本文關(guān)鍵詞：白脈軟膏聯(lián)合藏藥浴治療腦卒中后肢體痙攣的臨床研究　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 腦卒中 肢體痙攣 五味甘露藥浴顆粒 白脈軟膏 現(xiàn)代康復(fù)訓(xùn)練

【摘要】：目的:本研究通過觀察白脈軟膏結(jié)合五味甘露藥浴對腦卒中后肢體痙攣的臨床療效,明確白脈軟膏結(jié)合五味甘露藥浴對緩解腦卒中后肢體痙攣的有效性,并觀察此研究對患者肢體運(yùn)動功能改善及日常生活能力提高的情況,為臨床治療腦卒中后肢體痙攣的研究提供安全有效的新療法。方法:本研究為國家"十二五"科技支撐計(jì)劃《腦卒中后痙攣的中醫(yī)康復(fù)臨床規(guī)范研究》的一部分,利用中心電腦隨機(jī)分配的方法,將腦卒中后肢體痙攣患者隨機(jī)分為A、B、C三組,本中心A組(現(xiàn)代康復(fù)組)25例,B組(白脈軟膏組)29例,C組(白脈軟膏+五味甘露藥浴組)23例。A組病人給予基礎(chǔ)治療及現(xiàn)代康復(fù)訓(xùn)練,B組給予基礎(chǔ)治療、現(xiàn)代康復(fù)訓(xùn)練及白脈軟膏涂擦,C組在B組基礎(chǔ)上再加五味甘露藥浴顆粒藥浴,療程為4周。分別在治療前、治療4周后對患者進(jìn)行肢體功能狀況評估,包括肢體痙攣程度(改良Ashworth量表MAS)、日常生活活動能力(改良Barthel指數(shù)MBI)及肢體運(yùn)動功能(簡易Fugl-Meyer評定量表FMA),收集各組數(shù)據(jù),采用SPSS 21.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,得出結(jié)論。結(jié)果:一、基線比較:A、B、C三組患者一般資料(包括年齡、性別、病程、病性)及治療前MMSE、MAS、FMA及MBI評分之間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。二、組內(nèi)比較:治療4周后,三組患者肢體痙攣程度MAS評分與治療前比較均有下降,FMA及MBI評分均明顯升高,與治療前相比評分差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。三、組間比較:治療4周后,C組MAS評分及FMA評分較A組改善明顯,且兩組間療效對比差異具有的統(tǒng)計(jì)學(xué)意義(P0.05);C組在MAS評分與B組MAS評分的差異具有統(tǒng)計(jì)學(xué)意義(P0.05),在FMA評分上差異無統(tǒng)計(jì)學(xué)意義(P0.05);B組FMA評分及MAS評分較A組升高明顯,但兩組間療效差異沒有統(tǒng)計(jì)學(xué)意義(P0.05);A、B、C三組治療后MBI評分差異無統(tǒng)計(jì)學(xué)意義(P0.05)。四、分層比較,對病程、年齡分層分析統(tǒng)計(jì)結(jié)果顯示,三組數(shù)據(jù)在年齡、病程分層研究中的差異沒有統(tǒng)計(jì)學(xué)意義(P0.05)。五、研究過程中1例患者因發(fā)現(xiàn)腫瘤,終止試驗(yàn)研究。結(jié)論:一、三組治療均可緩解腦卒中后肢體痙攣程度,C組患者療效比A、B組顯著,且其差異具有統(tǒng)計(jì)學(xué)意義;B組患者療效比A組顯著,其差異無統(tǒng)計(jì)學(xué)意義,可能是組間例數(shù)不等、治療周期短或樣本量少所致。二、三組治療方案均對腦卒中后肢體痙攣患者的運(yùn)動功能及日常生活活動能力具有改善作用,C組在FMA改善方面比A、B組顯著;MBI評分前后差值高于A、B兩組,但差異不具有統(tǒng)計(jì)學(xué)意義;B組在FMA及MBI前后差值高于A組,但差異沒有統(tǒng)計(jì)學(xué)意義,陰性結(jié)果可能是組間例數(shù)不等、治療周期短或樣本量偏少所致。三、根據(jù)病程、年齡分層分析發(fā)現(xiàn)三組各項(xiàng)評分前后差值的差異無統(tǒng)計(jì)學(xué)意義,但由于樣本量偏少,組內(nèi)分層后人數(shù)不等,以及各種因素相互作用,試驗(yàn)結(jié)果可能為陰性,還需要增加樣本量試驗(yàn)驗(yàn)證。四、該研究未出現(xiàn)不良反應(yīng),具有可靠的安全性。
[Abstract]:Objective: to observe the clinical effect of Baimai ointment combined with five kinds of mannu on limb spasm after stroke, and to clarify the effectiveness of Baimai ointment combined with Wuwei mannu medicine bath in relieving limb spasm after stroke. We also observed the improvement of motor function and daily living ability of patients in this study. To provide a safe and effective new therapy for the treatment of limb spasm after stroke. A part of the S & T support Program "Clinical norms of TCM Rehabilitation for Post-Stroke spasm". Patients with limb spasm after stroke were randomly divided into three groups: group A (25 cases of modern rehabilitation group) and group B (29 cases of Baimai ointment group). Group C (Baimai ointment, Wuwei mannu, 23 cases, group A) were given basic treatment and modern rehabilitation training. Group B was given basic treatment, modern rehabilitation training and Baimai ointment were smeared. Group C on the basis of B plus five kinds of mannose medicine bath, the course of treatment is 4 weeks. Before treatment, 4 weeks after treatment to evaluate the limb function of the patients. Including limb spasticity (modified Ashworth scale as). Activity of daily living (Barthel index) and limb motor function (Fugl-Meyer) were collected. The results were as follows: 1. Baseline comparison of general data (including age, sex, course of disease) of three groups of patients (including age, sex and course of disease) was made by using SPSS 21. 