1.浙江中医药大学附属温州市中医院康复科(浙江 温州 325000)
刘薇,女,硕士,主治医师,主要从事脑血管疾病的临床康复工作
朱文宗,主任医师;E-mail:13857757396@163.com
扫 描 看 全 文
刘薇, 叶晓红, 朱文宗, 等. 小续命汤联合常规疗法治疗中风(风痰阻络证)后上肢肌痉挛的临床研究[J]. 上海中医药杂志, 2021,55(8):63-66.
Wei LIU, Xiaohong YE, Wenzong ZHU, et al. Clinical study on Xiaoxuming Decoction combined with conventional therapy in treating post-stroke upper limb spasticity (wind-phlegm obstructing collaterals syndrome)[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(8):63-66.
刘薇, 叶晓红, 朱文宗, 等. 小续命汤联合常规疗法治疗中风(风痰阻络证)后上肢肌痉挛的临床研究[J]. 上海中医药杂志, 2021,55(8):63-66. DOI: 10.16305/j.1007-1334.2021.2101022.
Wei LIU, Xiaohong YE, Wenzong ZHU, et al. Clinical study on Xiaoxuming Decoction combined with conventional therapy in treating post-stroke upper limb spasticity (wind-phlegm obstructing collaterals syndrome)[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(8):63-66. DOI: 10.16305/j.1007-1334.2021.2101022.
目的,2,观察小续命汤联合常规疗法治疗中风(风痰阻络证)后上肢肌痉挛的临床疗效。,方法,2,将90例中风(风痰阻络证)后上肢肌痉挛患者随机分为对照组和试验组,每组45例。对照组予常规内科治疗及康复训练,试验组在对照组治疗措施的基础上加用小续命汤。两组疗程均为12周,比较上肢表面肌电信号、改良Ashworth量表评定分级、Fugl-Meyer评分、改良Barthel量表评分的变化情况,同时进行安全性评价。,结果,2,①试验组脱落3例、对照组脱落1例,最终完成试验者86例,其中试验组42例、对照组44例。②治疗前后组内比较,两组肱二头肌、肱三头肌肌电积分(IEMG)、均方根(RMS)值均降低(,P,<,0.05);组间治疗后比较,肱二头肌、肱三头肌RMS值差异有统计学意义(,P,<,0.05)。③治疗前后组内比较,两组改良Ashworth量表评定分级均有所改善(,P,<,0.05);组间治疗后比较,改良Ashworth量表评定分级差异有统计学意义(,P,<,0.05)。④治疗6周、治疗后与治疗前组内比较,两组Fugl-Meyer评分、改良Barthel量表评分均升高(,P,<,0.05);组间治疗6周后比较,改良Barthel量表评分差异有统计学意义(,P,<,0.05);组间治疗后比较,Fugl-Meyer评分、改良Barthel量表评分差异有统计学意义(,P,<,0.05)。⑤治疗期间,两组均未发生明显的不良反应。,结论,2,小续命汤联合常规疗法治疗中风(风痰阻络证)后上肢肌痉挛疗效满意,能有效降低患者的上肢肌张力,缓解中风后肌痉挛症状,改善日常生活能力和运动功能。
Objective,2,To investigate the clinical effect of Xiaoxuming Decoction combined with conventional therapy on post-stroke upper limb spasticity (wind-phlegm obstructing collaterals syndrome).,Methods,2,Ninety patients with post-stroke upper limb spasticity (wind-phlegm obstructing collaterals syndrome) were randomly divided into control group (,n,=45) and test group (,n,=45). The control group was administered with conventional secondary prophylaxis combined with rehabilitation training, while the test group was administered with Xiaoxuming Decoction besides the treatment measures of the control group. The treatment duration was 12 weeks. The pre- and post-treatment clinical indicators, including surface electromyography (EMG) signals, Modified Ashworth Scale (MAS) scores, Fugl-Meyer Assessment (FMA) scores and Modified Barthel Index (MBI) scores, were compared between the two groups, and the safety was evaluated.,Results,2,①There were 3 drop-out cases in the test group and 1 drop-out case in the control group, and 86 cases completed the trial, including 42 cases in the test group and 44 cases in the control group. ②Intra-group comparison before and after treatment showed that the integrated EMG (IEMG) and root mean square (RMS) values of biceps and triceps decreased in both groups (,P,<,0.05); After treatment, RMS values of biceps and triceps were significantly different between the two groups (,P,<,0.05). ③According to the intra- group comparison of the two groups before and after treatment, the MAS scores of the two groups improved (,P,<,0.05); After treatment, there was a significant difference in the MAS scores between the two groups (,P,<,0.05). ④The scores of FMA and MBI increased after 6 weeks of treatment and after treatment in both groups compared to those before treatment (,P,<,0.05); According to the inter-group comparison after 6 weeks of treatment, the difference in scores of MBI was significant between the groups (,P,<,0.05); After treatment, the scores of FMA and MBI were significantly different between the two groups (,P,<,0.05). ⑤During the trial, no significant adverse reactions were observed in both groups.,Conclusion,2,The combined use of Xiaoxuming Decoction and conventional therapy is effective in treating post-stroke upper limb spasticity (wind-phlegm obstructing collaterals syndrome) by effectively reducing upper limb muscle tension, relieving post-stroke spasticity, and improving daily living ability and motor function.
