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Article(id=1322926407604642586, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.08.043, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339834356, onlineDateStr=2026-10-30, pubDate=1754755200000, pubDateStr=2025-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339834356, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339834356, creator=13701087609, updateTime=1793339834356, updator=13701087609, issue=Issue{id=1322926217711726961, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='8', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1754755200000', pubDateStr='2025-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339789083, creator='13701087609', updateTime=1793340517761, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929274071679978, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929274071679979, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=220, endPage=223, ext={EN=ArticleExt(id=1322926407873078043, articleId=1322926407604642586, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Curative Effect of Yangyin Tongbi Jiejing Decoction（养阴通痹解痉汤）Combined with Functional Training on Hemiplegia after Stroke and Its Effect on Hemorheology, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the effect of Yangyin Tongbi Jiejing Decoction（养阴通痹解痉汤）combined with functional training on hemiplegia after stroke.

Methods

A total of 108 patients with hemiplegia after stroke in the hospital were randomly divided into two groups with 54 patients in each group.The control group was given functional training，including regular turning over，positioning of the affected limb，sitting and sitting balance，sitting and standing transfer training，standing balance training，etc.The treatment group was given Yangyin Tongbi Jiezhu Decoction（1 dose/d）on the basis of the control group.The treatment time was 4 weeks.The therapeutic effect，TCM syndrome scores，Fugl-Meyer assessment scale（FMA），Barthel index（BI）Stroke-Specific Quality of Life Scale（SS-QOL），hemiplegic side knee joint，lower limb hip joint extension muscle strength，ankle dorsiflexion muscle strength，serum inflammatory factors and hemorheology index levels were compared after treatment.

Results

After treatment，the total effective rate of the treatment group was higher（P<0.05）.After treatment，the Fugl-Meyer score，BI score and SS-QOL score，the extension muscle strength of hemiplegic knee joint，lower limb hip joint and the dorsiflexion muscle strength of ankle joint in both groups were significantly higher than those before treatment（P<0.05）.And these indexes of the treatment group increased more obviously（P<0.05）.After treatment，the levels of hematocrit（Hct），plasma fibrinogen（FIB）and plasma viscosity（PV），serum tumor necrosis factor alpha（TNF-α），interleukin6（IL-6）and hypersensitive C-reactive protein（hs-CRP），and TCM syndrome scores in both groups were significantly lower than those before treatment（P<0.05），and the decrease was significant in the treatment group（P<0.05）.

Conclusion

Yangyin Tongbi Jiejing Decoction combined with functional training has a good effect on patients with hemiplegia after stroke.

, authors=Huaping JIN, Ting ZHU, Wei WU, Xinxing ZHU, Boye NI, authorsList=Huaping JIN, Ting ZHU, Wei WU, Xinxing ZHU, Boye NI, authorCompany=null, correspAuthors=Boye NI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322926409294947110, articleId=1322926407604642586, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=养阴通痹解痉汤联合功能训练治疗卒中后偏瘫的疗效及对血液流变学指标水平影响, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

探讨卒中后偏瘫采用养阴通痹解痉汤联合功能训练治疗的疗效。

方法

选取108例卒中后偏瘫患者，随机分为两组，每组54例。对照组给予功能训练，包括定时翻身、患肢位摆放、坐位及坐位平衡、坐站转移训练、站立平衡训练等，治疗组在对照组基础上给予养阴通痹解痉汤，1剂/d，治疗时间为4周。对比治疗后的疗效、中医证候积分、偏瘫身体功能评分法（Fugl-Meyer assessment scale，FMA）、日常生活活动能力（Barthel index，BI）和脑卒中专用生活质量量表（Stroke-specific quality of life scale，SS-QOL）、偏瘫侧膝关节、下肢髋关节伸展肌力及踝关节背曲肌力、血清炎性因子水平及血液流变学指标水平。

