温阳通络汤联合ZEPUmed智能运动训练系统治疗中风后痉挛性偏瘫临床研究

Clinical Study on Wenyang Tongluo Decoction Combined with ZEPUmed Intelligent Exercise Training System for Spastic Hemiplegia After Stroke

目的:观察温阳通络汤联合ZEPUmed智能运动训练系统治疗中风后痉挛性偏瘫(SHAS)的临床疗效。方法:选择86例SHAS患者按随机数字表法分为2组,对照组给予康复医学科常规治疗、基础康复训练、ZEPUmed智能运动训练系统治疗,研究组在对照组基础上加用温阳通络汤治疗。比较2组临床疗效、中医证候评分、改良Ashworth分级、Fugl-Meyer运动功能(FMA)、下肢各关节活动度、血清神经递质[谷氨酸(Glu)、γ-氨基丁酸(GABA)]水平。结果:研究组总有效率90.70%,对照组为72.09%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候评分均低于治疗前(P<0.05),且研究组中医证候评分低于对照组(P<0.05);2组改良Ashworth分级改善优于治疗前(P<0.05),且研究组改良Ashworth分级改善优于对照组(P<0.05);2组下肢FMA评分、髋关节屈曲度、膝关节屈曲度、踝关节背屈度均较治疗前增高(P<0.05),且研究组上述各项指标均高于对照组(P<0.05)。治疗后,2组GABA水平均高于治疗前(P<0.05),Glu水平均低于治疗前(P<0.05);且研究组GABA水平高于对照组(P<0.05),Glu水平低于对照组(P<0.05)。结论:应用温阳通络汤联合ZEPUmed智能运动训练系统治疗SHAS,对改善患者下肢运动功能及关节活动度均有积极意义,且能降低患肢肌张力,改善神经递质水平。

Objective:To observe the clinical effect of Wenyang Tongluo Decoction combined with ZEPUmed intelligent exercise training system for spastic hemiplegia after stroke(SHAS).Methods:A total of 86 cases of patients with SHAS were selected and divided into two groups according to the random number table method.The control group was given routine treatment,basic rehabilitation training and ZEPUmed intelligent exercise training system in rehabilitation medicine department,and the study group was additionally treated with Wenyang Tongluo Decoction based on the treatment of the control group.Clinical effects,traditional Chinese medicine(TCM)syndrome scores,modified Ashworth grading,Fugl-Meyer motor function(FMA),lower limb joint motion angle,and levels of serum neurotransmitters[glutamic acid(Glu)andγ-aminobutyric acid(GABA)]were compared between the two groups.Results:The total effective rate was 90.70%in the study group and 72.09%in the control group,the difference being significant(P<0.05).After treatment,TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the TCM syndrome scores in the study group were lower than those in the control group(P<0.05).The improvement of modified Ashworth grading in the two groups was better than that before treatment(P<0.05),and the improvement of modified Ashworth grading in the study group was better than that in the control group(P<0.05).FMA scores of lower limbs,hip flexion angle,knee flexion angle and ankle dorsiflexion angle in the two groups were increased when compared with those before treatment(P<0.05),and the above indexes in the study group were higher than those in the control group(P<0.05).After treatment,GABA levels in the two groups were higher than those before treatment(P<0.05),and Glu levels were lower than those before treatment(P<0.05);the level of GABA in the study group was higher than that in the control group(P<0.05),and the level of Glu in the study group was lower than that in the control group(P<0.05).Conclusion:The application of Wenyang Tongluo Decoction combined with ZEPUmed intelligent exercise training system for SHAS has positive significance in improving the lower limb motor function and joint motion of patients,and can reduce the muscle tension of affected limb and effectively improve the level of neurotransmitters.