左(右)归丸联合接骨续筋汤治疗脑卒中后偏瘫合骨质疏松临床研究

Clinical Study of Zuogui Pills/Yougui Pills Combined with Jiegu Xujin Decoction in the Treatment of Post-Stroke Hemiplegia and Osteoporosis

目的探讨左(右)归丸联合接骨续筋汤治疗脑卒中后偏瘫合骨质疏松的临床疗效,以及对患者运动功能、肢体功能和骨密度的影响。方法选取江苏省灌云县中医院2021年1月至2023年3月收治的脑卒中后偏瘫合骨质疏松患者120例,按随机数字表法分为对照组和观察组,各60例。两组患者均予常规康复训练,观察组患者加用左(右)归丸联合接骨续筋汤治疗,两组患者均连续治疗28 d。结果观察组总有效率为85.00%,显著高于对照组的66.67%(P<0.05)。治疗后,观察组患者骨密度显著高于对照组(P<0.05);骨代谢指标血清骨钙素水平显著高于对照组,β-交联胶原骨钙素、Ⅰ型前胶原氨基端肽水平均显著低于对照组(P<0.05);患侧Brunnstrom分期的高分期(Ⅴ-Ⅵ期)患者显著多于对照组(P<0.05);模拟视觉评分法(VAS)评分显著低于对照组(P<0.05),Fugl-Meyer评分量表(FMA)评分、Berg平衡量表(BBS)评分均显著高于对照组(P<0.05)。观察组和对照组不良反应发生率相当(6.67%比5.00%,P>0.05)。结论左(右)归丸联合接骨续筋汤治疗脑卒中后偏瘫合骨质疏松的临床疗效良好,可有效改善患者的运动功能和肢体功能,增强骨密度,且安全性良好。

Objective To investigate the clinical efficacy of Zuogui Pills/Yougui Pills combined with Jiegu Xujin Decoction in the treatment of patients with post-stroke hemiplegia and osteoporosis,and the effect on motor function,limb function and bone mineral density(BMD)in patients.Methods A total of 120 patients with post-stroke hemiplegia and osteoporosis admitted to the Guanyun Hospital of Traditional Chinese Medicine from January 2021 to March 2023 were selected and divided into the control group and the observation group by the random number table method,with 60 cases in each group.The patients in the two groups received routine rehabilitation training,on this basis,the patients in the observation group were treated with Zuogui Pills/Yougui Pills combined with Jiegu Xujin Decoction.Both groups were treated continuously for 28 d.Results The total effective rate in the observation group was 85.00%,which was significantly higher than 66.67%in the control group(P<0.05).After treatment,the BMD in the observation group was significantly higher than that in the control group(P<0.05).The bone metabolism indicator such as serum osteocalcin level in the observation group was significantly lower than that in the control group,while the levels ofβ-cross-linked collagen osteocalcin(β-CTX)and typeⅠprocollagen amino terminal peptide(PⅠNP)in the observation group were significantly lower than those in the control group(P<0.05).The patients with high stage(stageⅤ-Ⅵ)of Brunnstrom staging on the affected side in the observation group were significantly more than those in the control group(P<0.05).The Visual Analog Scale(VAS)score in the observation group was significantly lower than that in the control group(P<0.05),while the Fugl-Meyer Assessment(FMA)and Berg Balance Scale(BBS)scores in the observation group were significantly higher than those in the control group(P<0.05).The incidence of adverse reactions between the observation group and the control group was comparable(6.67%vs.5.00%,P>0.05).Conclusion Zuogui Pills/Yougui Pills combined with Jiegu Xujin Decoction has good clinical efficacy and safety in the treatment of patients with post-stroke hemiplegia and osteoporosis,which can effectively improve motor function and limb function,and enhance BMD.