温阳化痰通络汤联合温针灸对脑卒中后痉挛性偏瘫患者日常生活能力及运动功能的影响

Effect ofWenyang Huatan Tongluo decoction combined with warm needle moxibustion on the activities of daily living and motor function in patients with spastic hemiplegia after stroke

目的探讨温阳化痰通络汤结合温针灸对脑卒中后痉挛性偏瘫患者日常生活能力及运动功能的影响。方法选取2019年12月至2020年12月辽宁中医药大学附属医院康复二科收治的113例脑卒中后痉挛性偏瘫患者作为研究对象,根据就诊单双数分为对照组(n=56)与观察组(n=57)。对照组行西医治疗,观察组在对照组基础上加用温阳化痰通络汤联合温针灸治疗,比较两组治疗前后肢体痉挛程度、肢体运动功能Fugl-Meyer(FMA)评分及改良的Barthel指数(MBI)评分。结果治疗后,观察组Ashworth痉挛分级Ⅰ级比例高于治疗前,且高于对照组,差异有统计学意义(P<0.05),观察组Ⅱ、Ⅲ级比例与治疗前及对照组比较差异无统计学意义;对照组治疗前后Ashworth痉挛分级Ⅰ、Ⅱ、Ⅲ级比例比较差异无统计学意义。治疗后,两组FMA、MBI评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论温阳通络汤联合温针灸治疗脑卒中后痉挛性偏瘫能有效改善患者肌张及运动功能,提高患者日常活动能力。

Objective To investigate the effects of Wenyang Huatan Tongluo decoction combined with warm needle moxibustion on activities of daily living and motor function of patients with spastic hemiplegia after stroke.Methods 113 patients with spastic hemiplegia after stroke admitted to the second department of Rehabilitation of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from December 2019 to December 2020 were selected as the study subjects,and they were divided into the control group(n=56)and the observation group(n=57)according to the odd and even number of visits.The control group was treated with Western Medicine,and the observation group was treated with Wenyang Huatan Tongluo decoction combined with warm needle moxibustion on the basis of the control group,the degree of limb spasm,the limb motor function Fugl-Meyer assessment scale(FMA)score and the modified Barthel index(MBI)score were compared between the two groups before and after treatment.Results After treatment,the proportion of Ashworth spasm gradeⅠin the observation group was higher than that before treatment and higher than that in the control group,and the difference was statistically significant(P<0.05),there was no statistically significant difference in the proportion of Ashworth spasm gradeⅡandⅢin the observation group compared with that before treatment and the control group;there was no significant difference in the proportion of Ashworth gradeⅠ,Ⅱ,andⅢbefore and after treatment in the control group.After treatment,the FMA and MBI scores of the two groups were higher than those before treatment,and the observation group were higher than the control group,and the differences were statistically significant(P<0.05).Conclusion Wenyang Huatan Tongluo decoction combined with warm needle moxibustion in the treatment of spastic hemiplegia after stroke can effectively improve the muscle tension and motor function,and improve the daily activity ability of patients.