0 software. There was no significant difference in FMA and MBI scores between the two groups before and before treatment (P 0.05). Second, intragroup comparison: after 4 weeks of treatment. The MAS score of limb spasm degree in the three groups was significantly lower than that before treatment, and the scores of FMA and MBI were significantly higher than those before treatment (P 0.05). Comparison between groups: after 4 weeks of treatment, the scores of MAS and FMA in group C were significantly improved than those in group A, and the difference in curative effect between the two groups was statistically significant (P 0.05). The difference of MAS score between group C and group B was statistically significant (P 0.05), but there was no significant difference in FMA score between group C and group B (P 0.05). The scores of FMA and MAS in group B were significantly higher than those in group A, but there was no significant difference in curative effect between the two groups (P 0.05). There was no significant difference in MBI scores among the three groups after treatment (P 0.05). Fourth, the statistical results of the course of disease and age stratification analysis showed that the three groups of data were in the age. There was no significant difference in the course of the disease in the stratification study P0.05. 5. During the course of the study, one patient terminated the trial because of the discovery of the tumor. Conclusion: 1. The curative effect of group C was better than that of group A B, and the difference was statistically significant. The curative effect of group B was more significant than that of group A, and the difference was not statistically significant. It may be due to the difference in the number of cases between groups, the short period of treatment or the small sample size. 2. All the three treatments improved motor function and activity of daily living (ADL) of patients with limb spasm after stroke. The improvement of FMA in group C was significantly higher than that in group A (n = 5). The difference before and after MBI score was higher than that in group A and B, but the difference was not statistically significant. The difference before and after FMA and MBI in group B was higher than that in group A, but the difference was not statistically significant. The negative results may be caused by different cases, short treatment period or small sample size. Third, according to the course of disease. Age stratification analysis found that there was no significant difference between the three groups before and after scoring, but due to the small sample size, the number of people in the group after stratification, as well as the interaction of various factors, the test results may be negative. It also needs to increase sample size test verification. 4, this study has no adverse reactions, and has reliable safety.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.7

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