周后评定上肢肌力、手肌力和下肢肌力评分,简化Fugl-Meyer运动功能评分量表评分、Barthel指数评定量表评分及美国国立卫生院神经功能缺损(NIHSS)评分。结果:治疗后,2组上肢肌力、手肌力及下肢肌力评分均较治疗前降低(P<0.01);观察组3项肌力评分均低于对照组(P<0.01)。2组Fugl-Meyer量表上肢评分、下肢评分及总分均较治疗前升高(P<0.01);观察组上肢评分、下肢评分及总分均高于对照组(P<0.01)。2组NIHSS评分均较治疗前下降(P<0.01),日常生活能力评分均较治疗前升高(P<0.01);观察组NIHSS评分低于对照组(P<0.01),日常生活能力评分高于对照组(P<0.01)。结论:在现代医学常规治疗和护理的基础上加用艾灸联合中药熏洗干预HICH术后偏瘫患者,可有效改善肌张力和神经功能,减轻偏瘫程度,提高患者的运动能力和日常生活能力,有较好的疗效。

Objective:To observe the clinical effect of moxibustion and Chinese medicine fumigation and washing based on routine medical measures for hemiplegia after operation for hypertensive intracerebral hemorrhage(HICH).Methods:A total of 90 cases of patients with hemiplegia after operation for HICH with qi deficiency with blood stasis syndrome were divided into the control group and the observation group according to the random number table method,45 cases in each group.Both groups were given hydrochloride nicardipine injection to control blood pressure,edaravone injection to nourish nerves,and injection with sodium glycosides to improve microcirculation as well as given nursing measures including psychological nursing,posture managing and hemiplegia limb exercise.The observation group was additionally intervened with moxibustion combined with Chinese medicine fumigation and washing.Both groups were treated for four weeks.Before treatment and after four-week treatment,the scores of the muscle strength of upper limbs,hands and lower limbs,simplified Fugl-Meyer Motor Function Scale,Barthel Index and National Institutes of Health Stroke Scale(NIHSS)were evaluated.Results:After treatment,the scores of the muscle strength of upper limbs,hands and lower limbs in the two groups were decreased when compared with those before treatment(P<0.01);the above scores in the observation group were lower than those in the control group(P<0.01).The scores of upper and lower limbs in Fugl-Meyer scale and the total scores in the two groups were increased when compared with those before treatment(P<0.01);the above scores in the observation group were higher than those in the control group(P<0.01).NIHSS scores in the two groups were decreased when compared with those before treatment(P<0.01),and the scores of activities of daily living were increased(P<0.01);the NIHSS score in the observation group was lower than that in the control group(P<0.01),and the score of activities of daily living in the observation group was higher(P<0.01).Conclusion:Based on routine treatment and nursing in modern medicine,the intervention of moxibustion combined with Chinese medicine fumigation and washing for patients with hemiplegia after operation for HICH can improve muscle tension and neurological function,reduce the degree of hemiplegia,and enhance the exercise capacity and activities of daily living in patient,which achieves good curative effect.