何萍+石国锋+倪健强+时兢

【摘要】目的探討早期康复训练联合口服脉血康对脑梗死后下肢功能和痉挛性瘫痪的治疗效果。方法选择2015年5月～2017年4月收治入院的急性脑梗死患者97 例，根据出院后采用的康复治疗方式分为三组，对照组30 例，出院后自行康复治疗；康复联合脉血康组36 例，使用脉血康胶囊联合早期康复训练；康复组31 例，单纯使用早期康复训练。记录急性期脑梗死患者的Ashworth痉挛量表评分、简化FMA（Fugl-Meyer assessment，FMA）下肢评分及Barthel评分，90 天时完成随访，记录治疗90 天后Ashworth评分、下肢FMA及Barthel评分。结果三组患者在急性期的Ashworth评分、下肢FMA评分和Barthel评分差异无统计学意义（P>0.05）， 90天时康复联合脉血康组和康复组FMA评分、Barthel评分均高于对照组（P<0.05或0.01），Ashworth评分低于对照组（P<0.05或0.01）。康复联合脉血康组与康复组之间比较， 90天Ashworth评分差异无统计学意义 （P>0.05），而联合使用脉血康后，90天时下肢FMA评分和Barthel评分高于普通康复组（P<0.01）。结论康复联合脉血康治疗能更好地恢复脑梗死患者下肢功能，治疗痉挛性瘫痪，提高患者的日常生活能力。

【关键词】脉血康；脑梗死；康复；下肢功能

中图分类号：R743.32 文献标识码：ADOI：10.3969/j.issn.1003-1383.2017.04.007

【Abstract】ObjectiveTo observe the treatment effect of early rehabilitation therapy combined with oral Maixuekang on lower limb function and spastic paralysis after cerebral infarction.Methods97 patients with acute cerebral infarction admitted to hospital from May，2015 to April，2017 were selected.And then all patients were divided into three groups according to the rehabilitation methods after discharge：control group（n=30），recovered at home without any treatment；rehabilitation combined with Maixuekang group（n=36），given early rehabilitation therapy combined with oral Maixuekang；rehabilitation group（n=31），given early rehabilitation therapy only.The score of Ashworth spasticity scale，lower limb FMA（Fugl-Meyer assessment）score and Barthel score in patients with acute cerebral infarction were recorded.Follow-up visits were completed at 90 days，and the score of Ashworth spasticity scale，lower limb FMA score and Barthel score were recorded 90 days after treatment.ResultsThere was no significantly statistical difference in the Ashworth score，the lower limb FMA score and the Barthel score between the three groups（P>0.05）.At 90 days，lower limb FMA scores and Barthel scores of the rehabilitation combined with Maixuekang group and the rehabilitation group were higher than those of the control group（P<0.05 or 0.01），but the score of Ashworth spasticity scale were lower than that of the control group（P<0.05 or 0.01）.The difference of Ashworth scores at 90 days between the rehabilitation combined with Maixuekang group and the rehabilitation group was not statistically significant（P>0.05），but after the use of Maixuekang for 90 days，lower limb FMA and Barthel scores of the rehabilitation combined with Maixuekang group were higher than that of the rehabilitation group（P<0.01）.ConclusionEarly rehabilitation combined with Maixuekang can better restore the lower limb function of patients with cerebral infarction，treat spastic paralysis，and improve the daily living ability of patients.endprint

【Key words】Maixuekang；cerebral infarction；rehabilitation；lower limb function

缺血性脑卒中是临床常见病、多发病，每年我国新增病例超过200万人，其致残、致死率高，引起临床工作者的重视[1]。大部分患者在治疗后常遗留不同程度的残疾，影响功能恢复，无法独立生活，给个人和家庭带来痛苦。研究已经证实，专业的康复训练是脑卒中恢复中的重要一环。脑卒中患者中枢神经系统在结构和功能上存在重组和再生的可能，因此加强脑卒中恢复期的康复训练有助于最大程度激发患者神经修复潜能，并且可以预防各种相关并发症的出现[2]。在脑卒中的康复治疗实践过程中，患者容易出现偏瘫侧下肢伸肌痉挛，呈现偏瘫步态[3]。但是……