柴胡加龙骨牡蛎汤联合功能性电刺激治疗中风后下肢痉挛性偏瘫临床观察

Clinical Observation of Bupleurum Decoction plus Dragon Bone and Oyster Shell Combined with Functional Electrical Stimulation in the Treatment of Post Stroke Spastic Hemiplegia of Lower Extremities

目的:观察柴胡加龙骨牡蛎汤联合功能性电刺激(functional electrical stimulation,FES)治疗中风后患者下肢痉挛性偏瘫的临床疗效。方法:选择2021年4月至2022年4月南京中医药大学沭阳附属医院治疗的中风后痉挛性偏瘫患者108例,随机分为观察组、对照组A、对照组B,每组36例。对照A组给予FES治疗,对照B组给予柴胡加龙骨牡蛎汤加减治疗,观察组给予柴胡加龙骨牡蛎汤联合FES治疗。运用美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)、临床痉挛指数(clinical spasm index,CSI)、简化Fugl-Meyer量表(Fugl-Meyer assessment scale,FMA)、改良Barthel指数(modified barthel index,MBI)对三组患者治疗前后神经功能缺损程度、临床痉挛程度、肢体运动功能及日常生活活动能力进行评价,同时记录不良反应发生情况。结果:三组患者治疗后NIHSS评分、CSI评分低于本组治疗前,且观察组NIHSS评分、CSI评分低于对照组A、对照组B,差异具有统计学意义(P<0.05);三组患者治疗后FMA评分、MBI评分高于本组治疗前,且观察组FMA评分、MBI评分高于对照组A、对照组B,差异具有统计学意义(P<0.05);三组治疗过程中均无不良反应发生。结论:柴胡加龙骨牡蛎汤联合FES治疗中风后下肢痉挛性偏瘫,可改善患者神经功能缺损,缓解下肢痉挛程度,提高肢体活动功能及日常生活能力。

Objective:To observe the clinical efficacy of Bupleurum Decoction plus Dragon Bone and Oyster Shell combined with functional electrical stimulation(FES) on post stroke spastic hemiplegia of lower extremities.Methods:A total of 108 patients with post stroke spastic hemiplegia who were treated in Shuyang Affiliated Hospital of Nanjing University of Chinese Medicine from April 2021 to April 2022 were randomly divided into the observation group,the control group A and the control group B,with 36 cases in each group.The control group A was treated with FES;the control group B was treated with Modified Bupleurum Decoction plus Dragon Bone and Oyster Shell;and the observation group was treated with Bupleurum Decoction plus Dragon Bone and Oyster Shell combined with FES.The national institute of health stroke scale(NIHSS),clinical spasm index(CSI),simplified Fugl Meyer assessment scale(FMA),and modified Barthel index(MBI) were used to evaluate the degree of neurological impairment,clinical spasms,limb motor function,and activities of daily living of the three groups of patients before and after treatment,At the same time,the adverse reactions were recorded.Results:The NIHSS score and CSI score of the three groups after treatment were lower than those of the same group before treatment,and the NIHSS score and CSI score of the observation group were lower than those of control group A and control group B,with statistically significant differences(P<0.05).After treatment,the FMA score and MBI score of the three groups were higher than those of the same group before treatment,and the FMA score and MBI score of the observation group were higher than those of the control group A and control group B,with statistically significant differences(P<0.05).There were no adverse reactions in the three groups.Conclusion:Bupleurum Decoction plus Dragon Bone and Oyster Shell combined with FES can improve the neurological function of patients with post stroke spastic hemiplegia of lower limbs,alleviate the degree of lower limb spasticity,and improve the function of limb activities and the ability of daily life.