中风脑卒中肌痉挛小续命汤表面肌电图中药研究
strokecerebral apoplexymyospasmXiaoxuming Decoctionsurface electromyographytraditional Chinese herbal medicine research
中国老年保健医学研究会老龄健康服务与标准化分会. 中国高龄脑卒中患者康复治疗技术专家共识[J]. 中国老年保健医学,2019, 17(1): 8-15.
BRAININ M, NORRVING B, SUNNERHAGEN K S, et al. Poststroke chronic disease management: towards improved identification and interventions for poststroke spasticity-related complications[J]. Int J Stroke, 2011, 6(1): 42-46.
饶金柱,关健伟,曹黎明. 脑卒中后肌痉挛发病情况调查分析[J]. 中国实用神经疾病杂志,2013, 16(1): 74-76.
中华医学会神经病学分会. 2016版中国脑血管病诊治指南与共识[M]. 北京:人民卫生出版社,2016: 35-74.
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,1996,37(1): 55-56.
王玉龙. 康复功能评定学[M]. 北京:人民卫生出版社,2008.
中华医学会神经病学分会神经康复学组,中华医学会神经病学分会脑血管病组,卫生部脑卒中筛查与防治工程委员会办公室. 中国脑卒中康复治疗指南(2011完全版)[J]. 中国康复理论与实践,2012, 18(4): 301-318.
黄丹霞. 脑卒中后肌痉挛的发生率及危险因素调查研究[D]. 福州:福建中医药大学,2016.
BURRIDGE J H, WOOD D E, HERMENS H J, et al. Theoretical and methodological considerations in the measurement of spasticity[J]. Disabil Rehabil, 2005, 27(1-2): 69-80.
PANDYAN A D, GREGORIC M, BARNES M P, et al. Spasticity: Clinical perceptions, neurological realities and meaningful measurement[J]. Disabil Rehabil, 2005, 27(1-2): 2-6.
解铁军,侯静,王垒. 姿势控制在临床治疗中的疗效观察[J]. 中国药物与临床,2014,14(6): 813-814.
OMEEKINS G D, SO Y, QUAN D. American Association of Neuromuscular & Electrodiagnostic Medicine evidenced-based review: use of surface electromyography in the diagnosis and study of neuro muscular disorders[J]. Muscle Nerve,2008,38(4): 1219-1224.
DISSELHORST-KLUG C, SCHMITZ-RODE T, RAU G. Surface electromyography and muscle force: Limits in sEMG-force relationship and new approaches for applications[J]. Clin Biomech, 2009, 24(3): 225-235.
谭文波. 基于表面肌电的肌电生物反馈训练与治疗系统设计[D]. 广州:华南理工大学,2019.
孙彤,贾子善,戈含笑,等.脑卒中后肢体痉挛的物理治疗研究进展[J]. 中国康复理论与实践,2019, 25(5): 497-505.
0
浏览量
390
下载量
0
CSCD
10
CNKI被引量
关联资源
相关文章
相关作者
相关机构