益气活血复遂汤联合针刺治疗脑梗死恢复期气虚血瘀证痉挛性瘫痪的临床观察

Clinical Observation of Yiqi Huoxue Fusui Decoction Combined with Acupuncture in the Treatment of Spastic Paralysis with Qi Deficiency and Blood Stasis Syndrome in the Recovery Stage of Cerebral Infarction

【目的】观察益气活血复遂汤联合针刺治疗脑梗死恢复期气虚血瘀证痉挛性瘫痪的临床疗效。【方法】将84例脑梗死恢复期气虚血瘀证痉挛性瘫痪的患者随机分为观察组和对照组,每组各42例,对照组给予“手足十二针”针刺治疗,观察组在对照组治疗的基础上,给予益气活血复遂汤治疗,共治疗4周。治疗4周后,评价2组临床疗效,观察2组患者治疗前后中医证候积分的变化情况,以及改良Ashworth量表(MAS)评分的情况。比较2组患者治疗前后简化Fugl-Meyer运动功能评定量表(FMA)以及改良Barthel指数(MBI)量表评分的变化情况。并评价2组的安全性及不良反应的发生情况。【结果】(1)观察组总有效率为90.48%(38/42),对照组为57.14%(24/42)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者中医证候积分均明显改善(P<0.05),且观察组在改善气虚血瘀中医证候积分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者MAS评分明显改善(P<0.05),且观察组在改善MAS评分方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者FMA评分明显改善(P<0.05),且观察组在改善FMA评分方面明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗后,2组患者日常生活活动能力明显改善(P<0.05);且观察组在改善日常生活活动能力方面优于对照组,差异有统计学意义(P<0.05)。(6)2组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】益气活血复遂汤联合针刺治疗脑梗死恢复期气虚血瘀证痉挛性瘫痪,能有效改善患者肢体痉挛的临床症状,提高日常活动能力,有利于提升患者日常生活活动能力,疗效显著。

Objective To observe the clinical efficacy of Yiqi Huoxue Fusui Decoction combined with acupuncture in the treatment of spastic paralysis with qi deficiency and blood stasis syndrome in the recovery stage of cerebral infarction.Methods Eighty-four patients with spastic paralysis of qi deficiency and blood stasis type during recovery from cerebral infarction were randomly divided into an observation group and a control group,with 42 patients in each group.The control group was treated with“acupuncture of twelve needles on hands and feet”,and the observation group was treated with Yiqi Huoxue Fusui Decoction on the basis of the control group.After 4 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the traditional Chinese medicine(TCM)syndrome score and the modified Ashworth Scale(MAS)score were observed before and after treatment.The changes in the simplified Fugl-Meyer Motor Function Assessment Scale(FMA)and the modified Barthel index(MBI)scale scores were compared before and after treatment in the two groups.The safety of the two groups and the occurrence of adverse effects were also evaluated.Results(1)The total effective rate of the observation group was 90.48%(38/42)and that of the control group was 57.14%(24/42).The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the TCM syndrome scores of patients in both groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the TCM syndrome scores of qi deficiency and blood stasis,and the difference was statistically significant(P<0.05).(3)After treatment,the MAS scores of the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the MAS scores,and the difference was statistically significant(P<0.05).(4)After treatment,the FMA scores of patients in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the FMA scores,and the difference was statistically significant(P<0.05).(5)After treatment,the ability of daily living activities were significantly improved in the two groups(P<0.05);the observation group was superior to the control group in improving the ability of daily living activities,and the difference was statistically significant(P<0.05).(6)There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of Yiqi Huoxue Fusui Decoction and acupuncture exerts significant effect in treating spastic paralysis with qi deficiency and blood stasis syndrome in the recovery stage of cerebral infarction.It can effectively improve the clinical symptoms of limb spasticity and the ability to perform daily activities,which is conducive to enhance the patient’s ability to perform daily living activities.