中药熏洗配合肌电生物反馈治疗脑出血后痉挛性偏瘫临床研究

Clinical Study on Chinese Medicine Fumigation and Washing Combined with Electromyography Biofeedback for Spastic Hemiplegia After Cerebral Hemorrhage

目的:观察中药熏洗配合肌电生物反馈治疗脑出血后痉挛性偏瘫的临床疗效。方法:选取76例脑出血后痉挛性偏瘫患者为研究对象,以随机数字表法分为观察组和对照组各38例。所有患者住院期间均采取常规对症治疗,对照组给予肌电生物反馈治疗,观察组以中药熏洗配合肌电生物反馈治疗。治疗4周后比较2组临床疗效,比较2组治疗前后Brunnstrom分级、痉挛程度、中医证候积分、日常生活活动能力(BI)评分、美国国立卫生研究院卒中量表(NIHSS)评分及表面肌电图。结果:观察组治疗总有效率89.47%,高于对照组68.42%(P<0.05)。治疗后,2组Brunnstrom分级均改善(P<0.05),且观察组改善效果优于对照组(P<0.05)。治疗后,2组痉挛症状程度均减轻(P<0.05),且观察组轻于对照组(P<0.05)。治疗后,2组中医证候积分、NIHSS评分均降低(P<0.05),且观察组低于对照组(P<0.05),2组BI评分均升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,2组股直肌、股二头肌表面肌电均方根值(RMS)均降低(P<0.05),且观察组低于对照组(P<0.05),2组股直肌、股二头肌肌肉最大收缩力(MVC)、肌电积分值(iEMG)均升高(P<0.05),且观察组高于对照组(P<0.05)。结论:针对脑出血后痉挛性偏瘫患者采取中药熏洗配合肌电生物反馈治疗效果显著,可减轻患者神经功能缺损程度、肢体偏瘫和痉挛程度,缓解症状及体征,改善表面肌电图,提高患者日常生活活动能力。

Objective:To observe the clinical effect of Chinese medicine fumigation and washing combined with electromyography biofeedback for spastic hemiplegia after cerebral hemorrhage.Methods:A total of 76 cases of patients with spastic hemiplegia after cerebral hemorrhage were selected as the research objects and were divided into the observation group and the control group according to the random number table method,with 38 cases in each group.All patients received routine symptomatic treatment during hospitalization;the control group was treated with electromyography biofeedback,and the observation group was treated with Chinese medicine fumigation and washing combined with electromyography biofeedback.After 4 weeks of treatment,the clinical effects were compared between the two groups.Before and after treatment,the Brunnstrom grading,degree of spasm,traditional Chinese medicine(TCM) syndrome scores,Barthel Index(BI) scores,National Institutes of Health Stroke Scale(NIHSS) scores and surface electromyography were compared between the two groups.Results:The total effective rate was 89.47% in the observation group,higher than that of 68.42% in the control group(P<0.05).After treatment,Brunnstrom grading in the two groups was improved(P<0.05),and the improvement effect in the observation group was better than that in the control group(P<0.05).After treatment,the degree of spasm in the two groups was reduced(P<0.05),and the degree of spasm in the observation group was less severe than that in the control group(P<0.05).After treatment,TCM syndrome scores and NIHSS scores in the two groups were decreased(P<0.05),and the above two scores in the observation group were lower than those in the control group(P<0.05);BI scores in the two groups were increased when compared with those before treatment(P<0.05),and the above score in the observation group was higher than that in the control group(P<0.05).After treatment,the root mean square(RMS) of rectus femoris and biceps femoris in the two groups was decreased(P<0.05),and the RMS in the observation group was lower than that in the control group(P<0.05);the muscle maximal voluntary contraction(MVC) and integrated electromyography(iEMG) of rectus femoris and biceps femoris in the two groups were increased(P<0.05),and the MVC and iEMG in the observation group were higher than those in the control group(P<0.05).Conclusion:Chinese medicine fumigation and washing combined with electromyography biofeedback for patients with spastic hemiplegia after cerebral hemorrhage has a significant curative effect,which can reduce the degree of neurological impairment,limb hemiplegia and spasm,relieve symptoms and signs,improve surface electromyography,and enhance the activities of daily living.