大秦艽汤联合早期综合康复治疗脑卒中后上肢痉挛性瘫痪临床观察
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Clinical Observation of Daqin jiao Tang Combined with Early Comprehensive Rehabilitation for Post-stroke Spastic Paralysis of the Upper Extremities
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    摘要:

    目的:观察大秦艽汤联合早期综合康复治疗脑卒中后上肢痉挛性瘫痪的临床疗效。方法:选取脑卒中后上肢痉挛性瘫痪患者136例,随机分为对照组和观察组各68例。对照组给予早期综合康复治疗,观察组在对照组基础上服用大秦艽汤。治疗4周后,比较2组上肢痉挛改善率、治疗前后Fugl-Meyer评估量表(FMA)评分、改良Barthel指数(MBI)、美国国立卫生研究院卒中量表(NIHSS)评分,检测血清神经元特异性醇化酶(NSE)、同型半胱氨酸(Hcy)含量变化。结果:治疗后,上肢痉挛总改善率观察组为70.59%,对照组为51.47%,2组比较,差异有统计学意义( P <0.05)。治疗后,2组FMA与MBI评分均较治疗前升高( P <0.05),NHISS评分均较治疗前降低( P <0.05);观察组FMA评分、MBI评分均较对照组升高更明显( P <0.05),观察组NHISS评分较对照组降低更明显( P <0.05)。治疗后,血清Hcy与NSE含量均较治疗前降低( P <0.05),观察组血清Hcy与NSE含量较对照组降低更明显( P <0.05)。结论:大秦艽汤联合早期综合康复可以改善患者卒中后上肢痉挛状态和上肢功能,缓解神经受损,降低卒中相关蛋白表达,提高患者生活能力,对卒中后肢体重塑有重要意义。

    Abstract:

    Objective:To observe the clinicaleffect of Daqinjiao tang combined with early comprehensive rehabilitation for post-stroke spastic paralysis of the upper extremities.Methods:Selected 136 cases of patients with post-stroke spastic paralysis of the upper extremities,and divided the min to the control group and the observation group randomly,68 cases in each group.The control group was given early comprehensive rehabilitation for treatment,while the observation group additionally received Daqinjiao tang for treatment.After treatment for 4 weeks,compared the improvement rate of spasmin the upper extremities of both groups,the scores of Fugl-Meyer assessment(FMA),modified Barthel index(MBI)and scores of National Institute of Health stroke scale(NIHSS)in both groups before and after treatment,and detected changes of the content of neuron-specific enolase(NSE)and homocy steine(Hcy)in serum.Results:After treatment,the improvement rate of spasmin the upper extremities was 70.59% in the observation group and 51.47% in the control group,difference being significant( P < 0.05).After treatment,scores of FMA and MBI in both groups were higher than those before treatment( P <0.05),and scores of NHISS were lower than those before treatment(P < 0.05);scores of FMA and MBI in the observation group were increased more significantly than those in the control group(P < 0.05),and the score was of NHISS was decreased more significantly than that in the controlgroup(P < 0.05).After treatment,the contents of Hcy and NSE in serumwere respectively lower than those before treatment(P < 0.05),and the contents of Hcy and NSE in serumof the observation group were reduced more evidently than those of the controlgroup( P <0.05).Conclusion:Daqinjiao tang combined with early comprehensive rehabilitation can improve the post-stroke spastic status of the upper extr emities and upper extremity function of patients,alleviate nerve injury and promote the living ability of patients,which is significantly meaningful for post-stroke extremity remodeling.

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陈琳,徐守宇.大秦艽汤联合早期综合康复治疗脑卒中后上肢痉挛性瘫痪临床观察[J].新中医,2018,50(7):68-71

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  • 在线发布日期: 2018-07-09
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