中药“拘挛方”泡洗缓解中风急性期后踝关节拘挛症状临床观察

发布时间：2018-06-23 13:26

本文选题：中药熏洗 + 中风　；参考：《北京中医药大学》2014年硕士论文

【摘要】：[目的] 评价中药熏洗疗法对改善中风急性期后踝关节拘挛的有效性和安全性。 [方法] 收集中风恢复期和后遗症期踝关节拘挛患者57例,符合纳入标准的患者27例,采用病例序列研究的方法,在给予常规的脑血管病基本药物治疗、康复训练治疗和针灸治疗的基础上,增加中药熏洗治疗,观察疗效及安全性。泡洗于每天睡前进行,时间为20min,治疗2周。分别在疗前、疗后、治疗结束后1个月采用综合痉挛量表、修订的改良Ashworth痉挛量表评分、踝关节背屈和跖屈角度及活动范围、拘挛症状VAS评分、疼痛症状VAS评分、麻木症状VAS评分、患者自身报告结局量表(PRO)等进行疗效评价。 [结果] 近期疗效评价：中药熏洗疗法治疗中风急性期后踝关节拘挛患者,应用综合痉挛量表评价,患者治疗前评分为12(2),治疗后评分为10(3),差异有显著统计学意义(P0.01)；应用修订的改良Ashworth痉挛量表评价,患者治疗前评级为2(0),治疗后评级为2(1),差异有统计学意义(PO.05)；在踝关节背屈角度方面,治疗前为97.20±9.11501°,治疗后为87.24±8.536°,差异有显著统计学意义(P0.01)；在踝关节跖屈角度方面,治疗前为129.48±6.740°,治疗后为134.56±5.026°,差异有显著统计学意义(P0.01)；在踝关节活动范围方面,治疗前为32.28±9.316°,治疗后为47.32±8.793°,差异有显著统计学意义(P0.01)；应用视觉类比评分法评价拘挛症状,治疗前评分为8(3),治疗后评分为6(5),差异有显著统计学意义(P0.01)；应用视觉类比评分法评价疼痛症状,治疗前评分为8(4),治疗后评分为1(5),差异有统计学意义(P0.05)；应用视觉类比评分法评价麻木症状,治疗前评分为7(3),治疗后评分为3(7),差异有显著统计学意义(P0.01)；应用患者自身报告结局量表评价,治疗前评分为23.56±9.90825,治疗后评分为26.24±6.180,差异有显著统计学意义(P0.01)。综合表明中药熏洗疗法对改善中风急性期后踝关节拘挛程度、踝关节背屈和跖屈角度及活动范围、拘挛症状、疼痛症状、麻木症状及自身结局评价均有明显改善。远期疗效评价：经统计学计算,治疗完成1个月后患者踝关节拘挛程度、拘挛症状、疼痛症状、麻木症状及自身结局评价较疗前显著改善,差异有显著统计学意义(P0.05)；除了患者自觉拘挛症状较治疗后略有反弹之外,患者踝关节拘挛程度、疼痛、麻木及自身结局评价较治疗结束后均无明显变化(P0.05)。表明停止中药熏洗治疗后,患者踝关节拘挛程度、疼痛、麻木及自身结局评价疗效稳定。安全性评价：纳入的27例患者,中药熏洗治疗过程中,没有出现近期及远期不适。表明中药熏洗疗法安全可靠。[结论] 初步观察中药熏洗疗法对改善中风恢复期和后遗症期踝关节拘挛症状的临床疗效和安全性。结果证实中药熏洗疗法不仅可以改善患者拘挛症状,对于中风后的疼痛、麻木症状也有很好的治疗效果,从而对于改善中风后患者自身结局评分亦有良好的影响。该疗法疗效确切,疗效稳定,安全性高,应用简便。
[Abstract]:Purpose of the project

To evaluate the efficacy and safety of traditional Chinese medicine fumigation and washing therapy on ankle joint spasm after acute stroke .

Methodology

A total of 57 patients were treated with routine cerebral vascular diseases , rehabilitation training and acupuncture therapy . The results were compared with routine treatment of cerebrovascular disease , rehabilitation training and acupuncture treatment . The results were as follows : 1 month after treatment , 2 weeks after treatment . The scores of the scores of the scores of the spasticity , VAS scores of pain symptom , VAS score of numbness symptom and the self - reported outcome scale ( PRO ) were evaluated .

The result is not valid .

Short - term curative effect evaluation : Chinese medicine fumigation and washing therapy was used to treat the patients with ankle joint after acute stroke , and the scores of patients before treatment were 12 ( 2 ) , 10 ( 3 ) after treatment and 10 ( 3 ) after treatment ( P0.01 ) .
Modified modified Ashworth spasticity scale was used to evaluate patients with a pre - treatment rating of 2 ( 0 ) and a post - treatment rating of 2 ( 1 ) , with a statistically significant difference ( PO.05 ) ;
In ankle dorsiflexion angle , 97.20 卤 9.115 01 掳 before treatment , 87.24 卤 8.536 掳 after treatment , there was significant difference ( P0.01 ) .
The angle of flexion of ankle was 129.48 卤 6.740 掳 before treatment and 134.56 卤 5.26 掳 after treatment ( P0.01 ) .
In the range of ankle activity , 32.28 卤 9.316 掳 before treatment , 47.32 卤 8.793 掳 after treatment , there was significant difference ( P0.01 ) .
The visual analog scoring method was used to evaluate the symptoms of the spasm , the score before treatment was 8 ( 3 ) , the post - treatment score was 6 ( 5 ) , the difference was statistically significant ( P0.01 ) .
The symptom of pain was evaluated by visual analog scoring method , the score before treatment was 8 ( 4 ) , the post - treatment score was 1 ( 5 ) , the difference was statistically significant ( P0.05 ) .
The scores of pre - treatment and post - treatment were 7 ( 3 ) , 3 ( 7 ) and 3 ( 7 ) after treatment , and the difference was statistically significant ( P0.01 ) .
The scores of pre - treatment were 23.56 卤 9.90825 and 26.24 卤 6.180 after treatment , and the scores were 26.24 卤 6.180 and 26.24 卤 6.180 , respectively .

Long - term curative effect evaluation : After statistic calculation , the degree of ankle joint spasm , spasm symptom , pain symptom , numbness symptom and self - outcome were significantly improved after 1 month after treatment , and the difference was statistically significant ( P0.05 ) .
There was no significant change in the degree of ankle joint , pain , numbness and self - outcome after the treatment of the patient ' s conscious myoclonus symptoms ( P0.05 ) .

Safety evaluation : There were no recent and long - term discomfort in 27 patients included in the traditional Chinese medicine fumigation and washing therapy . The results showed that the traditional Chinese medicine fumigation and washing therapy was safe and reliable .

The results showed that the traditional Chinese medicine fumigation therapy not only can improve the clinical curative effect and safety of the patients with stroke recovery period and sequelae period , but also has good curative effect on the pain and numbness symptom after stroke , so as to have good curative effect , stable curative effect , high safety and convenient application .
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

【参考文献】