结果

经过治疗后，治疗组总有效率较高（P<0.05）；治疗后两组Fugl-Meyer评分、BI评分和SS-QOL评分及偏瘫侧膝关节、下肢髋关节伸展肌力及踝关节背曲肌力较治疗前明显升高（P<0.05）；并且治疗组升高较多（P<0.05）；治疗后两组患者血细胞比容（Hematocrit，HCT）、血浆纤维蛋白原（Fibrinogen，FIB）和血浆黏度（Plasma viscosity，PV）水平、血清肿瘤坏死因子-α（Tumor necrosis factor alpha，TNF-α）、白细胞介素-6（Interleukin6，IL-6）、超敏C反应蛋白（Hypersensitive c-reactive protein，hs-CRP）水平及中医证候评分较治疗前显著较低（P<0.05），且治疗组降低较多（P<0.05）。

结论

卒中后偏瘫患者采用养阴通痹解痉汤联合功能训练治疗具有较好的疗效。

, authors=金华平, 朱婷, 吴炜, 朱新星, 倪波业, authorsList=金华平, 朱婷, 吴炜, 朱新星, 倪波业, authorCompany=null, correspAuthors=倪波业, authorNote=

金华平（1989-），女，江苏盐城人，主管治疗师，学士，研究方向：神经康复。

, correspAuthorsNote=
倪波业（1983-），女，江苏连云港人，副主任治疗师，学士，研究方向：神经康复。E-mail：。
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金华平（1989-），女，江苏盐城人，主管治疗师，学士，研究方向：神经康复。

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金华平（1989-），女，江苏盐城人，主管治疗师，学士，研究方向：神经康复。

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组别例数显效有效无效恶化总有效
对照组5417287245（82.00）
治疗组5419323051（94.00）
χ2值11.203
P值<0.05
), ArticleFig(id=1322926411664728908, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926407604642586, language=CN, label=表1, caption=

两组卒中后偏瘫患者疗效对比

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效恶化总有效
对照组5417287245（82.00）
治疗组5419323051（94.00）
χ2值11.203
P值<0.05
), ArticleFig(id=1322926411744420685, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926407604642586, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数Fugl-Meyer评分SS-QOL评分BI评分
治疗前治疗后治疗前治疗后治疗前治疗后
对照组5435.53±4.7656.27±7.49116.57±15.76168.49±21.4343.69±6.2856.43±8.85
治疗组5435.48±4.8265.58±9.17116.63±15.82187.65±25.6743.75±6.3363.77±9.48
t值0.4654.8820.1875.2870.2755.245
P值>0.05<0.05>0.05<0.05>0.05<0.05
), ArticleFig(id=1322926411824112462, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926407604642586, language=CN, label=表2, caption=

两组卒中后偏瘫患者Fugl-Meyer评分、BI评分和SS-QOL评分比较（）

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组别例数Fugl-Meyer评分SS-QOL评分BI评分
治疗前治疗后治疗前治疗后治疗前治疗后
对照组5435.53±4.7656.27±7.49116.57±15.76168.49±21.4343.69±6.2856.43±8.85
治疗组5435.48±4.8265.58±9.17116.63±15.82187.65±25.6743.75±6.3363.77±9.48
t值0.4654.8820.1875.2870.2755.245
P值>0.05<0.05>0.05<0.05>0.05<0.05
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组别例数偏身麻木痰多而黏头晕目眩
治疗前治疗后治疗前治疗后治疗前治疗后
对照组542.68±0.421.79±0.312.75±0.511.82±0.292.86±0.531.69±0.25
治疗组542.72±0.431.23±0.192.73±0.531.22±0.182.89±0.511.09±0.17
t值0.3194.6740.4724.9640.3794.358
P值>0.05<0.05>0.05<0.05>0.05<0.05
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两组卒中后偏瘫患者中医证候积分比较（）

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组别例数偏身麻木痰多而黏头晕目眩
治疗前治疗后治疗前治疗后治疗前治疗后
对照组542.68±0.421.79±0.312.75±0.511.82±0.292.86±0.531.69±0.25
治疗组542.72±0.431.23±0.192.73±0.531.22±0.182.89±0.511.09±0.17
t值0.3194.6740.4724.9640.3794.358
P值>0.05<0.05>0.05<0.05>0.05<0.05
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组别例数CP/（mPa·s）FIB/（g/L）HCT/（%）
治疗前治疗前治疗前治疗后治疗前治疗后
对照组541.95±0.371.32±0.274.99±0.853.97±0.6252.68±8.5943.45±6.72
治疗组541.97±0.350.95±0.114.97±0.863.28±0.4952.73±8.6835.49±4.84
t值0.4584.7290.2954.7930.4725.279
P值>0.05<0.05>0.05<0.05>0.05<0.05
), ArticleFig(id=1322926412121908050, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926407604642586, language=CN, label=表4, caption=

