愈瘫胶囊结合康复训练治疗脊髓损伤后下肢痉挛的短期临床疗效观察

发布时间：2017-12-27 20:28

本文关键词：愈瘫胶囊结合康复训练治疗脊髓损伤后下肢痉挛的短期临床疗效观察　出处：《福建中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的观察中药制剂愈瘫胶囊结合康复训练对脊髓损伤后下肢痉挛状态、肌电图F波的影响,探讨愈瘫胶囊结合康复训练对脊髓损伤后下肢痉挛状态的治疗作用,为愈瘫胶囊治疗脊髓损伤后下肢痉挛状态的临床疗效提供一定的参考依据。方法采用前瞻性随机对照单盲的研究方法。病例选择：将符合纳入标准的46例脊髓损伤后下肢痉挛状态患者,随机分为实验组(愈瘫胶囊+常规康复治疗)和对照组(常规康复治疗)。治疗方法：试验组在服用洛阳正骨医院院内制剂愈瘫胶囊基础上结合常规康复治疗,对照组患者仅接受常规康复治疗。愈瘫胶囊服用方法为一次1.75g,3次/日,连续服用4周；康复训练1次/日,5日／周,共治疗4周。在治疗前、治疗2周、治疗4周(结束时)、治疗后1个月评定两组患者下肢痉挛状态。采用改良的Ashworth痉挛程度量表(Modified Ashworth Scale,MAS),临床痉挛指数量表(Composite Spasticity Scale,CSS)评定痉挛状态,肌电图F波的时间离散度及F波出现频率的变化评定神经功能的恢复。所得数据,计量资料用x±s表示,采用SPSS 19.0统计软件进行统计分析。结果1痉挛缓解程度：两组患者下肢MAS分级、CSS指数、MAS分级改善疗效在治疗2周、治疗4周、治疗后1个月与治疗前比较,差异有统计学意义(P0.05),优于治疗前。试验组与对照组比较,MAS分级、CSS指数、MAS分级改善疗效在治疗2周时,差异无统计学意义(P0.05),在治疗4周、治疗后1个月时,差异有统计学意义(P0.05),试验组优于对照组。2肌电图F波：两组患者肌电图F波时间离散度及平均出现率在治疗2周时与治疗前比较,差异无统计学意义(P0.05)。治疗4周、治疗后1个月与治疗前比较,差异有统计学意义(P0.05),均低于治疗前。试验组与对照组比较,肌电图F波时间离散度及平均出现率在治疗2周时,差异无统计学意义(P0.05),在治疗4周、治疗后1个月时,差异有统计学意义(P0.05),试验组低于对照组。结论愈瘫胶囊结合康复治疗和单一的康复治疗均能缓解脊髓损伤患者的下肢痉挛状态,与单一的康复治疗相比,愈瘫胶囊结合康复治疗缓解痉挛效果更好。
[Abstract]:Objective To observe the traditional Chinese medicine preparation Yutan capsule combined with rehabilitation training on lower limb spasticity, EMG F wave after spinal cord injury, to investigate the Yutan capsule combined with rehabilitation training in treating lower limb spasticity after spinal cord injury, and to provide reference for the clinical curative effect of Yutan capsule in the treatment of spinal cord injury after lower limb spasm state. Methods a prospective randomized, randomized, single blind study was used. Case selection: 46 patients with lower limb spasticity after spinal cord injury who were eligible for inclusion criteria were randomly divided into the experimental group (Yu Pai Capsule plus routine rehabilitation therapy) and the control group (routine rehabilitation therapy). Treatment: the experimental group received routine rehabilitation therapy combined with the rehabilitation capsule on the basis of Luoyang Bone-setting Hospital, while the control group received conventional rehabilitation only. The therapy of healing capsule was 1.75g, 3 times per day for 4 weeks, rehabilitation training 1 times / day, 5 days / week for 4 weeks. The lower extremity spasm was evaluated in two groups of patients before treatment, 2 weeks, 4 weeks (end) and 1 months after treatment. The Ashworth Modified Ashworth Scale (MAS) and the clinical spasm index scale (Composite Spasticity Scale, CSS) were used to evaluate spasticity, the time dispersion of electromyogram F wave and the frequency of the occurrence of F waves, and to evaluate the recovery of neurological function. The data were obtained and the measurement data were expressed by X + s, and the statistical analysis was carried out by the SPSS 19 statistical software. Results 1, the degree of spasticity relieved: two groups of patients with lower extremity MAS grade, CSS index and MAS classification improved the curative effect in 2 weeks, 4 weeks after treatment and 1 months after treatment, the difference was statistically significant (P0.05), better than before treatment. Compared with the control group, the MAS grading, CSS index and MAS grading improved the curative effect. The difference was not statistically significant at 2 weeks of treatment (P0.05). The difference was statistically significant at 4 weeks, 1 months after treatment (P0.05), and the test group was better than the control group. 2 F wave of electromyography: the time dispersion and average rate of F wave of electromyography in the two groups were compared with that before treatment at 2 weeks (P0.05). 4 weeks of treatment and 1 months after treatment compared with before treatment, the difference was statistically significant (P0.05), all lower than before the treatment. Compared with the control group, the time discrepancy and the average occurrence rate of F wave in the electromyographic group were not statistically significant at 2 weeks (P0.05). There was a statistically significant difference between the 4 weeks and 1 months after treatment (P0.05), and the experimental group was lower than the control group. Conclusion Yu Pai capsule combined with rehabilitation therapy and single rehabilitation therapy can relieve the spasticity of lower limbs in patients with spinal cord injury. Compared with single rehabilitation therapy, Yu Pai capsule combined with rehabilitation therapy has a better effect on relieving spasticity.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R651.2

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