中药熏洗治疗脑梗死痉挛性瘫痪的效果

摘要

目的 研究在张力平衡针法基础上联合中药熏洗治疗脑梗死痉挛性瘫痪的临床疗效与安全性.方法 2014年6月至2017年6月脑梗死痉挛性瘫痪患者258例,随机分为对照组(n=130)和观察组(n=128).两组均给予常规治疗加张力平衡针法,观察组另予中药熏洗患肢,共6周.治疗前、治疗3周后、治疗6周后,采用改良Ashworth量表(MAS)、Fugl-Meyer评定量表(FMA)、改良Barthel指数(MBI)和神经功能缺损量表(NDS)对患者进行评定,记录不良反应发生情况.结果 治疗3周后,两组患者FMA、MBI与NDS评分均无显著性差异(P>0.05).治疗6周后,观察组MAS临床疗效明显优于对照组(χ2=11.121,P=0.001);两组患者FMA、MBI与NDS评分均较治疗前改善(t>7.382,P<0.05),观察组FMA、MBI与NDS评分优于对照组(t>4.412,P<0.05);治疗后未出现明显不良反应.结论 加用中药熏洗能改善脑梗死痉挛性瘫痪患者的肌张力、日常生活活动与运动功能.%Objective To observe the efficacy and security of Chinese Medicine fumigation based on tension balance acupuncture on spasticity after ischemic stroke. Methods From June, 2014 to June, 2017, 258 patients with spasticity after ischemic stroke were assigned into control group (n=130) and observation group (n=128). All the patients received routine rehabilitation and tension bal-ance acupuncture, and the observation group received Chinese Medicine fumigation in addition, for six weeks. They were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA), modified Barthel In-dex (MBI) and Neurological Deficit Scale (NDS) before, three weeks and six weeks after treatment. The inci-dence of side-effect was recorded. Results There was no significant difference in scores of FMA, MBI and NDS between two groups three weeks after treatment (P>0.05). Six weeks after treatment, the scores of FMA, MBI and NDS improved in both groups (t>7.382, P<0.05), and improved more in the observation group than in the control group (t>4.412, P<0.05), while the clinical efficacy on spasm was also better (χ2=11.121, P=0.001). The side-effect was slight in both groups. Conclusion Combination with Chinese Medicine fumigation can ameliorate the spasticity of upper limb in ischemic stroke patients, to promote the recovery of motor function and activities of daily living.