两组卒中后偏瘫患者CP、FIB和HCT水平对比（）

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组别例数CP/（mPa·s）FIB/（g/L）HCT/（%）
治疗前治疗前治疗前治疗后治疗前治疗后
对照组541.95±0.371.32±0.274.99±0.853.97±0.6252.68±8.5943.45±6.72
治疗组541.97±0.350.95±0.114.97±0.863.28±0.4952.73±8.6835.49±4.84
t值0.4584.7290.2954.7930.4725.279
P值>0.05<0.05>0.05<0.05>0.05<0.05
), ArticleFig(id=1322926412218377043, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926407604642586, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IL-6/（ng/L）TNF-α/（ng/L）hs-CRP/（mg/L）
治疗前治疗后治疗前治疗后治疗前治疗后
对照组5465.85±7.2353.53±6.5465.65±8.3655.68±7.2319.56±3.1211.36±1.81
治疗组5465.69±7.2542.72±5.3965.74±8.4246.95±6.5219.63±3.097.39±1.15
t值0.0457.1290.0914.2190.1718.191
P值>0.05<0.05>0.05<0.05>0.05<0.05
), ArticleFig(id=1322926412306457428, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926407604642586, language=CN, label=表5, caption=

两组卒中后偏瘫患者炎性因子水平比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IL-6/（ng/L）TNF-α/（ng/L）hs-CRP/（mg/L）
治疗前治疗后治疗前治疗后治疗前治疗后
对照组5465.85±7.2353.53±6.5465.65±8.3655.68±7.2319.56±3.1211.36±1.81
治疗组5465.69±7.2542.72±5.3965.74±8.4246.95±6.5219.63±3.097.39±1.15
t值0.0457.1290.0914.2190.1718.191
P值>0.05<0.05>0.05<0.05>0.05<0.05
), ArticleFig(id=1322926412381954901, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926407604642586, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数踝关节背曲肌力膝关节伸展肌力髋关节伸展肌力
治疗前治疗后治疗前治疗后治疗前治疗后
对照组5483.47±14.38101.42±16.56162.74±25.64194.68±29.85195.47±26.84231.68±32.85
治疗组5483.53±14.45114.29±18.96162.81±25.39217.58±35.68195.63±26.79257.94±35.76
t值0.0357.0130.1144.3980.0965.091
P值>0.05<0.05>0.05<0.05>0.05<0.05
), ArticleFig(id=1322926412470035286, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926407604642586, language=CN, label=表6, caption=

两组卒中后偏瘫患者下肢肌力比较（）

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组别例数踝关节背曲肌力膝关节伸展肌力髋关节伸展肌力
治疗前治疗后治疗前治疗后治疗前治疗后
对照组5483.47±14.38101.42±16.56162.74±25.64194.68±29.85195.47±26.84231.68±32.85
治疗组5483.53±14.45114.29±18.96162.81±25.39217.58±35.68195.63±26.79257.94±35.76
t值0.0357.0130.1144.3980.0965.091
P值>0.05<0.05>0.05<0.05>0.05<0.05
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养阴通痹解痉汤联合功能训练治疗卒中后偏瘫的疗效及对血液流变学指标水平影响
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金华平 , 朱婷 , 吴炜 , 朱新星 , 倪波业
中华中医药学刊 | 省级项目平台 2025,43(8): 220-223
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中华中医药学刊 |省级项目平台 2025 , 43 (8) : 220 -223
养阴通痹解痉汤联合功能训练治疗卒中后偏瘫的疗效及对血液流变学指标水平影响
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金华平（1989-），女，江苏盐城人，主管治疗师，学士，研究方向：神经康复。

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金华平, 朱婷, 吴炜, 朱新星, 倪波业
作者信息
  • 苏州大学附属第一医院，江苏 苏州 215000
通讯作者:
倪波业（1983-），女，江苏连云港人，副主任治疗师，学士，研究方向：神经康复。E-mail：。
作者简介:

