Abstract:

Objective　To investigate the effect of Qidong Yixin Granules combined with core muscle group training on patients with spinal cord injury. Methods　A retrospective analysis was performed on 98 patients with spinal cord injury in Zhumadian Traditional Chinese Medicine Hospital from January 2022 to August 2024, and they were divided into a control group (47 cases) and a combination group (51 cases) according to different treatment methods. In the control group, there were 26 males and 21 females, aged 32-58 (44.03±4.05) years, the course of disease was 3-8 (5.84±1.07) months, the injured segments were thoracic segment in 25 cases, lumbar segment in 17 cases, and cervical segment in 5 cases, and the American Spinal Cord Injury Association (ASIA) classification was grade C in 29 cases and grade D in 18 cases. In the combination group, there were 28 males and 23 females, aged 30-55 (42.95±5.02) years, the course of disease was 3-9 (6.08±1.10) months, the injured segments were thoracic segment in 22 cases, lumbar segment in 19 cases, and cervical segment in 10 cases, and the ASIA classification was grade C in 30 cases and grade D in 21 cases. The control group received core muscle group training on the basis of conventional treatment, twice a day, 5 days a week; the combination group was treated with Qidong Yixin Granules orally on the basis of control group, 5 g/time, 3 times a day. Both groups were treated for 3 months. The clinical efficacies of the two groups were compared, as well as Fugl-Meyer Lower Limb Motor Function Assessment Scale (FMA-LE), Holden Walking Function Classification (FAC), Berg Balance Scale (BBS), ASIA motor score, plasma viscosity (PV), whole blood high shear viscosity (HBV), hematocrit (HCT), whole blood low shear viscosity (LBV), CD3⁺, CD4⁺/CD8⁺, and natural killer (NK) cell levels before treatment and 3 months after treatment. Statistical methods used were t test and χ² test. Results　The total effective rate of the combination group was higher than that of the control group [94.12% (48/51) vs. 76.60% (36/47)] (P=0.013). After 3 months of treatment, the FMA-LE [(26.48±2.56) points], FAC [(4.16±0.29) points], BBS [(36.13±6.41) points], and ASIA motor scores [(80.01±5.03) points] in the combination group were higher than those in the control group [(20.58±2.02) points, (2.68±0.42) points, (30.59±5.14) points, and (67.17±5.17) points] (all P<0.001); the PV [(1.31±0.11) mPa·s], HBV [(4.15±0.32) mPa·s], HCT [(42.10±2.07)%], LBV [(7.49±0.51) mPa·s], and CD8⁺ [(35.84±2.11)%] in the combination group were lower than those in the control group [(1.49±0.15) mPa·s, (4.87±0.39) mPa·s, (45.74±2.68)%, (9.11±0.63) mPa·s, and (41.69±1.87)%], and the CD3⁺ [(68.19±4.22)%], CD4⁺/CD8⁺ (1.67±0.16), and NK cells [(29.10±3.11)%] were higher than those in the control group [(59.69±3.48)%, 1.56±0.09, and (17.69±4.07)%] (all P<0.001). Conclusion　Qidong Yixin Granules combined with core muscle group training can improve the therapeutic effect of spinal cord injury patients, improve exercise and balance function, promote blood circulation, and enhance immune function.

Key words:

Spinal cord injury,  Qidong Yixin Granules,  Core muscle group training,  Lower limb function,  Balance ability

摘要：

目的　探讨脊髓损伤患者经芪冬颐心颗粒联合核心肌群训练治疗的效果。方法　回顾性分析2022年1月至2024年8月驻马店市中医院的98例脊髓损伤患者，按不同治疗方法分为对照组47例、联合组51例。对照组男26例、女21例，年龄32～58（44.03±4.05）岁；病程3～8（5.84±1.07）个月；损伤节段：胸段25例、腰段17例、颈段5例；美国脊髓损伤协会（ASIA）分级：C级29例、D级18例。联合组男28例、女23例，年龄30～55（42.95±5.02）岁；病程3～9（6.08±1.10）个月；损伤节段：胸段22例、腰段19例、颈段10例；ASIA分级：C级30例、D级21例。对照组在常规治疗基础上采用核心肌群训练，2次/d，5 d/周；联合组在对照组基础上口服芪冬颐心颗粒治疗，5 g/次，3次/d。两组均持续治疗3个月。比较两组临床疗效，治疗前、治疗3个月后的Fugl-Meyer下肢运动功能评定量表（FMA-LE）、Holden步行功能分级（FAC）、Berg平衡量表（BBS）、ASIA运动评分、血浆黏度（PV）、全血高切黏度（HBV）、红细胞压积（HCT）、全血低切黏度（LBV）、CD3⁺、CD4⁺/CD8⁺、自然杀伤（NK）细胞水平。统计学方法采用t检验、χ²检验。结果　联合组总有效率高于对照组［94.12%（48/51）比76.60%（36/47）］（P=0.013）。治疗3个月后，联合组FMA-LE［（26.48±2.56）分］、FAC［（4.16±0.29）分］、BBS［（36.13±6.41）分］、ASIA运动评分［（80.01±5.03）分］均高于对照组［（20.58±2.02）分、（2.68±0.42）分、（30.59±5.14）分、（67.17±5.17）分］（均P<0.001）；联合组PV［（1.31±0.11）mPa·s］、HBV［（4.15±0.32）mPa·s］、HCT［（42.10±2.07）%］、LBV［（7.49±0.51）mPa·s］、CD8⁺［（35.84±2.11）%］低于对照组［（1.49±0.15）mPa·s、（4.87±0.39）mPa·s、（45.74±2.68）%、（9.11±0.63）mPa·s、（41.69±1.87）%］，CD3⁺［（68.19±4.22）%］、CD4⁺/CD8⁺（1.67±0.16）、NK细胞［（29.10±3.11）%］高于对照组［（59.69±3.48）%、1.56±0.09、（17.69±4.07）%］（均P<0.001）。结论　芪冬颐心颗粒联合核心肌群训练可提高脊髓损伤患者疗效，改善运动与平衡功能，促进血液循环，提高免疫功能。

关键词:

脊髓损伤, 芪冬颐心颗粒, 核心肌群训练, 下肢功能, 平衡能力