Clinical study on Buyang Huanwu Tongluo decoction in the treatment of Qi deficiency and blood stasis stroke sequelae
补阳还五通络汤干预气虚血瘀中风后遗症治疗的临床研究

摘要

目的 探讨补阳还五通络汤在气虚血瘀中风后遗症治疗中的应用效果。方法 将2024年4月-2025年4月苏州市中医医院气虚血瘀脑中风后遗症60例患者随机分为对照组和治疗组，每组各30例。对照组予中风后遗症的一般治疗原则处理，治疗组在对照组的基础上联合补阳还五通络汤治疗，两组均治疗12周。比较两组的临床有效率、神经功能、肢体功能、日常生活能力、中医证候积分及血液流变学指标。结果 治疗12周后，治疗组的临床总有效率高于对照组但无统计学差异（P>0.05）；两组的神经功能缺损评分降低（P<0.05），而上下肢体功能和日常生活能力评分升高（P<0.05），且治疗组的神经功能缺损评分低于对照组（P<0.05），上下肢体功能评分和日常生活能力评分高于对照组（P<0.05）；两组的中医症状肢体麻木、口舌歪斜、头晕头痛和烦躁易怒积分降低（P<0.05），且治疗组的以上四项指标水平均低于对照组（P<0.05）；两组的纤维蛋白原、全血高切黏度、全血低切黏度、血浆黏度均降低（P<0.05），且治疗组的以上四项指标水平均低于对照组（P<0.05）。结论 补阳还五通络汤干预气虚血瘀中风后遗症治疗可提高临床效果，对神经功能、肢体运动功能、生活能力均具有积极的影响，可明显改善中医症状积分和血液流变学指标，具有临床潜在的应用与推广价值。

Abstract

Objective To explore the application effect of Buyang Huanwu Tongluo Decoction in the treatment of stroke sequelae of qi deficiency and blood stasis.
Methods From April 2024 to April 2025,60 patients with cerebral apoplexy sequelae of qi deficiency and blood stasis in Suzhou Hospital of Traditional Chinese Medicine were randomly divided into control group and treatment group, 30 cases in each group. The control group was treated with the general treatment principle of stroke sequelae. The treatment group was treated with Buyang Huanwu Tongluo Decoction on the basis of the control group. Both groups were treated for 12 weeks. The clinical effective rate, neurological function, limb function, daily living ability, TCM syndrome score and hemorheological indexes were compared between the two groups.
Results After 12 weeks of treatment, the total clinical effective rate of the treatment group was higher than that of the control group, but there was no statistical difference (P > 0.05). The neurological deficit scores of the two groups were decreased (P < 0.05), while the scores of upper and lower limb function and daily living ability were increased (P < 0.05). The neurological deficit score of the treatment group was lower than that of the control group (P < 0.05), and the scores of upper and lower limb function and daily living ability were higher than those of the control group (P < 0.05). The scores of TCM symptoms of limb numbness, tongue deviation, dizziness, headache and irritability in the two groups were decreased (P < 0.05), and the levels of the above four indexes in the treatment group were lower than those in the control group (P < 0.05). The levels of fibrinogen, whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity in the two groups were decreased (P < 0.05), and the levels of the above four indexes in the treatment group were lower than those in the control group (P < 0.05).
Conclusion   Buyang Huanwu Tongluo Decoction can improve the clinical effect of the treatment of stroke sequelae of qi deficiency and blood stasis, and has a positive effect on neurological function, limb motor function and living ability. It can significantly improve the TCM symptom score and hemorheology index, and has potential clinical application and promotion value.