摘要
目的:观察补阳还五汤联合经颅磁治疗气虚血瘀型缺血性脑卒中偏瘫的临床效果。方法:选取2022年7月—2023年12月皖南医学院第二附属医院康复科收治的气虚血瘀型缺血性脑卒中偏瘫患者82例,按简单随机法分为对照组和观察组,每组41例。两组患者均给予常规对症治疗,对照组予以经颅磁刺激治疗,观察组在对照组治疗的基础上增加补阳还五汤。对两组患者治疗前后中医证候积分、步行能力、医学研究委员会(MRC)六级肌力量表评分、Fugl-Meyer运动功能评定量表评分、下肢骨骼肌肌力、血液黏度指标进行统计分析,并记录不良反应。结果:治疗后,两组患者上述指标均有不同程度改善,与治疗前比较,差异均有统计学意义(P<0.05,P<0.01)。治疗后,观察组中医证候积分(偏身麻木、气短乏力、舌色黯、舌下脉络增长)、血液黏度指标(低切全血黏度、高切全血黏度、红细胞聚集指数、纤维蛋白原)低于对照组,步行能力(6 min行走距离、10 m行走时间)优于对照组,上肢MRC六级肌力评分、下肢FMA评分、下肢骨骼肌肌力(髋关节伸展、膝关节伸展、踝关节背屈)均高于对照组,差异均有统计学意义(P<0.05,P<0.01)。两组患者治疗期间均未出现不良反应。结论:补阳还五汤联合经颅磁刺激治疗气虚血瘀型缺血性脑卒中偏瘫,可改善神经功能,显著提升患者运动功能与步行能力,调节血液流变学状态,对中医证候的整体改善效果优于单一经颅磁刺激治疗,为临床治疗此类疾病提供了中西医结合的新路径。
Objective:To evaluate the clinical efficacy of Yang-Tonifying Five-Returning Decoction(Buyang Huanwu Tang)combined with transcranial magnetic stimulation(TMS)for hemiplegia after ischemic stroke manifesting qi deficiency and blood stasis pattern.Methods:Eighty-two patients with hemiplegia after ischemic stroke manifesting qi deficiency and blood stasis pattern were enrolled at the Rehabilitation Department of The Second Affiliated Hospital of Wannan Medical College from July 2022 to December 2023.Using simple randomization,patients were divided into control group(n=41,receiving TMS)and observation group(n=41,receiving TMS plus Yang-Tonifying Five-Returning Decoction).Both groups of patients received conventional symptomatic treatment.Outcomes analyzed included TCM syndrome scores,walking capacity,Medical Research Council(MRC)muscle strength scale(upper limb),Fugl-Meyer Assessment(FMA)scores(lower limb),lower limb muscle strength,hemorheological indices,and adverse events.Results:Both groups showed significant improvement in all parameters post-treatment compared to baseline(P<0.05,P<0.01).The observation group demonstrated significantly lower TCM syndrome scores(hemilateral numbness,shortness of breath,fatigue,dark tongue coloration,sublingual varices)and hemorheological indices(low-shear whole blood viscosity,high-shear whole blood viscosity,erythrocyte aggregation index,fibrinogen),superior walking capacity(6-minute walk distance,10-meter walk time),higher MRC scores(upper limb),FMA scores(lower limb),and muscle strength(hip extension,knee extension,ankle dorsiflexion)compared to controls(P<0.05,P<0.01).No adverse reactions occurred in either group.Conclusion:Combined Yang-Tonifying Five-Returning Decoction and TMS improves neurological function,enhances motor performance and ambulation capacity,regulates hemorheology,and provides superior holistic symptom relief compared to transcranial magnetic stimulation alone,offering an integrated approach for hemiplegia after ischemic stroke with qi deficiency and blood stasis pattern.
作者
何胜飞
张金琴
李杜娟
李文
李扬缜
He Shengfei;Zhang Jinqin;Li Dujuan;Li Wen;Li Yangzhen(Department of Traditional Chinese Medicine,The Second Affiliated Hospital of Wannan Medical College,Wuhu Anhui 241000;Rehabilitation Department,The Second Affiliated Hospital of Wannan Medical College,Wuhu Anhui 241000)
出处
《山西中医药大学学报》
2025年第8期873-877,888,共6页
Journal of Shanxi University of Chinese Medicine
基金
芜湖市卫生健康委科研项目(WHWJ2023z006)。
关键词
缺血性脑卒中
偏瘫
补阳还五汤
经颅磁刺激
ischemic stroke
hemiplegia
Yang-Tonifying Five-Returning Decoction
transcranial magnetic stimulation
