黄芪桂枝五物汤联合悬吊训练治疗不完全性脊髓损伤患者的康复效果分析

Rehabilitation efficacy in patients with incomplete spinal cord injury treated with Huangqi Guizhi Wuwu Decoction combined with suspension training

摘要:

目的 探讨黄芪桂枝五物汤联合悬吊训练治疗不完全性脊髓损伤患者的康复效果及对血清胶质纤维酸性蛋白（GFAP）、神经生长因子（NGF）的影响。方法 选取2018年2月—2019年12月河北北方学院附属第一医院收治的32例不完全性脊髓损伤患者为研究对象，随机分为对照组、研究组，每组16例。对照组给予常规综合康复训练联合悬吊训练治疗，研究组在对照组基础上另给予黄芪桂枝五物汤，两组均持续治疗8周后评价效果。记录两组中医症状积分及临床疗效，统计两组肌力、肌张力及下肢运动功能情况，对比两组平衡能力及日常生活活动功能的变化，记录两组血清NGF、GFAP及不良事件发生情况。结果 研究组治疗前后的主症、次症中医证候评分，以及徒手肌力评定评分、改良Ashworth痉挛量表评分的下降程度大于对照组（P <0.05）。研究组总有效率高于对照组（P <0.05）。研究组治疗前后下肢运动评分、功能性步行能力量表评分、Berg平衡量表评分、Barthel指数（BI）评分、NGF、GFAP的差值高于对照组（P <0.05）。两组治疗期间无不良事件发生。结论 黄芪桂枝五物汤治疗不完全性脊髓损伤患者可提高康复效果，改善肌力、肌张力、下肢运动功能、日常生活能力及神经营养因子，且安全性良好。

Abstract:

Objective To explore the rehabilitation efficacy in patients with incomplete spinal cord injury (SCI) treated with Huangqi Guizhi Wuwu Decoction combined with suspension training and the effects of the treatment on serum glial fibrillary acidic protein (GFAP) and nerve growth factor (NGF).Methods A total of 32 patients with incomplete SCI admitted to our hospital from February 2018 to December 2019 were randomly divided into control group and study group, with 16 cases in each group. The control group was given conventional comprehensive rehabilitation training combined with suspension training, and the study group was additionally given Huangqi Guizhi Wuwu Decoction. Both groups were treated for consecutive 8 weeks and then the therapeutic effect was evaluated. The scores of TCM symptoms and clinical efficacy of the two groups were recorded. The muscle strength, muscle tone and lower limb motor function of the two groups were evaluated. The changes in balance function and activities of daily living were compared between the two groups. The serum levels of NGF and GFAP and the adverse events were recorded in the two groups.Results The decreases in the scores of primary and secondary TCM syndromes, manual muscle test, and Modified Ashworth Scale after the treatment in the study group were higher than those in the control group (P < 0.05). The total effective rate in the study group was higher than that in the control group (P < 0.05). The differences in the scores of lower extremity motor function, Functional Ambulation Categories, Berg Balance Scale, and Barthel Index, as well as the levels of NGF and GFAP before and after the treatment in the study group were greater than those in the control group (P < 0.05). There was no adverse event during the treatment period in the two groups.Conclusions Huangqi Guizhi Wuwu Decoction can enhance the rehabilitation efficacy in patients with incomplete SCI. It improves muscle strength, muscle tone, lower limb motor function, activities of daily living and the levels of neurotrophic factors without safety concerns.