目的 观察白芍络石方治疗脑梗死后痉挛性瘫痪的临床疗效及其安全性.方法 选取符合诊断的脑梗死后痉挛性瘫痪患者60例,采用随机、平行对照方法,分为中药组及对照组各30例.对照组予以常规治疗,中药组在常规治疗的基础上加用白芍络石方治疗,两组疗程均为4周.观察治疗前、治疗第2周末、第4周末的肌力(Robert Lovett法评定)、上肢肌张力(MAS评分评价)、下肢肌张力(CSS评分评价)、神经功能缺损程度(NIHSS评分评价)及日常生活能力(MBI评分评价)的变化,并观察干预后的不良反应.结果 治疗2周后中药组患者肢体上下肢肌力、上肢肌张力改善明显优于对照组(P<0.05),治疗4周后中药组下肢肌力、MBI评分、NIHSS评分改善明显优于对照组(P<0.05),且治疗过程中未出现明显血常规、肝肾功能异常等不良反应.结论 白芍络石方能改善脑梗死后偏瘫患者的运动能力,缓解偏瘫上肢的痉挛,提升其日常生活能力,且安全可靠.%Objective To evaluate the clinical efficacy and security of Baishaoluoshi decoction in treating spasticity after ischemic stroke. Methods 60 patients with post-stroke spasticity were randomly divided into Chinese medicine group (Baishao Luoshi decoction) and control group. The control group was received conventional therapy for 4 weeks, and the Chinese medicine group were treated with Baishao Luoshi decoction for 4 weeks on the basis of conventional therapy. Before treatment, after treatment for 2 weeks and 4 weeks, the myodynamia was evaluated by Robert Lovett's method, the muscle tension of the upper limb was evaluated by Modified Ashworth score (MAS), the muscle tension of the lower limb was evaluated by Compopsite Spasticity Scale (CSS), the neurological deficit symptoms were evaluated by National Institute of Health stroke scale (NIHSS), and the daily living ability was evaluated by Modified Barther Index (MBI). The adverse reaction after intervention was observed. Results After treatment for 2 weeks, the improvement of myodynamia of upper and lower limbs and muscle tension of the upper limb in Chinese Medicine group was better than that in the control group (P<0.05). After treatment for 4 weeks, the improvement of the myodynamia of lower limbs, MBI, and NIHSS were superior to that in the control group (P<0.05). In addition, there was no negative effects of blood routine, liver and kidney functions during treatment.Conclusion Baishao Luoshi decoction can enhance the motor function, ameliorate the spasticity of upper limb, improve the daily living ability in post-stroke spasticity patients, and with a reliable security.
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