金华平（1989-），女，江苏盐城人，主管治疗师，学士，研究方向：神经康复。

Curative Effect of Yangyin Tongbi Jiejing Decoction（养阴通痹解痉汤）Combined with Functional Training on Hemiplegia after Stroke and Its Effect on Hemorheology
Huaping JIN, Ting ZHU, Wei WU, Xinxing ZHU, Boye NI
Affiliations
  • The First Affiliated Hospital of Soochow University，Suzhou 215000，Jiangsu，China
出版时间: 2025-08-10 doi: 10.13193/j.issn.1673-7717.2025.08.043
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摘要
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目的

探讨卒中后偏瘫采用养阴通痹解痉汤联合功能训练治疗的疗效。

方法

选取108例卒中后偏瘫患者，随机分为两组，每组54例。对照组给予功能训练，包括定时翻身、患肢位摆放、坐位及坐位平衡、坐站转移训练、站立平衡训练等，治疗组在对照组基础上给予养阴通痹解痉汤，1剂/d，治疗时间为4周。对比治疗后的疗效、中医证候积分、偏瘫身体功能评分法（Fugl-Meyer assessment scale，FMA）、日常生活活动能力（Barthel index，BI）和脑卒中专用生活质量量表（Stroke-specific quality of life scale，SS-QOL）、偏瘫侧膝关节、下肢髋关节伸展肌力及踝关节背曲肌力、血清炎性因子水平及血液流变学指标水平。

结果

经过治疗后，治疗组总有效率较高（P<0.05）；治疗后两组Fugl-Meyer评分、BI评分和SS-QOL评分及偏瘫侧膝关节、下肢髋关节伸展肌力及踝关节背曲肌力较治疗前明显升高（P<0.05）；并且治疗组升高较多（P<0.05）；治疗后两组患者血细胞比容（Hematocrit，HCT）、血浆纤维蛋白原（Fibrinogen，FIB）和血浆黏度（Plasma viscosity，PV）水平、血清肿瘤坏死因子-α（Tumor necrosis factor alpha，TNF-α）、白细胞介素-6（Interleukin6，IL-6）、超敏C反应蛋白（Hypersensitive c-reactive protein，hs-CRP）水平及中医证候评分较治疗前显著较低（P<0.05），且治疗组降低较多（P<0.05）。

结论

卒中后偏瘫患者采用养阴通痹解痉汤联合功能训练治疗具有较好的疗效。

养阴通痹解痉汤  /  功能训练  /  卒中后偏瘫  /  血液流变学指标水平
Objective

To investigate the effect of Yangyin Tongbi Jiejing Decoction（养阴通痹解痉汤）combined with functional training on hemiplegia after stroke.

Methods

A total of 108 patients with hemiplegia after stroke in the hospital were randomly divided into two groups with 54 patients in each group.The control group was given functional training，including regular turning over，positioning of the affected limb，sitting and sitting balance，sitting and standing transfer training，standing balance training，etc.The treatment group was given Yangyin Tongbi Jiezhu Decoction（1 dose/d）on the basis of the control group.The treatment time was 4 weeks.The therapeutic effect，TCM syndrome scores，Fugl-Meyer assessment scale（FMA），Barthel index（BI）Stroke-Specific Quality of Life Scale（SS-QOL），hemiplegic side knee joint，lower limb hip joint extension muscle strength，ankle dorsiflexion muscle strength，serum inflammatory factors and hemorheology index levels were compared after treatment.

Results

After treatment，the total effective rate of the treatment group was higher（P<0.05）.After treatment，the Fugl-Meyer score，BI score and SS-QOL score，the extension muscle strength of hemiplegic knee joint，lower limb hip joint and the dorsiflexion muscle strength of ankle joint in both groups were significantly higher than those before treatment（P<0.05）.And these indexes of the treatment group increased more obviously（P<0.05）.After treatment，the levels of hematocrit（Hct），plasma fibrinogen（FIB）and plasma viscosity（PV），serum tumor necrosis factor alpha（TNF-α），interleukin6（IL-6）and hypersensitive C-reactive protein（hs-CRP），and TCM syndrome scores in both groups were significantly lower than those before treatment（P<0.05），and the decrease was significant in the treatment group（P<0.05）.

