加减桂枝汤泡洗对缺血性中风病（中经络）急性期偏瘫患者的影响研究

背景　为减少中风病致残程度，其急性期综合康复越来越受重视。中药泡洗改善中风病后遗症状已受到临床肯定，但关于其在中风病急性期应用的研究报道较少。目的　探讨加减桂枝汤泡洗对缺血性中风病（中经络）急性期偏瘫患者的影响。方法　选取2017年3月-2018年5月在海南省中医院住院的缺血性中风病（中经络）急性期偏瘫患者116例为研究对象，随机分为对照组55例和观察组58例。两组患者均采用急性脑梗死规范治疗方案，观察组患者在此基础上配合加减桂枝汤泡洗14 d。比较两组患者治疗90 d内肢体肿胀发生率，治疗前及治疗14、90 d美国国立卫生研究院卒中量表（NIHSS）评分，治疗前及治疗90 d后白介素4（IL-4），白介素6（IL-6）及超敏C反应蛋白（hs-CRP）水平。结果　对照组患者治疗90 d内肢体肿胀发生率为14.5%，高于观察组患者的1.7%（P<0.05）。治疗前两组患者NIHSS评分比较，差异无统计学意义（P>0.05）；治疗14、90 d后两组患者NIHSS评分均低于治疗前，且观察组NIHSS评分低于对照组（P<0.05）。治疗前两组患者IL-4、IL-6及hs-CRP水平比较，差异无统计学意义（P>0.05）；治疗90 d后两组患者IL-4、IL-6及hs-CRP水平均低于治疗前，且观察组IL-4、IL-6及hs-CRP水平低于对照组（P<0.05）。两组患者治疗期间均未出现严重不良反应。结论　加减桂枝汤泡洗可有效促进缺血性中风病（中经络）急性期偏瘫患者神经功能恢复，降低炎性因子如IL-4、IL-6、及hs-CRP水平，减少肢体肿胀的发生且较安全。

Effect of Soaking and Fumigation Washing Therapy of Modified Guizhi Decoction on Patients with Hemiplegia in Acute Stage of Ischemic Stroke（Meridian Obstruction）

Background　In order to reduce the degree of disability caused by stroke，comprehensive rehabilitation in the acute stage has received more and more attention.Soaking and fumigation washing therapy of Traditional Chinese Medicine has been clinically affirmed to improve the sequela symptoms of stroke，but there are few studies about its effect in the acute stage of stroke.Objective　To investigate the effect of soaking and fumigation washing therapy of modified Guizhi decoction on patients with hemiplegia in acute stage of ischemic stroke（meridian obstruction）.Methods　A total of 116 patients with hemiplegia in acute stage of ischemic stroke（meridian obstruction）were selected and randomly divided into control group（n=55） and observation group（n=58）in the Traditional Chinese Medicine Hospital of Hainan Province from March 2017 to May 2018.Patients in the both groups received standard treatment of acute cerebral infarction，while patient in observation group was extraly treated with soaking and fumigation washing therapy of modified Guizhi decoction for 14 days.Incidence of limb swelling was observed within 90 days of treatment，National Institutes of Health Stroke Scale（NIHSS）score was compared between the two groups before treatment，14 and 90 days after treatment，so was levels of interleukin-4（IL-4），interleukin-6（IL-6） and high-sensitivity C-reactive protein（hs-CRP） before treatment and 90 days after treatment.Results　Incidence of limb swelling was 14.5% in control group within 90 days of treatment，which was statistically significantly higher than that in observation goup of 1.7%（P<0.05）.There was no statistically significant difference in NIHSS score between the two groups before treatment（P<0.05）.After 14 days and 90 days of treatment，NIHSS score in the two groups was statistically significantly lower than that before treatment，respectively，meanwhile NIHSS score in observation group was statistically significantly lower than that in control group，respectively（P<0.05）.There was no statistically significant difference in levels of IL-4，IL-6 and hs-CRP between the two groups before treatment（P>0.05）.After 90 days of treatment，levels of IL-4，IL-6 and hs-CRP in the two groups were statistically significantly lower than those before treatment（P<0.05），meanwhile levels of IL-4，IL-6 and hs-CRP in observation group were statistically significantly lower compared with those in control group（P<0.05）. Conclusion　Soaking and fumigation washing therapy of modified Guizhi decoction can effectively promote the recovery of neurological function in patients with hemiplegia in acute stage of ischemic stroke（meridian obstruction），reduce the levels of inflammatory cytokines（such as IL-4，IL-6 and hs-CRP）and risk of limb swelling，with relatively high safety.