本文關(guān)鍵詞：愈癱膠囊結(jié)合康復(fù)訓(xùn)練治療脊髓損傷后下肢痙攣的短期臨床療效觀察　出處：《福建中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 脊髓損傷 下肢痙攣 愈癱膠囊 康復(fù)治療

【摘要】：目的觀察中藥制劑愈癱膠囊結(jié)合康復(fù)訓(xùn)練對(duì)脊髓損傷后下肢痙攣狀態(tài)、肌電圖F波的影響,探討愈癱膠囊結(jié)合康復(fù)訓(xùn)練對(duì)脊髓損傷后下肢痙攣狀態(tài)的治療作用,為愈癱膠囊治療脊髓損傷后下肢痙攣狀態(tài)的臨床療效提供一定的參考依據(jù)。方法采用前瞻性隨機(jī)對(duì)照單盲的研究方法。病例選擇：將符合納入標(biāo)準(zhǔn)的46例脊髓損傷后下肢痙攣狀態(tài)患者,隨機(jī)分為實(shí)驗(yàn)組(愈癱膠囊+常規(guī)康復(fù)治療)和對(duì)照組(常規(guī)康復(fù)治療)。治療方法：試驗(yàn)組在服用洛陽(yáng)正骨醫(yī)院院內(nèi)制劑愈癱膠囊基礎(chǔ)上結(jié)合常規(guī)康復(fù)治療,對(duì)照組患者僅接受常規(guī)康復(fù)治療。愈癱膠囊服用方法為一次1.75g,3次/日,連續(xù)服用4周；康復(fù)訓(xùn)練1次/日,5日／周,共治療4周。在治療前、治療2周、治療4周(結(jié)束時(shí))、治療后1個(gè)月評(píng)定兩組患者下肢痙攣狀態(tài)。采用改良的Ashworth痙攣程度量表(Modified Ashworth Scale,MAS),臨床痙攣指數(shù)量表(Composite Spasticity Scale,CSS)評(píng)定痙攣狀態(tài),肌電圖F波的時(shí)間離散度及F波出現(xiàn)頻率的變化評(píng)定神經(jīng)功能的恢復(fù)。所得數(shù)據(jù),計(jì)量資料用x±s表示,采用SPSS 19.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果1痙攣緩解程度：兩組患者下肢MAS分級(jí)、CSS指數(shù)、MAS分級(jí)改善療效在治療2周、治療4周、治療后1個(gè)月與治療前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),優(yōu)于治療前。試驗(yàn)組與對(duì)照組比較,MAS分級(jí)、CSS指數(shù)、MAS分級(jí)改善療效在治療2周時(shí),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),在治療4周、治療后1個(gè)月時(shí),差異有統(tǒng)計(jì)學(xué)意義(P0.05),試驗(yàn)組優(yōu)于對(duì)照組。2肌電圖F波：兩組患者肌電圖F波時(shí)間離散度及平均出現(xiàn)率在治療2周時(shí)與治療前比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療4周、治療后1個(gè)月與治療前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),均低于治療前。試驗(yàn)組與對(duì)照組比較,肌電圖F波時(shí)間離散度及平均出現(xiàn)率在治療2周時(shí),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),在治療4周、治療后1個(gè)月時(shí),差異有統(tǒng)計(jì)學(xué)意義(P0.05),試驗(yàn)組低于對(duì)照組。結(jié)論愈癱膠囊結(jié)合康復(fù)治療和單一的康復(fù)治療均能緩解脊髓損傷患者的下肢痙攣狀態(tài),與單一的康復(fù)治療相比,愈癱膠囊結(jié)合康復(fù)治療緩解痙攣效果更好。
[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.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R651.2

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