加味补阳还五汤联合泼尼松治疗脑卒中后肩手综合征临床研究
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R743.3

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Clinical Study on Modified Buyang Huanwu Tang Combined with Prednisone for Shoulder-Hand Syndrome After Stroke
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    摘要:

    目的:观察加味补阳还五汤联合泼尼松治疗脑卒中后肩手综合征的临床疗效。方法:选取98 例脑卒中后肩手综合征患者作为研究对象,以随机数字表法分为对照组48 例和治疗组50 例,2 组均口服醋酸泼尼松片治疗,同时服用硫糖铝咀嚼片保护胃黏膜,治疗组加予加味补阳还五汤治疗。2 组均以治疗4 周为1 个疗程,1 个疗程结束后评价临床疗效。观察治疗前、治疗4 周后2 组患者的运动功能[Fugl-Meyer 运动功能评分]、上肢功能[上肢功能评定量表(DASH) 评分]、疼痛程度[视觉模拟评分法(VAS) 评分]、手功能及肿胀程度等。结果:治疗后,治疗组临床疗效总有效率(90.00%) 高于对照组(70.83%)(P<0.05)。2 组Fugl-Meyer 运动功能评分均较治疗前提高,DASH、VAS 评分均较治疗前降低,差异均有统计学意义(P<0.05)。治疗组Fugl-Meyer 运动功能评分高于对照组,DASH、VAS 评分均低于对照组,差异均有统计学意义(P<0.05)。2 组废用手所占比例均较治疗前减少(P<0.05),辅助手、实用手所占比例均较治疗前增加(P<0.05)。治疗组废用手所占比例少于对照组(P<0.05),实用手所占比例高于对照组(P<0.05),2 组辅助手所占比例无统计学差异(P>0.05)。2 组患侧手肿胀程度均较治疗前减轻,治疗组轻度肿胀者所占比例高于对照组(P<0.05),重度肿胀者所占比例低于对照组(P<0.05),2 组中度肿胀者所占比例无统计学差异(P>0.05)。结论:加味补阳还五汤联合泼尼松治疗脑卒中后肩手综合征临床疗效确切,能有效改善患者的上肢运动功能、手功能,减轻患侧肢体疼痛及肿胀程度。

    Abstract:

    Abstract: Objective: To observe the clinical effect of modified Buyang Huanwu tang combined with prednisone for shoulder- hand syndrome after stroke. Methods:A total of 98 cases of patients with shoulder- hand syndrome after stroke were selected as the research objects, and were divided into the control group and the treatment group according to the random number table method,48 and 50 cases in each group respectively. Both groups were given the oral administration of prednisone acetate tablets as well as the sucralfate chewable tablets to protect the gastric mucosa,and the treatment group was additionally treated with modified Buyang Huanwu tang. Both groups were treated for four weeks as a course. After one course of treatment, the clinical effect was evaluated. Before and after four- week treatment, the motor function was observed by Fugl-Meyer scores,the upper limb function by Disability of Arm,Shoulder,and Hand(DASH) scores and the pain degree by Visual Analogue Scale(VAS) scores; hand function and swelling degree in the two groups were observed. Results: After treatment, the total effective rate was 90.00% in the treatment group, higher than that of 70.83% in the control group(P<0.05). Fugl-Meyer scores in the two groups were increased when compared with those before treatment, and the scores of DASH and VAS were decreased,differences being significant(P<0.05). Fugl-Meyer score in the treatment group was higher than that in the control group,the scores of DASH and VAS were lower,differences being significant(P< 0.05). In the two groups,the proportion of nonfunctional hands was decreased when compared with that before treatment (P<0.05), and the proportions of auxiliary hands and functional hands were increased(P<0.05). The proportion of nonfunctional hands in the treatment group was lower than that in the control group(P<0.05),and the proportion of functional hands was higher(P<0.05). There was no significant difference being found in the comparison of the proportions of auxiliary hands between the two groups(P>0.05). The swelling degree of the affected hands in the two groups was reduced when compared with that before treatment, the proportion of mild swelling in the treatment group was higher than that in the control group(P<0.05),and the proportion of severe swelling was lower(P<0.05). There was no significant difference being found in the comparison of the proportions of moderate swelling between the two groups(P>0.05). Conclusion:The therapy of modified Buyang Huanwu tang combined with prednisone has definite clinical effect in treating shoulder- hand syndrome after stroke,which can effectively improve the motor function of upper limbs and hand function,and reduce the pain and swelling degree of the affected limbs.

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金于,王宇展.加味补阳还五汤联合泼尼松治疗脑卒中后肩手综合征临床研究[J].新中医,2021,53(5):44-48

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  • 在线发布日期: 2021-03-15
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