中华中医药学刊

目的 探讨中医益气活血方治疗脑卒中恢复期病人临床疗效及对神经功能和血清神经元特异性烯醇化酶(NSE)水平影响性。方法 抽取2019年2月—2020年12月共78例脑卒中恢复期患者为研究对象，按照治疗方案不同分成两组，每组39例。对照组抗凝、抗血小板聚集和康复综合训练，研究组在对照组基础上益气活血中药汤剂口服，均治疗4周。观察治疗前、完成治疗后在神经功能、血清学指标、临床症状积分等指标变化并比较。结果 (1)两组末次治疗时C反应蛋白、D-二聚体、同型半胱氨酸较治疗前均显著下降(P<0.05),且研究组下降幅度显著高于对照组，差异有统计学意义(P<0.05)。(2)两组治疗后较治疗前美国国立卫生研究院卒中量表(NIHSS)均显著下降(P<0.05),但组间治疗前、治疗1周后NIHSS评分比较差异无统计学意义(P>0.05),组间治疗2周、3周、4周后研究组NIHSS评分均显著低于同时期对照组，差异有统计学意义(P<0.05)。(3)两组末次治疗时改良Barthel指数(BI)、Fugl-Meyer法(FMA)、脑卒中专用生活质量量表(SS-QOL)较治疗前均显著升高(P<0.05),且研究组升高幅度显著高于对照组，差异有统计学意义(P<0.05)。(4)两组末次治疗时半身不遂、舌强语謇、面色白光白、自汗出、气短乏力、舌脉象较治疗前均显著下降(P<0.05),且研究组改善水平均显著优于对照组，差异有统计学意义(均P<0.05)。结论 中医益气活血方能改善脑卒中恢复期神经功能，能提高患者生活质量和运动功能，抑制炎性反应，促进血循环。

Objective To investigate the clinical efficacy of Yiqi Huoxue Recipe(益气活血方) in the treatment of convalescent stroke patients and its influence on neurological function and serum neuron specific enolase(NSE). Methods Seventy-eight patients with stroke in convalescence from February 2019 to December 2020 were selected and divided into two groups according to different treatment schemes, 39 cases in each group. The control group was treated with anticoagulation, antiplatelet aggregation and comprehensive rehabilitation training, while the study group was treated with Yiqi Huoxue Recipe on the basis of the control group for 4 weeks. The changes of neurological function, serological indexes and clinical symptom scores before and after treatment were observed and compared. Results(1)The levels of C-reactive protein, D-dimer and homocysteine in the two groups at the last treatment were significantly decreased compared with those before treatment(P<0.05),and the decrease rate in the study group was significantly higher than that in the control group(P<0.05).(2)The National Institute of Health stroke scale(NIHSS) scores of the two groups after treatment were significantly lower than those before treatment(P<0.05),but there was no significant difference between the two groups before treatment and after 1 week of treatment(P>0.05). The NIHSS scores of the study group after 2,3 and 4 weeks of treatment were significantly lower than those of the control group at the same time, and the difference was statistically significant(P<0.05).(3)The modified Barthel Index(BI),Fugl Meyer method(FMA) and stroke specific quality of life scale(SS-QOL) of the two groups at the last treatment were significantly higher than those before treatment(P<0.05),and the increase amplitude of the study group was significantly higher than that of the control group, the difference was statistically significant(P<0.05).(4)At the last treatment, hemiplegia, strong tongue, pale complexion, spontaneous sweating, shortness of breath and fatigue and tongue pulse condition of the two groups were significantly decreased(P<0.05),and the improvement level of the study group was significantly better than that of the control group, the differences were statistically significant(P<0.05). Conclusion Yiqi Huoxue Recipe can improve the neurological function, the quality of life and motor function, inhibit inflammatory reaction and promote blood circulation.