化痰通络解痉汤熏洗治疗脑卒中痉挛性瘫痪82例临床观察

Clinical Observation of 82 Cases of Post-Stroke Spastic Paralysis Treated with Fumigation with Huatan Tongluo Jiejing Decoction

目的观察化痰通络解痉汤熏洗治疗卒中后痉挛性瘫痪的临床疗效。方法将82例脑卒中痉挛性瘫痪患者随机分为中药熏洗A组、中药熏洗B组和热水熏洗组。三组患者均采用西医常规治疗,并配合康复运疗法中抗痉挛体位控制和易化技术训练,以抑制上肢痉挛、手指屈曲痉挛、下肢痉挛及踝关节背屈等训练为主。在此基础上热水熏洗组、中药熏洗A组和B组分别采用热水以及化痰通络解痉汤熏洗治疗,中药熏洗A组每次熏洗30 min,中药熏洗B组每次熏洗1 h及以上。观察三组患者治疗后肌痉挛(Ashworth量表、CSI量表)、日常生活能力(Barthel指数)及生存质量(PRO量表)情况。结果三组患者治疗后中药熏洗A组和B组,Ashworth量表、CSI量表、Barthel指数评定、PRO量表与热水熏洗组相比,差异有统计学意义(P<0.01);中药熏洗A组和B组各量表评分比较无明显差异(P>0.05)。结论化痰通络解痉汤熏洗治疗可有效地改善患肢痉挛状态,提高患者日常生活能力,改善其生存质量,较单纯西医康复疗法为佳。

Objective To observe the clinical effect on post- stroke spastic paralysis treated with fumigation with huatan tongluo jiejing decoction. Methods Eighty- two post- stroke spastic paralysis were randomized into a Chinese medicine fumigation A group( A group),a Chinese medicine fumigation B group( B group) and a hot water fumigation group. The routine treatment of western medicine was adopted in the three groups,combined with the rehabilitation therapy to inhibit the spasm of upper limb,fingers,lower limbs and ankle. On the basis of those treatments,the hot water and huatan tongluo jiejing decoction were used in three groups correspondingly. In the A group,fumigation was done for 30 min and in the B group,it was done for over 1 h. After treatment,muscular spasm,daily living ability and survival quality were observed in the three groups. Results After treatment,the results of Ashworth scale,CSI scale,Barthel index and PRO scale in the A and B groups were different significantly as compared with those in the hot water fumigation group( P< 0. 01). The differences were not significant between the A and B groups( P > 0. 05). Conclusion The fumigation with huatan tongluo jiejing decoction effectively relieves the spasm of the affected limbs and improves the daily living ability and survival quality in the patients. The effects are better than those with simple western medicine.