低频神经肌肉电刺激联合活血通络舒筋方治疗脑卒中后偏瘫的临床研究

doi:10.3760/cma.j.cn441417-20250422-22003

摘要/Abstract

摘要： 目的　探讨低频神经肌肉电刺激联合活血通络舒筋方治疗脑卒中后偏瘫的疗效。方法　采用前瞻性研究，选取2022年3月至2024年3月兵器工业总医院收治的卒中后偏瘫患者92例，其中男49例、女43例，年龄（56.67±6.93）岁。采用电脑随机术法分为观察组和对照组，各46例。对照组给予低频神经肌肉电刺激治疗，观察组在对照组基础上采用活血通络舒筋方治疗，均治疗1个月。比较两组的临床疗效、肌张力、运动功能、日常活动能力、生活质量、偏瘫侧下肢肌电图、中医证候评分及不良反应。采用t检验、χ²检验进行统计分析。结果　观察组总有效率为95.65%（44/46），对照组为80.43%（37/46），差异有统计学意义（χ²=5.059，P<0.05）。治疗后肌张力低于治疗前，且观察组低于对照组，但差异均无统计学意义（均P>0.05）。治疗后两组偏瘫侧上肢Fugl-Meyer量表（FMA）评分、下肢FMA评分、日常活动能力及生活质量评分均高于治疗前，且观察组高于对照组［（52.06±5.71）分比（49.35±5.23）分，（26.51±4.08）分比（22.64±3.51）分，（56.18±6.74）分比（52.41±6.02）分，（82.03±9.51）分比（77.16±10.73）分，t=2.374、4.877、2.829、2.304，均P<0.05］。治疗后两组偏瘫侧下肢M波最大波幅（Mmax）、H波最大波幅（Hmax）、主证与次证评分均低于治疗前，且观察组低于对照组［（1.26±0.14）mV比（1.41±0.17）mV，（1.31±0.36）mV比（1.65±0.44）mV，（10.05±2.61）分比（11.48±3.54）分，（7.53±2.31）分比（9.06±2.52）分，t=4.620、4.056、2.205、3.035，均P<0.05］。两组在治疗期间未出现严重不良反应。结论　低频神经肌肉电刺激联合活血通络舒筋方治疗脑卒中后偏瘫患者疗效显著，有助于促进患者患侧运动功能的恢复。

关键词: 脑卒中, 偏瘫, 低频神经肌肉电刺激, 活血通络舒筋方

Abstract: Objective　To explore the effect of Huoxue Tongluo Shujin Formula combined with low-frequency neuromuscular electrical stimulation for patients with post-stroke hemiplegia. Methods　A total of 92 patients with post-stroke hemiplegia treated at Ordnance Industry General Hospital from March 2022 to March 2024 were selected for the prospective study, including 49 males and 43 females who were (56.67±6.93) years old. They were divided into an observation group and a control group using computerized randomization, with 46 cases in each group. The control group received low-frequency neuromuscular electrical stimulation; in addition, the observation group were treated with Huoxue Tongluo Shujin Formula. After one month's treatment, the clinical efficacies, muscle tonicities, motor function, daily living abilities, life quality, electromyography of lower limb on the hemiplegic side, scores of Chinese medicine symptoms, and incidence rates of adverse reactions were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　The clinical efficacy in the observation group was higher than that in the control group [95.65% (44/46) vs. 80.43% (37/46)], with a statistical difference (χ²=5.059; P<0.05). The muscle tension after the treatment was lower than that before the treatment, and that the observation group was lower than that the control group, but the differences were not statistically significant (all P > 0.05). After the treatment, the scores of Fugl-Meyer Assessment (FMA) of the upper and lower limbs on the hemiplegic side, daily living ability, and life quality were higher than those before the treatment in both groups, and the scores in the observation group were higher than those in the control group (52.06±5.71 vs. 49.35±5.23, 26.51±4.08 vs. 22.64±3.51, 56.18±6.74 vs. 52.41±6.02, and 82.03±9.51 vs. 77.16±10.73; t=2.374, 4.877, 2.829, and 2.304; all P<0.05). After the treatment, the maximum amplitude of M-wave (Mmax), maximum amplitude of H-wave (Hmax), and the scores of main and secondary syndromes were lower than those before the treatment in both groups, and those in the observation group were lower than those in the control group [(1.26±0.14) mV vs. (1.41±0.17) mV, (1.31±0.36) mV vs. (1.65±0.44) mV, 10.05±2.61 vs. 11.48±3.54, and 7.53±2.31 vs. 9.06±2.52; t=4.620, 4.056, 2.205, and 3.035; all P<0.05]. No serious adverse reactions were observed in either group during the treatment. Conclusion　Huoxue Tongluo Shujin Formula combined with low-frequency neuromuscular electrical stimulation for patients with post-stroke hemiplegia is effective and can promote their recovery of motor function.

Key words: Stroke, Hemiplegia, Low frequency neuromuscular electrical stimulation, Huoxue Tongluo Shujin , Formula

薛良李霁锋张桂莲. 低频神经肌肉电刺激联合活血通络舒筋方治疗脑卒中后偏瘫的临床研究[J]. 国际医药卫生导报, 2025, 31(22): 3705-3711.

Xue Liang, Li Jifeng, Zhang Guilian. Low-frequency neuromuscular electrical stimulation with Huoxue Tongluo Shujin Formula combined for patients with post-stroke hemiplegia[J]. International Medicine and Health Guidance News, 2025, 31(22): 3705-3711.

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