栝楼桂枝汤加减治疗中风肢体痉挛的临床疗效及对脑动脉血流动力学指标的影响

doi:10.3969/j.issn.1671-7171.2020.11.018

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【目的】探讨栝楼桂枝汤加减治疗中风肢体痉挛的临床效果观察及对脑血流动力学指标的影响。【方法】选取2017年1月至2019年7月本院收治的108例中风肢体痉挛患者,根据治疗方法将其分为观察组和对照组,每组各54例。对照组给予内科常规治疗联合康复训练,观察组在对照组基础上给予栝楼桂枝汤治疗。记录两组治疗前后脑血流动力学指标、患侧肌电活动、简化Fugl-Meyer评分、改良Ashworth痉挛量表(MAS)、改良Barthel指数量表(BI)及血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、神经元特异性醇化酶(NSE)、同型半胱氨酸(Hcy)水平变化,并统计两组患者临床治疗总有效率。【结果】观察组总有效率为94.44%(51/54),显著高于对照组81.48%(44/54),差异有统计学意义(χ²=4.285,P=0.038<0.05)。治疗后,两组ACA、MCA、PCA平均血流速度较治疗前上升,观察组显著高于对照组,差异有统计学意义(P<0.05)。两组患者血清IL-1β、TNF-α、NSE、Hcy水平均低于治疗前,观察组显著低于对照组,差异均有统计学意义(P<0.05)。两组患侧肱二头肌、股四头肌RMS值较治疗前下降,观察组患侧肱二头肌、股四头肌RMS值低于对照组,差异有统计学意义(P<0.05)。两组患者简化Fugl-Meyer评分、BI评分较治疗前上升,MAS评分较治疗前下降,观察组简化Fugl-Meyer评分、BI评分高于对照组,MAS评分低于对照组,差异均有统计学意义(P<0.05)。【结论】栝楼桂枝汤加减治疗中风肢体痉挛可调节相关炎症因子的表达,改善脑血流动力学,有利于促进患侧肢体康复。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	史轲
	范秀凤
	岳静

关键词 ：中风/并发症, 四肢麻痹/并发症, 中风/中药疗法, 四肢麻痹/中药疗法, 血液动力学

Abstract：【Objective】To investigate the clinical effect of Trichosanthes kirilowii (Gualou Guizhi) decoction in the treatment of apoplectic limb spasm and its influence on cerebral hemodynamic indexes.【Methods】From January 2017 to July 2019, 108 cases of apoplectic limb spasm in our hospital were selected and divided into observation group and control group according to the treatment method, with 54 cases in each group. The control group was given routine medical treatment combined with rehabilitation training, and the observation group was given the Trichosanthes kirilowii decoction on the basis of the control group. The changes of cerebral hemodynamic indexes, myoelectric activity of affected side, simplified Fugl Meyer score, modified Ashworth spasticity scale (MAS), modified Barthel Index (BI) and serum levels of interleukin-1β(IL-1β), tumor necrosis factor-α(TNF -α), neuron specific alcoholase (NSE) and homocysteine (Hcy) were recorded before and after treatment, and the total effective rate of the two groups was statistically analyzed.【Results】The total effective rate of the observation group was 94.44% (51/54), which was significantly higher than that of the control group (81.48%) (χ²=4.285,P=0.038<0.05). After treatment, the average blood flow velocity of ACA, MCA and PCA in the two groups increased compared with that before treatment, and the observation group was significantly higher than the control group, the difference was statistically significant (P<0.05). The serum levels of IL-1β, TNF -α, NSE and Hcy in the two groups were lower than those before treatment, and those in the observation group were significantly lower than those in the control group (P<0.05).The RMS values of biceps brachii and quadriceps femoris in the two groups were lower than those before treatment. The RMS values of biceps brachii and quadriceps femoris in the observation group were lower than those in the control group (P<0.05). The simplified Fugl Meyer score and Bi score of the two groups were higher than those before treatment, while the MAS score was lower than that before treatment. The simplified Fugl Meyer score and Bi score of the observation group were higher than those of the control group, and the MAS score was lower than that of the control group (P<0.05).【Conclusion】The modified Trichosanthes kirilowii decoction can regulate the expression of related inflammatory factors, improve cerebral hemodynamics, and promote the affected limb.

Key words： Stroke/CO Quadriplegia/CO Stroke/ZD Quadriplegia/ZD Hemodynamics

收稿日期: 2020-09-16

PACS:

R255.2

引用本文:

史轲, 范秀凤, 岳静. 栝楼桂枝汤加减治疗中风肢体痉挛的临床疗效及对脑动脉血流动力学指标的影响[J]. 医学临床研究, 2020, 37(11): 1657-1660.
SHI Ke, FAN Xiu-feng, YUE Jing. Clinical Effect Observation of Trichosanthes Kirilowii (Gualou Guizhi) Decoction in the Treatment of Apoplectic Limb Spasm and its Influence on Cerebral Hemodynamic Indexes. JOURNAL OF CLINICAL RESEARCH, 2020, 37(11): 1657-1660.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.11.018 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I11/1657

[1] 韩晓涛.老年脑卒中偏瘫合并肺部感染的临床特点及危险因素分析[J].中国临床保健杂志,2019,22(6):818-820.
[2] Benjamin T, Kalinosky RB, Brian DS. Structurofunctional resting-state networks correlate with motor function in chronic stroke[J].Neuroimage Clin,2017, 16:610-623.
[3] 张亚男,邹忆怀,罗树云, 等.邹忆怀教授论治缺血性中风经验[J].陕西中医,2019,40(12):1765-1767.
[4] 林凌.栝楼桂枝汤经穴导入对脑卒中后痉挛性足下垂的疗效观察[J].上海针灸杂志,2018,37(7):746-750.
[5] 中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-384.
[6] 国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(11):55.
[7] 满斌,王悦.中风后痉挛性瘫痪的中西医治疗进展[J].湖南中医杂志,2018,34(6):171-174.
[8] Valkenborghs SR, Visser MM, Nilsson M, et al. Aerobic exercise prior to task-specific training to improve poststroke motor function: A case series[J].Physiother Res Int,2018, 23(3):e1707.
[9] 付东婷,杨明,南红梅.中风病急性期中医综合诊疗方案的疗效评价[J].吉林中医药,2019,39(12):1609-1612.
[10] 寿雅琨,刘芳,周胜强, 等.国医大师刘祖贻运用温阳活血法治疗中风后遗症经验[J].湖南中医药大学学报,2019,39(10):1179-1182.
[11] 李娜,常静玲.从古今医案谈中风病常用四组药对[J].环球中医药,2019,12(12):1895-1898.
[12] 王静敏.平衡舒筋手法联合参芪复瘫汤治疗中风后手痉挛疗效观察[J].中国实用神经疾病杂志,2018,21(13):1485-1488.
[13] Jungsoo L. Alteration and role of interhemispheric and intrahemispheric connectivity in motor network after stroke[J].Brain Topography,2018, 31(4):1-12.
[14] Adelyn PT, Nikhilesh N, Jason G, et al. Effects of somatosensory electrical stimulation on motor function and cortical oscillations[J].J Neuroeng Rehabil,2017, 14(1):113.
[15] 古春青,武继涛.化瘀通脉汤联合针刺对脑卒中后肢体痉挛患者血清NSE、Hcy水平的影响[J].中医学报,2017,32(12):2549-2552.
[16] 孙丽,施海涛,周萍萍, 等.应用表面肌电图评价针刺四间穴治疗脑卒中手痉挛的临床疗效分析[J].中国中医药科技,2018,25(4):606-607.