摘要
目的探讨加味黄芪桂枝五物汤联合康复训练治疗脑卒中后肩-手综合征(SHS)的效果。方法选取2017年10月—2019年10月北京市和平里医院收治的脑卒中后SHS患者96例,采用随机数字表法将其分为对照组和研究组,各48例。对照组给予常规康复训练,研究组在对照组的基础上联合加味黄芪桂枝五物汤治疗。比较两组患者临床疗效、SHS评估量表(SHSS)、Fugl-Meyer量表(FMA)及视觉模拟评分(VAS)、血清降钙素基因相关肽(CGRP)、P物质(SP)、缓激肽(BK)含量及不良反应发生情况。结果治疗后研究组临床总有效率高于对照组(P<0.05)。治疗后两组SP、BK均较治疗前降低,CGRP较治疗前升高(P<0.05),且研究组治疗后SP、BK低于对照组,CGRP高于对照组(P<0.05)。治疗后两组SHSS、VAS评分均较治疗前降低,FMA较治疗前升高(P<0.05),且研究组治疗后SHSS、VAS评分低于对照组,FMA高于对照组(P<0.05)。治疗期间对照组未见明显不良反应,研究组出现1例胃肠道不适。结论加味黄芪桂枝五物汤联合康复训练治疗脑卒中后SHS可有效改善患者临床症状,疗效显著,其作用可能与CGRP含量的升高以及BK和SP水平降低有关。
Objective To investigate the effect of Jiawei Huangqi Guizhi Wuwu Decoction combined with rehabilitation training in the treatment of shoulder-hand syndrome(SHS)after stroke.Methods Ninety-six patients with SHS after stroke admitted to Beijing Hepingli Hospital from October 2017 to October 2019 were selected,they were divided into control group and study group according to the random number table method,with 48 cases in each group.The control group was given routine rehabilitation training,on basis of control group,the study group was given Jiawei Huangqi Guizhi Wuwu Decoction.The clinical efficacy,SHS scale(SHSS),Fugl-Meyer assessment(FMA),visual analogue scale(VAS),serum calcitonin gene-related peptide(CGRP),substance P(SP),bradykinin(BK)and adverse reactions were compared between the two groups.Results After treatment,the total clinical effective rate of the study group was significantly higher than that of the control group(P<0.05).After treatment,SP and BK in the two groups were lower than those before treatment,CGRP was higher than that before treatment(P<0.05).After treatment,SP and BK in the study group were lower than those in the control group,CGRP was higher than that in the control group(P<0.05).After treatment,the scores of SHSS and VAS in the two groups were lower than those before treatment,and the FMA was higher than that before treatment(P<0.05).After treatment,the scores of SHSS and VAS in the study group were lower than those in the control group,and the FMA was higher than that in the control group(P<0.05).During the treatment period no obvious adverse reactions were observed in the control group and one case of gastrintestinal discomfort occurred in the study group.Conclusion Jiawei Huangqi Guizhi Wuwu Decoction combined with rehabilitation training in the treatment of patients with SHS after stroke can effectively improve the clinical symptoms,the effect is significant,which may be related to the increase of CGRP content and the decrease of BK and SP levels.
作者
刘伟
李博
刘景峰
LIU Wei;LI Bo;LIU Jingfeng(Department of Neurology,Beijing Hepingli Hospital,Beijing 100013,China)
出处
《中国医药导报》
CAS
2020年第32期131-134,共4页
China Medical Herald
基金
首都卫生发展科研专项项目(首发2016-2-2019)。
关键词
加味黄芪桂枝五物汤
康复训练
脑卒中
肩手综合征
疗效
Jiawei Huangqi Guizhi Wuwu Decoction
Rehabilitation training
Stroke
Shoulder-hand syndrome
Effect
