活络柔筋汤内服和熏洗治疗缺血性中风恢复期手功能障碍42例

目的:探讨活络柔筋汤内服和熏洗对缺血性中风恢复期手功能障碍恢复的改善作用。方法:83例患者随机按数字表法分为针灸组41组和观察组42例。针灸组采用针灸治疗;观察组在针灸组治疗的基础上加用活络柔筋汤内服和熏洗。两组疗程均为6周。进行治疗前后平衡功能偏瘫恢复(Lindmark)评分表、标准12级偏瘫功能评估(Brunnstrom)手运动功能评定表、手总主动活动度(TAM)量表和日常生活能力的评定(Barthel,BI)指数评估量表。结果:观察组疾病疗效总有效率为92.86%,优于针灸组的73.17%(P<0.05);治疗后观察组Lindmark评分量表手运动协调能力、感觉功能评分及总分均高于针灸组(P<0.01);两组治疗后Brunnstrom手运动功能明显好转,观察组的改善优于针灸组(P<0.05);治疗后观察组TAM的改善优于针灸组(P<0.05);两组治疗后BI指数分级明显好转,观察组的改善优于针灸组(P<0.05)。结论:在针灸治疗的基础上,加用活络柔筋汤内服和熏洗改善了手的运动能力、感觉能力和手腕关节活动度,减轻了病残程度,促进了手功能恢复,从而提高了患者的生活自理能力,两者联合使用起到良好的协同效应。

Oral and Fumigating-washing Administration of Huoluo Roujin Decoction in Treating 42 Cases with Hand Dysfunction During Ischemic Stroke Recovery Period

Objective: To discuss the improving effect of Huoluo Roujin decoction on hand dysfunction in patients during ischemic stroke recovery period after oral and fumigating-washing administration. Method: Eighty-three patients were randomly divided into the acupuncture group (41 cases) and the observation group (42 cases) by random number table. Patients in acupuncture group received acupuncture treatment. Based on the treatment of the acupuncture group, patients in observation group received Huoluo Roujin decoction by oral and fumigating-washing administration. All patients in two groups received one 6 week periods of treatment. Lindmark score table, Brunnstrom hand movement function evaluation table, the total active motion table (TAM) and Barthel (BI) index scale were used to evaluate the effect after the treatment. Result: The total curative rate in observation group was 92.86%, which is superior to that in acupuncture group 73.17% (P<0.05). After treatment, the single score of Lindmark rating scale hand movement coordination, sensory function, and the combined total score in observation group were superior to those in acupuncture group (P<0.01). The improvement of Brunnstrom hand movement function in both groups were obviously better after treatment, and the observation group had better results (P<0.05). The TAM improvement in observation group was superior to that in acupuncture group (P<0.05). BI index classification in both groups was markedly improved, and the observation group had better results (P<0.05). Conclusion: Based on acupuncture treatment, oral and fumigating-washing administration of Huoluo Roujin decoction could enhance the self-care abilitis of patients by improving the movement, sensory ability and wrist joint activity, reliving the disable degree and promoting functional recovery of hands. The combination of Huoluo Roujin decoction and acupuncture showed a good synergistic effect.