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

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...

Clinical Study on Modified Buyang Huanwu Tang Combined with Prednisone forShoulder-Hand Syndrome After Stroke

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.