Conclusion

Yangyin Tongbi Jiejing Decoction combined with functional training has a good effect on patients with hemiplegia after stroke.

Yangyin Tongbi Jiejing Decoction（养阴通痹解痉汤）  /  functional training  /  hemiplegia after stroke  /  hemorheology index level
金华平, 朱婷, 吴炜, 朱新星, 倪波业. 养阴通痹解痉汤联合功能训练治疗卒中后偏瘫的疗效及对血液流变学指标水平影响. 中华中医药学刊, 2025 , 43 (8) : 220 -223 . DOI: 10.13193/j.issn.1673-7717.2025.08.043
Huaping JIN, Ting ZHU, Wei WU, Xinxing ZHU, Boye NI. Curative Effect of Yangyin Tongbi Jiejing Decoction（养阴通痹解痉汤）Combined with Functional Training on Hemiplegia after Stroke and Its Effect on Hemorheology[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (8) : 220 -223 . DOI: 10.13193/j.issn.1673-7717.2025.08.043
正文
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偏瘫属于卒中后一种常见的后遗症，80%脑卒中患者均伴有不同程度的劳动能力丧失，临床表现主要为活动不利、一侧肢体肌力减退，也多见伴有同侧肢体疼痛不觉、冷热不知等感觉障碍，严重影响患者个人生活能力、运动功能及生活质量等[1-2]。康复训练能够提高肢体活动能力，从而防止肢体肌肉萎缩，有助于提高患者肢体功能[3-4]。脑卒中在中医上属于“中风”的范畴，卒中后的偏瘫病因为“阴阳失调”后致“筋脉失养”，相关研究表明养阴通痹解痉汤具有活血通络解痉、养阴益血的功效，能够改善患者肢体功能[5]。研究表明伸筋草、木通、鸡血藤具有通络行痹的作用，丹皮配以当归具有养血、活血化瘀的作用[6]。本研究选取卒中后偏瘫患者108例，探讨养阴通痹解痉汤联合功能训练治疗卒中后偏瘫的疗效。报道如下。
1　资料和方法
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1.1　研究对象和分组
选取2019年6月—2023年6月我院收治的卒中后偏瘫患者108例，其中男57例，女51例，年龄46～77岁，平均（58.95±6.53）岁，病程20～120 d，平均（53.47±9.21）d，脑梗死67例，脑出血41例，随机分为两组。对照组54例，男29例，女25例，年龄46～76岁，平均（58.99±6.58）岁，病程20～120 d，平均（53.55±9.26）d，脑梗死34例，脑出血20例；治疗组54例，男28例，女26例，年龄46～77岁，平均（58.91±6.48）岁，病程20～120 d，平均（53.39±9.16）d，脑梗死33例，脑出血21例。两组患者一般资料比较，差异无统计学意义（P>0.05），具有临床可比性。
1.2　诊断标准、纳入标准和排除标准
诊断标准：符合脑卒中的诊断标准[7]，均经头颅MRI或CT确诊。中医诊断标准[8]：临床多见感觉消失或减退，半身不遂，不语或言语謇涩，口舌歪斜，痰多而黏，头晕目眩，色黄，活动不利、一侧肢体肌力减退，舌质黯淡，大便秘结，脉弦滑，舌苔白腻或薄白，中医辨证为风痰瘀阻证。
纳入标准：符合脑卒中的诊断标准，中医辨证为风痰瘀阻证型，患者目前意识清楚，生命体征平稳，患者为首次发病或复发，在本次发作前无明显神经功能缺损症状遗留；患者依从性较好，均签署知情同意书。
排除标准：患有偏瘫病史；患者依从性较差；伴有严重精神疾病、痴呆病、恶性肿瘤、全身感染等疾病。
1.3　治疗方法
