补阳还五汤加减联合针刺治疗缺血性脑卒中后肢体运动功能障碍临床观察

目的 观察补阳还五汤加减联合针刺治疗缺血性脑卒中后肢体运动功能障碍的疗效。方法 将64例患者随机分为对照组和治疗组，观察过程中每组均脱落2例，每组最终完成病例数均为30例。在西医基础治疗的同时，治疗组采用补阳还五汤加减联合针刺疗法，对照组采用针刺疗法，每日1次，每周6次，所有患者均接受28 d的治疗。采用中医证候积分评定患者中医证候疗效，Fugl- Meyer运动功能评分量表（Fugl- Meyer motor function assessment，FMA）评估患者运动功能，Berg平衡量表（Berg balance scale，BBS）评估患者平衡功能，改良Barthel指数（modified Barthel index，MBI）评估患者日常生活能力，并进行临床疗效评价。结果 与治疗前比较，两组患者治疗后中医证候积分显著降低（P<0.05），治疗组中医证候积分降低程度显著大于对照组（P<0.05）。与治疗前比较，两组患者治疗后FMA评分、BBS评分、MBI评分均显著升高（P<0.05），且治疗组FMA评分、BBS评分、MBI评分升高程度更显著（P<0.05）。治疗组临床疗效显著优于对照组（P<0.05）。结论 在针刺治疗基础上联用补阳还五汤加减内服可提高缺血性脑卒中后肢体运动功能障碍的疗效。

Clinical Effect of Modified Buyang Huanwu Decoction Combined with Acupuncture in Treatment of Limb Motor Dysfunction after Ischemic Stroke

Objective To investigate the clinical effect of modified Buyang Huanwu Decoction combined with acupuncture in the treatment of limb motor dysfunction after ischemic stroke. Methods A total of 64 patients were randomly divided into control group and treatment group; 2 patients in each group were lost to follow- up during the experiment, and finally 30 patients in each group completed the experiment. In addition to basic Western medicine treatment, the patients in the treatment group were given modified Buyang Huanwu Decoction combined with acupuncture, and those in the control group were given acupuncture alone, once a day and 6 times a week; all patients were treated for 28 days. Traditional Chinese medicine (TCM) syndrome score was used to evaluate the treatment outcome of TCM syndrome; Fugl- Meyer Assessment (FMA) Scale was used to evaluate motor function; Berg Balance Scale (BBS) was used to evaluate balance function; modified Barthel Index (MBI) was used to evaluate activities of daily living; clinical outcome was also assessed. Results After treatment, both groups had a significant reduction in TCM syndrome score (P<0.05), and the treatment group had a significantly greater reduction than the control group (P<0.05). After treatment, both groups had significant increases in FMA, BBS, and MBI scores (P<0.05), and the treatment group had significantly greater increases than the control group (P<0.05). The treatment group had a significantly better clinical outcome than the control group (P<0.05). Conclusion Oral administration of modified Buyang Huanwu Decoction combined with acupuncture can improve the treatment outcome of limb motor dysfunction after ischemic stroke.