五味甘露药浴颗粒对脑卒中偏瘫患者功能康复的临床研究

Clinical Study of Wuwei Ganlu Yaoyu Granules on Function Recovery of Cerebral Infarction Patients with Hemiplegia

目的评价五味甘露药浴颗粒对脑卒中偏瘫功能康复及炎症介质与血液流变学指标的影响。方法选取2020年2月~2021年2月某院诊治符合研究标准的110例脑卒中偏瘫患者,采用随机数字表法分为对照组(53例)和观察组(57例),对照组采用该院脑血管病常规治疗结合早期康复训练,观察组在对照组基础上结合五味甘露药浴颗粒治疗,疗程均为12周;采用国立卫生研究院卒中量表(NIHSS)评分、Fugl-Meyer运动功能评分表(Fugl-Meyer Assessment Scale,FMA)、修订的Barthel指数法、中医症状积分、焦虑自评量表(SAS)评分以及抑郁自评量表(SDS)于治疗前后各评价一次;检测治疗前后缓释肽(BK)、降钙素基因相关肽(CGRP)、P物质(SP)及血液流变学指标。结果两组患者治疗后NIHSS评分、中医症状积分、SAS评分及SDS评分均降低,且观察组低于对照组;FMA评分和Barthel指数均升高,且观察组高于对照组(P<0.05)。观察组患者BK与SP水平均低于对照组,CGRP水平高于对照组(P<0.05)。观察组患者全血黏度、纤维蛋白原及血小板积聚率均低于对照组(P<0.05)。观察组临床总有效率(87.72%)高于对照组总有效率(77.36%,P<0.05)。结论在西医常规治疗基础上结合五味甘露药浴颗粒治疗可以更好改善脑卒中偏瘫患者神经功能、运动功能及日常生活能力,提高患者生活能力。其作用机制可能与抑制患者神经源性炎症反应,改善血液流变学有关。

OBJECTIVE To evaluate the clinical efficacy of Wuwei Ganlu Yaoyu granules(WGYG)on function recovery of cerebral infarction patients with hemiplegia,and the effect on inflammatory factors and hemorheology.METHODS A total of 110 cerebral infarction patients with hemiplegia during February 2020 and February 2021 were randomly divided into two groups according to random number table:control group(53),observation group(57).Patients in control group were treated with routine therapy of cerebral infarction and early rehabilitation exercise.Patients in observation group were treated with WGYG on the basis of the control group.The course of treatment was 12 weeks.Before and after treatment,scores of national institutes of health stroke scale(NIHSS),scores of fugl-meyer assessment scale(FMA),barthel index(Barthel),TCM symptom scores,anxiety self-rating scale(SAS)and depression self-rating scale(SDS)scores were graded.And levels of bradykinin(BK),calcitonin gene related peptide(CGRP),substance P(SP)and hemorheology were detected with ELISA.RESULTS Scores of NIHSS,TCM symptom,SAS and SDS after treatment were lower than those before treatment in two groups,and the scores in observation group were lower than those in control group(P<0.05).Score of FMA and Barthel after treatment were all higher than those before treatment in two groups,and the scores in observation group were higher than those in control group(P<0.05).And levels of BK and SP were all lower than those in control group(P<0.05),and level of CGRP was higher than those in control group(P<0.05).And total clinical effective rate in observation group(87.72%)was higher than in control group(77.36%,P<0.05).CONCLUSION On the basis of conventional western medicine treatment,WGYG can improve neurological function,motor function and limbs function recovery of cerebral infarction patients with hemiplegia,to improve patients’quality of life.The possible mechanisms may be related to inhibit the neurogenic inflammatory reactions and regulate the hemorheology.