两组入院后均给予常规治疗、护理等，对照组患者给予功能训练：（1）定时翻身，患肢位摆放；（2）坐位及坐位平衡；（3）病情稳定后活动双侧上下肢关节，根据耐受程度将活动度从小到大；（4）坐站转移训练；（5）站立平衡训练；（6）搭桥练习；（7）体位变化训练，从30°根据情况每天训练30 min后，7 d后抬高到90°；（8）日常生活活动训练；（9）步行训练，1次/d，60 min/d。治疗组在对照组的基础上给予养阴通痹解痉汤，组方组成：伸筋草30 g，生地黄30 g，熟地黄30 g，白芍20 g，山茱萸20 g，鸡血藤15 g，当归10 g，丹皮10 g，地龙10 g，木通8 g，甘草8 g，将上述成分加到1000 mL水中，煎至250 mL，1次温服，1剂/d，治疗时间为4周。
1.4　观察指标
1.4.1　临床疗效
临床疗效[9]：显效：治疗后生活质量、日常生活能力、肢体运动功能明显提高，活动受限不明显，临床症状消失；有效：治疗后生活质量、日常生活能力、肢体运动功能有所提高，活动功能出现轻度受限，临床症状明显好转；无效：治疗后临床症状、生活质量、日常生活能力、肢体运动功能无明显好转。
治疗总有效率＝（显效率+有效率）
1.4.2　观察指标
（1）偏瘫身体功能评分法（Fugl-Meyer assessment scale，FMA）评分[10]：治疗前后采用Fugl-Meyer评分评价患者上肢、屈曲等肢体功能，该表总分为100分，评分越高肢体功能越好。（2）脑卒中专用生活质量量表（Stroke-specific quality of life scale，SS-QOL）评分[11]：采用SS-QOL评价患者生活质量，评分越高患者预后情况越好；（3）Barthel指数量表（Barthel，BI）[12]：采用BI指数评价患者日常生活能力，满分为100分，评分越高代表日常生活能力越强；（4）中医证候积分[13]：采用《中药新药临床研究指导原则（试行）》对患者偏身麻木、痰多而黏、头晕目眩等症状进行中医证候评分，根据症状轻重评分为0～3分，共4级，评分越高代表患者症状越严重；血液流变学指标水平：治疗前后抽取患者肘静脉血5 mL，离心取上清液，采用血液流变学检测仪测定血细胞比容（Hematocrit，HCT）、血浆纤维蛋白原（Fibrinogen，FIB）和血浆黏度（Plasma viscosity，PV）水平；治疗前后采用ELISA法测定两组血清肿瘤坏死因子-α（Tumor necrosis factor alpha，TNF-α），白细胞介素-6（Interleukin6，IL-6），超敏C反应蛋白（Hypersensitive c-reactive protein，hs-CRP）水平；下肢肌力：治疗前后采用美国MARK-10肌力检测仪测定两组偏瘫侧膝关节、下肢髋关节伸展肌力及踝关节背曲肌力，测量3次取均值。
1.5　统计学方法
采用SPSS 19.0软件处理。计量和计数数据组间比较分别采用配对资料t检验及卡方检验。
2　结果
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2.1　临床疗效比较
治疗后治疗组疗效明显较高（P<0.05）。见表1。
2.2　Fugl-Meyer评分、BI评分和SS-QOL评分比较
治疗后两组Fugl-Meyer评分、BI评分和SS-QOL评分较治疗前明显升高（P<0.05）；并且治疗组Fugl-Meyer评分、BI评分和SS-QOL评分显著高于对照组（P<0.05）。见表2。
2.3　中医证候积分比较
治疗后两组偏身麻木、痰多而黏、头晕目眩评分较治疗前显著较低（P<0.05），且治疗组降低较多（P<0.05）。见表3。
2.4　血液流变学指标水平比较
治疗后两组CP、FIB和HCT水平较治疗前显著降低（P<0.05）；且治疗组降低较多（P<0.05）。见表4。
2.5　血清炎性因子水平比较
治疗后两组血清炎性因子水平较治疗前均明显降低（P<0.05），且治疗组降低较多（P<0.05）。见表5。
2.6　下肢肌力比较
治疗后两组偏瘫侧膝关节、下肢髋关节伸展肌力及踝关节背曲肌力较治疗前均明显升高（P<0.05），且观察组升高更显著（P<0.05）。见表6。
3　讨论
