低频神经肌肉电刺激联合活血通络舒筋方对脑梗死后偏瘫肩痛风痰瘀阻证患者的治疗效果

Therapeutic Effect of Low Frequency Neuromuscular Electrical Stimulation Combined with Huoxue Tongluo Shujin Formula on Patients with Hemiplegia,Shoulder Pain,Wind-Phlegm Stasis Syndrome aftercerebral Infarction

目的探讨低频神经肌肉电刺激联合活血通络舒筋方对脑梗死后偏瘫肩痛风痰瘀阻证患者的治疗效果。方法回顾性选取2021—2023年西安庆华医院收治的脑梗死后偏瘫肩痛风痰瘀阻证患者86例,将接受低频神经肌肉电刺激治疗的患者纳入对照组(n=42),接受低频神经肌肉电刺激联合活血通络舒筋方治疗的患者纳入联合组(n=44),两组均连续治疗1个月。比较两组临床疗效和治疗前后中医证候(主症、次症)积分、视觉模拟量表(VAS)评分、神经功能指标〔神经营养因子(NTF)、神经生长因子(NGF)、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、美国国立卫生研究院卒中量表(NIHSS)评分〕、肩关节活动度、Fugl-Meyer上肢运动功能量表(FMA-UE)评分及治疗期间不良反应发生率。结果联合组临床疗效优于对照组(P<0.05)。治疗后,两组主证、次症积分及VAS评分分别低于本组治疗前,且联合组主证、次症积分及VAS评分低于对照组(P<0.05)。治疗后,两组NTF、NSE、BDNF分别高于本组治疗前,NGF、NIHSS评分分别低于本组治疗前,且联合组NTF、NSE、BDNF高于对照组,NGF、NIHSS评分低于对照组(P<0.05)。治疗后,两组肩关节屈曲、外展、内旋、外旋活动度分别大于本组治疗前,FMA-UE评分分别高于本组治疗前,且联合组肩关节屈曲、外展、内旋、外旋活动度大于对照组,FMA-UE评分高于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论低频神经肌肉电刺激联合活血通络舒筋方可提高脑梗死偏瘫肩痛风痰瘀阻证患者的临床疗效,改善中医证候,减轻疼痛程度,改善患者神经功能、肩关节活动度及上肢运动功能,且安全性较高。

Objective To investigate the therapeutic effect of low frequency neuromusculaRelectrical stimulation combined with Huoxue Tongluo Shujin formula on patients with hemiplegia,shouldeRpain,wind-phlegm stasis syndrome after cerebral infarction.Methods A total of 86 patients with hemiplegia shouldeRpain,wind-phlegm stasis syndrome afteRcerebral infarction admitted to Xi'an Qinghua Hospital from 2021 to 2023 were retrospectively selected.The patients who received low frequency neuromusculaRelectrical stimulation were included in the control group(n=42),and the patients who received low frequency neuromusculaRelectrical stimulation combined with Huoxue Tongluo Shujin formula were included in the combined group(n=44),both groups were continuously treated foR1 month.The clinical efficacy,and TCM syndrome(main and secondary symptoms)score,Visual Analogue Scale(VAS)score,nerve function indenes[neurotrophic factoR(NTF),nerve growth factor(NGF),neuron specific enolase(NSE),brain-derived neurotrophic factoR(BDNF),National Institutes of Health Stroke Scale(NIHSS)score],shouldeRrange of motion,and Fugl-MeyeRAssessment UppeRExtremity(FMA-UE)score before and after treament,and adverse reactions during the treatment were compared between the two groups.Results The clinical efficacy of the combined group was betteRthan that of the control group(P<0.05).AfteRtreatment,the main syndrome and secondary symptom scores and VAS scores of the two groups were loweRthan those before treatment,respectively,and the main syndrome and secondary symptom scores and VAS scores of the combined group were loweRthan those of the control group(P<0.05).After treatment,NTF,NSE and BDNF in the two groups were higheRthan those before treatment,NGF and NIHSS scores were lower than those before treatment,respectively,and NTF,NSE and BDNF in the combined group were higheRthan those in the control group,NGF and NIHSS scores were loweRthan those in the control group(P<0.05).AfteRtreatment,the flexion,abduction,internal rotation,and external rotation of the shouldeRrange of motion of the two groups were greateRthan those before treatment,and FMA-UE score was higheRthan that before treatment,respectively,and the flexion,abduction,internal rotation,and external rotation of the shouldeRrange of motion of the combined group were greateRthan those of the control group,and FMA-UE score was higheRthan that of the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Low frequency neuromusculaRelectrical stimulation combined with Huoxue Tongluo Shujin formula can improve the clinical efficacy and TCM syndromes of patients with hemiplegia,shoulder pain,wind-phlegm stasis syndrome afteRcerebral infarction,reduce the degree of pain,improve nerve function,shouldeRrange of motion and uppeRextremity motoRfunction with high safety.