补气健脑通络汤对气虚血瘀证缺血性脑卒中恢复期运动障碍的改善

目的:观察补气健脑通络汤联合针灸治疗缺血性脑卒中(气虚血瘀证)恢复期运动障碍的临床疗效及对血清S-100B蛋白(S-100B),同型半胱氨酸(Hcy)水平的影响。方法:将96例缺血性脑卒中患者采用随机按住院前后顺序分为针灸组和观察组各48例。两组均采用常规内科治疗和肢体康复训练;针灸组采用针刺治疗,3次/周;观察组在针灸组治疗的基础上服用补气健脑通络汤,1剂/d,常规早晚水煎内服。两组疗程均为8周。采用Brunstrom评价两组临床疗效;对两组治疗前后上、下肢肌力和运动功能(FMMS),日常生活活动(BI)指数,平衡能力(BBS)和步行能力进行评分;检测两组治疗前后血清S-100B和Hcy水平。结果:观察组临床总有效率为87.5%,针灸组为68.75%,观察组优于针灸组(P0.05);治疗后观察组上、下肢肌力评分明显低于针灸组(P0.01),FMMS评分明显高于针灸组(P0.01);观察组治疗后BI和BBS评分显著高于针灸组(P0.01),步行能力评分明显低于针灸组(P0.01);观察组治疗后血清S-100B和Hcy水平低于针灸组,比较差异均有统计学意义(P0.01)。结论:在常规内科和肢体康复训练治疗的基础上,补气健脑汤联合针灸治疗缺血性脑卒中(气虚血瘀证)恢复期患者,能明显改善患者上、下肢肌张力和运动功能,提高日常生活活动能力,提高平衡能力和步行能力,同时降低了患者血清S-100B和Hcy水平。

Effect of Buqi Jiannao Tongluo Tang on Improvement of Movement Disorder in Recovery Stage of Ischemic Stroke with Qi Deficiency and Blood Stasis Syndrome

Objective: To observe the clinical efficacy of Buqi Jiannao Tongluo Tang combined with acupuncture in improving ischemic stroke (syndrome of blood stasis due to qi deficiency) at recovery phase and its effect on serum S-100B protein (S-100B) and homocysteine(Hcy). Method: Ninety-six cases patients with ischemic stroke were randomly divided into acupuncture group (48 cases) and observation group (48 cases) according to their hospitalization sequence. All cases were given with conventional medical treatment and rehabilitation training for limbs. Patients in acupuncture group received the therapy of acupuncture (3 times/week). On the basis of acupuncture group,the patients in treatment group were also treated with Buqi Jiannao Tongluo Tang (1 dose/day,bid) with conventional water frying. The treatment course was 8 weeks for both groups. The clinical efficacy was evaluated by Brunstrom method. Muscle strength and Fugl-Meyer motor scale(FMMS) for upper and lower limbs,activities of daily living (BI index),Berg balance scale(BBS) and walking ability were assessed before and after treatment in both groups. Serum levels of S-100B and Hcy were detected before and after treatment in both groups. Result: The total effective rate was 87.5% in observation group, superior to 68.75% in acupuncture group (P<0.05). After treatment, muscle strength scores for upper and lower limbs in observation group were significantly lower than those in acupuncture group(P<0.01),while FMMS scores were significantly higher than those in acupuncture group(P<0.01). After treatment, BI and BBS scores in the observation group were significantly higher than those of acupuncture group (P<0.01), and score for walking ability of observation group was lower than that in acupuncture group after treatment (P<0.01). S-100B and Hcy serum levels in observation group were significantly lower than those of acupuncture group after treatment with statistically significant difference between two groups (P<0.01). Conclusion: On the basis of conventional medical treatment and rehabilitation training for limbs,Buqi Jiannao Tongluo Tang combined with acupuncture can improve muscle strength and motor function for upper and lower limbs,activity of daily living,ability of balance,and walking ability,and reduce serum levels of S-100B and Hcy for the treatment of ischemic stroke (syndrome of blood stasis due to qi deficiency) at recovery phase.