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脑卒中是临床上一种常见神经系统疾病，80%脑卒中患者均伴有不同程度的劳动能力丧失，其中最常见的后遗症是卒中后偏瘫，主要临床表现是患者出现运动功能障碍[14-16]。功能训练能够提高肌肉组织的血液供应及经气运行，可防止肌肉发生萎缩，维持偏瘫肢体关节功能[17-19]。该病在中医上属于“中风”的范畴，主要病因为“阴阳失调、气血逆乱”，卒中后偏瘫病多因“阴阳失调”后致“筋脉失养”，正气已虚，内盛之邪减弱，致正虚邪留，主要临床表现为筋脉失养、阴液不足、痰瘀阻络，肢体筋络肌肉失养而致痉挛性瘫痪[20-22]。故在临床上治疗原则为“平衡阴阳”和“养阴解痉”。本研究所用养阴通痹解痉汤，起到养阴解痉和平衡阴阳的作用。养阴通痹解痉汤中生熟二地为君药，熟地黄具有补益肝肾养血的作用，使血濡全身，筋脉充养。生地味甘具有滋阴液而通痹，肌肉筋脉得养[23-24]。山茱萸为臣药，可补益肝肾和通痹解痉；甘草与白芍相配可酸甘化阴。研究表明伸筋草、木通、鸡血藤具有通络行痹的作用；甘草芍药汤具有解除运动肌和平滑肌痉挛的作用；丹皮配以当归具有养血、活血化瘀的作用。全方配合具有活血通络解痉、养阴益血的作用[25-27]。
本研究治疗后治疗组疗效较高（P<0.05），提示卒中后偏瘫采用养阴通痹解痉汤联合功能训练治疗可提高疗效[28-32]。治疗后治疗组Fugl-Meyer评分、BI评分和SS-QOL评分明显高于对照组（P>0.05），提示联用养阴通痹解痉汤能够改善患者肢体功能，提高生活质量，还通过日常生活能力训练，有助于患者疾病恢复，提高患者生活质量，改善患者日常生活能力[28-32]。本研究治疗后治疗组偏身麻木、痰多而黏、头晕目眩评分显著较低（P<0.05），提示养阴通痹解痉汤联合功能训练治疗卒中后偏瘫能够改善患者临床症状，分析原因为养阴通痹解痉汤具有活血通络解痉、养阴益血的功效，加之功能训练以循序渐进的方式提高患者上下肢关节活动度，改善偏瘫后行动不便、肢体麻木等相关症状[33]。治疗后治疗组CP、FIB和HCT水平明显较低（P>0.05），提示联用养阴通痹解痉汤联合功能训练治疗卒中后偏瘫能够改善患者血流动力学，有助于患者预后，丹皮配以当归具有养血、活血化瘀的作用之效，可改善机体血液循环，联合康复训练中对肢体进行功能性训练，从而改善血流动力学指标[4，34-35]。炎症反应在卒中的发生和进展中起着重要作用，炎症反应加快了缺血性损伤的形成并影响神经组织再生及神经元死亡，在脑卒中病情中起到重要作用，故本研究监测其治疗前后炎性因子水平变化[35]。治疗后观察组血清炎性因子水平明显较低（P<0.05），提示卒中后偏瘫患者采用养阴通痹解痉汤联合功能训练治疗可缓解机体炎性因子水平，有助于患者预后[36-37]。治疗后两组偏瘫侧膝关节、下肢髋关节伸展肌力及踝关节背曲肌力较治疗前均明显升高（P<0.05），且观察组升高更显著（P<0.05），提示养阴通痹解痉汤联合功能训练治疗卒中后偏瘫可改善患者下肢肌力，改善患者预后[3，38]。
综上所述，卒中后偏瘫患者采用养阴通痹解痉汤联合功能训练治疗可提高临床疗效。
基金
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  • 江苏省自然科学基金项目(BK202210615)
文献
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2025年第43卷第8期
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doi: 10.13193/j.issn.1673-7717.2025.08.043
  • 首发时间：2026-10-30
  • 出版时间：2025-08-10
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基金
江苏省自然科学基金项目(BK202210615)
作者信息
    苏州大学附属第一医院，江苏 苏州 215000

通讯作者:

倪波业（1983-），女，江苏连云港人，副主任治疗师，学士，研究方向：神经康复。E-mail：。
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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2025.08.043
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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