中药热奄包联合补阳还五汤加减对中风偏瘫患者生活质量的影响研究

Influence of Chinese medicine hot packages combined with modified Buyang Huanwu decoction on the quality of life of patients with hemiplegia after stroke

目的观察中药热奄包联合补阳还五汤加减对中风偏瘫患者生活质量的影响。方法将2021年1月—2022年12月在安徽中医药大学第二附属医院住院的70例中风偏瘫患者随机分为对照组与研究组,对照组给予常规西医基础治疗+康复训练。研究组在对照组基础上给予中药热奄包联合补阳还五汤加减治疗,2组疗程均为2周。比较2组临床疗效,观察2组干预前后患者中医症状积分、肌力状况、肢体功能、步行情况和日常生活自理能力的变化[Lovett肌力评分、简式Fugl-Meyer量表(FMA)评分、10 m最大步行速度测试(10 MWT)和Barthel指数量表(BI)]。最后统计2组生活质量量表(SF-36)评分的改善情况。结果研究组临床总有效率为91.43%明显高于对照组的68.57%(P<0.05)。与治疗前比较,治疗后2组中医症状积分呈下降趋势(P<0.05),且研究组降低程度高于对照组(P<0.05);治疗后2组Lovett肌力评分、FMA评分、10 MWT和BI评分均有增加趋势(P<0.05),且研究组增加程度高于对照组(P<0.05)。治疗后实验组SF-36量表的各维度评分均高于治疗前(P<0.05),且活力(VT)、躯体疼痛(BP)、总体健康(GH)、生理机能(PF)、社会功能(SF)维度评分高于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论中药热奄包联合补阳还五汤加减治疗中风偏瘫的疗效确切,能改善肌力、肢体功能,步行能力和生活自理能力,从而有利于生活质量的提高。

Objective To observe the influence of Chinese medicine hot packages combined with modified Buyang Huanwu decoction on the quality of life of stroke patients with hemiplegia,Methods A total of 85 patients with hemiplegia after stroke admitted to our hospital from January 2021 to December 2022 were randomly divided into two groups,and the control group(35 cases)was given a conventional western medicine basic treatment plus a rehabilitation training.On the basis of the control group,the study group was treated with traditional Chinese medicine hot packages combined with modified Buyang Huanwu decoction,and the course of treatment was two weeks in both groups.The clinical efficacy was compared between the two groups,and the changes in the TCM symptom scores,muscle strength,limb function,walking and self-care ability in daily life[Lovett muscle strength scores,short Fugl-Meyer assessment scale(FMA)scores,10m maximum walking speed test(10 MWT)and modified Barthel index scale(BI)]were observed in the two groups before and after intervention.Finally,the improvement of quality of life scale(SF-36)scores was statistically analyzed in the two groups.Results The total clinical effective rate of the study group was 91.43%,significantly higher than that of the control group(68.57%)(P<0.05).Compared with before treatment,the TCM symptom scores decreased in the two groups after treatment(P<0.05),and the decrease was more intense in the study group than that in the control group(P<0.05).After treatment,the Lovett muscle strength scores,FMA scores,10 MWT and BI scores increased in the two groups(P<0.05),and the increase was more intense in the study group than that in the control group(P<0.05).After treatment,the scores of all the items in the SF-36 scale were higher in the study group than those before treatment(P<0.05),and the scores of vitality(VT),body pain(BP),general health(GH),physiological function(PF)and social function(SF)were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The efficacy of Chinese medicine hot packages combined with modified Buyang Huanwu decoction can improve muscle strength,limb function,walking ability and self-care ability in the treatment of hemiplegia after stroke,which is conducive to the improvement of quality of life.