补阳还五汤超声导入治疗缺血性脑卒中后上肢运动功能障碍临床研究

Clinical Study on Ultrasound Introduction of Buyang Huanwu Decoction for Upper Limb Motor Dysfunction After Ischemic Stroke

目的:观察补阳还五汤超声导入治疗缺血性脑卒中后上肢运动功能障碍气虚血瘀证的临床疗效。方法:选取60例缺血性脑卒中后上肢运动功能障碍气虚血瘀证患者,采用随机数字表法分为对照组与治疗组,每组30例。对照组给予内科与常规康复治疗,治疗组在对照组基础上给予补阳还五汤超声导入治疗。2组均治疗8周。比较2组痉挛程度、上肢运动功能、生活质量及表面肌电信号指标。结果:治疗4周、8周后,2组改良Ashworth量表分级均较治疗前改善,差异均有统计学意义(P<0.05);治疗组改良Ashworth量表分级改善情况均优于同期对照组,差异均有统计学意义(P<0.05)。组别和时间的交互作用对简式Fugl-Meyer运动功能评定量表(FMA)、改良Barthel指数评定量表(MBI)评分的影响均有统计学意义(P<0.05)。组别因素对FMA、MBI评分的单独效应均有统计学意义(P<0.05)。时间因素对2组FMA、MBI评分的单独效应均有统计学意义(P<0.05)。治疗4周后,2组FMA、MBI评分均较治疗前升高,差异均有统计学意义(P<0.05)。治疗8周后,2组FMA、MBI评分均较治疗4周后升高,差异均有统计学意义(P<0.05)。治疗4周、8周后,治疗组FMA、MBI评分均高于同期对照组,差异均有统计学意义(P<0.05)。治疗8周后,2组肱二头肌、肱三头肌肌肉活动时的肌电均方根(RMS)及积分肌电值(iEMG)均较治疗前降低,治疗组上述4项上肢肌电信号指标值均低于对照组,差异均有统计学意义(P<0.05)。结论:补阳还五汤超声导入治疗缺血性脑卒中后上肢运动功能障碍气虚血瘀证疗效满意,能有效降低上肢肌张力,缓解肌痉挛症状,改善患者的日常生活能力和运动功能。

Objective:To observe the clinical effect of ultrasound introduction of Buyang Huanwu Decoction on upper limb motor dysfunction after ischemic stroke with qi deficiency and blood stasis syndrome.Methods:A total of 60 cases of patients with upper limb motor dysfunction after ischemic stroke with qi deficiency and blood stasis syndrome were selected and divided into the control group and the treatment group according to the random number table method,with 30 cases in each group.The control group was given medical therapy and routine rehabilitation treatment,and the treatment group was additionally treated with ultrasound introduction of Buyang Huanwu Decoction based on the treatment of the control group.Both groups were treated for eight weeks.The levels of spasm,upper limb motor function,quality of life and surface electromyography signal indexes were compared between the two groups.Results:After four and eight weeks of treatment,the grading in Modified Ashworth Scale in the two groups were improved when compared with those before treatment,differences being significant(P<0.05).The improvement of Modified Ashworth Scale in the treatment group was better than that in the control group at the same period,difference being significant(P<0.05).The interaction of group and time had statistically significant effects on the scores of Fugl-Meyer Assessment(FMA)and Modified Barthel Index(MBI)(P<0.05).The single effects of group factors on the scores of FMA and MBI were statistically significant(P<0.05).The time factors had statistical significance on the scores of FMA and MBI in the two groups(P<0.05).After four weeks of treatment,the scores of FMA and MBI in the two groups were increased when compared with those before treatment,differences being significant(P<0.05).After eight weeks of treatment,the scores of FMA and MBI in the two groups were increased when compared with those after four weeks of treatment,differences being significant(P<0.05).After four and eight weeks of treatment,the scores of FMA and MBI in the treatment group were higher than those in the control group at the same time period,differences being significant(P<0.05).After eight weeks of treatment,the Root Mean Square(RMS)and integrated Electrpmyogran(iEMG)of biceps and triceps in the two groups were decreased when compared with those before treatment,and the above four surface electromyography signal indexes of upper limbs in the treatment group were lower than those in the control group,differences being significant(P<0.05).Conclusion:Ultrasound introduction of Buyang Huanwu Decoction has a satisfactory curative effect on upper limb motor dysfunction after ischemic stroke with qi deficiency and blood stasis syndrome,which can effectively reduce upper limb muscle tension,relieve muscle spasm symptoms,and improve activities of daily living and motor function of patients.