万氏温胆汤口服、中药熏洗联合现代康复训练治疗风痰阻络型卒中后肢体运动功能障碍临床观察

目的观察万氏温胆汤口服、中药熏洗联合现代康复训练治疗风痰阻络型卒中后肢体运动功能障碍临床疗效。方法将120例风痰阻络型卒中后肢体运动功能障碍患者按照随机数字表法分为2组。对照组60例予现代康复训练;治疗组60例在对照组治疗基础上加用万氏温胆汤口服、中药熏洗。2组均治疗3个月。观察2组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、简化Fugl-Meyer运动功能评分法(FMA)评分及改良Barthel指数评定量表(BI)评分变化;比较2组治疗前后中医证候评分变化;比较2组患肢肿胀疗效;比较2组治疗前后血脂指标总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)变化。结果2组治疗后NHISS评分均较本组治疗前降低(P<0.05),FMA评分、BI评分均较本组治疗前升高(P<0.05),且治疗组治疗后NHISS评分低于对照组(P<0.05),FMA评分、BI评分均高于对照组(P<0.05)。2组治疗后主症评分、次症评分、舌脉评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗组患肢肿胀总有效率90.0%(54/60),对照组患肢肿胀总有效率70.0%(42/60),治疗组患肢肿胀疗效优于对照组(P<0.05)。2组治疗后TC、TG及LDL-C均较本组治疗前降低(P<0.05),HDL-C较本组治疗前升高(P<0.05),且治疗组治疗后TC、TG及LDL-C均低于对照组(P<0.05),HDL-C高于对照组(P<0.05)。结论在现代康复训练基础上联合万氏温胆汤口服及中药熏洗治疗风痰阻络型卒中后肢体运动功能障碍,能明显促进患者肢体功能康复,有效改善中医症状及血脂指标。

Clinical observation on the treatment of wind-phlegm blocking collaterals type of motor dysfunction after stroke with Wanshi Wendan decoction,Chinese medicine fumigating and washing combined with modern re-habilitation training

Objective To observe the effect of Wanshi Wendan decoction,Chinese medicine fumigating and washing combined with modern rehabilitation training in the treatment of wind-phlegm blocking collaterals type of motor dyfunction after stroke.Methods 120 apoplexy patients with wind-phlegm blocking collaterals type were divided into two groups according to the random number table method.60 cases in control group were treated by modern rehabilitation training.60 cases in treatment group were treated by Wanshi Wendan decoction,and Chinese medicine fumigating and washing on the basis of the treatment in the control group.Both groups were treated for 3 months.Before and after treatment,the National institutes of health stroke scale(NIHSS),simplified Fugl-Meyer motor function scoring method(FMA)and modified Barthel index rating scale(BI)were observed between two groups.Before and after treatment,the changes of TCM syndrome score,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)were compared between two groups.The effect of swelling of affected limb were observed between two groups.Results After treatment,the scores of NHISS in two groups was lower than those in the group before treatment(P<0.05),FMA and BI in the two groups were higher than those in the group before treatment(P<0.05).After treatment,the NHISS score of the treatment group was lower than that of the control group(P<0.05),and the FMA and MBI score were higher than that of the control group(P<0.05).The main symptom score,secondary symptom score and total tongue vein score of the two groups were lower than those of the group before treatment(P<0.05),and the treatment group was significantly lower(P<0.05).The total effective rate of swelling of affected limb was 90.0%(54/60)in the treatment group and 70.0%(42/60)in the control group.The clinical curative effect of the treatment group was better than that of the control group(P<0.05).After treatment,TC,TG and LDL-C in the two groups were lower than that in the group before treatment(P<0.05),HDL-C was higher than that in the group before treatment(P<0.05).After treatment,TC,TG and LDL-C in the treatment group were lower than those in the control group(P<0.05),and HDL-C was higher than those in the control group(P<0.05).Conclusion On the basis of modern rehabilitation training,combined with Wanshi Wendan decoction and Chinese medicine fumigation and washing,it can obviously promote the rehabilitation of limb function,effectively improve the symptoms of traditional Chinese medicine and blood lipid index.