目的 探讨蜡疗合通窍活血中药治疗脑卒中后痉挛性瘫痪疗效及对甘氨酸(Gly)、γ-氨基丁酸(GABA)水平的影响.方法 将120例脑卒中后痉挛性瘫痪患者随机分为对照组(60例)和治疗组(60例),分别采用Bobath疗法和在此基础上加用蜡疗合通窍活血中药治疗;统计2组患者近期疗效,观察2组治疗前后中医证候积分、CSS评分、痉挛指数(CSI)、改良Ashworth评分、Barthel指数评分、生存质量测定量表简表(QOL-BREF)评分及Gly、GABA水平变化情况.结果 治疗组患者近期疗效显著优于对照组(P＜0.05);治疗组患者治疗后中医证候积分、CSS评分、CSI及改良Ashworth评分均显著低于治疗前及同期对照组(P均＜0.05),治疗后Barthel指数、QOL-BREF评分、Gly及GABA水平均显著高于治疗前及同期对照组(P均＜0.05).结论 蜡疗合通窍活血中药治疗脑卒中后痉挛性瘫痪可有效减轻临床症状体征,降低肢体痉挛程度,提高日常生活质量,并有助于上调Gly和GABA水平.%Objective It is to investigate the clinical effects of wax therapy combined with Tongqiao Huoxue decoction in the treatment of spastic paralysis after stroke and influence on levels of gamma-aminobutyric acid (GABA) and glycine (Gly).Methods 120 patients with spastic paralysis after stroke were chosen and randomly divided into both group including control group (60 patients) treated with Bobath therapy and treatment group (60 patients) treated with wax therapy combined with Tongqiao Huoxue decoction,the clinical efficacy for short-term,the TCM syndrome scores,CSS scores,spasticity index (CSI),modified Ashworth scores,Basel (Barthel) index scores,quality of life scale (QOL-BREF) scores,the levels of Gly and GABA before and after treatment of both groups were compared.Results The clinical efficacy for short-term of treatment group were significantly better than that of control group (P ＜ 0.05).The TCM syndrome scores,CSS scores,CSI,modified Ashworth scores after treatment in the treatment group were significantly lower than thatin the control group and before treatment(P ＜ 0.05).The Barthel index scores,QOL-BREF scores,the levels of Gly and GABA after treatment of treatment group were significantly higher than control group and before treatment (P ＜ 0.05).Conclusion Wax therapy combined with Tongqiao Huoxue decoction can efficiently relieve the clinical symptoms and signs,reduce the degree of limb spasticity,improve the quality of daily life and be helpful to up-regulate the levels of Gly and GABA in the treatment of spastic paralysis after stroke.
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