目的 探讨黄芪桂枝五物汤加味联合中频脉冲电刺激治疗糖尿病合并脑卒中偏瘫的临床疗效。方法 选取2019年4月-2022年3月河北北方学院附属第一医院康复科及内分泌科老年糖尿病合并脑卒中偏瘫患者120例，依据随机表分为对照组60例和治疗组60例，对照组给予中频脉冲电刺激加常规康复运动疗法，治疗组在对照组基础上给予黄芪桂枝五物汤加味治疗，比较两组患者治疗前后血糖水平、运动神经电生理指标[运动诱发电位潜伏期(motor evoked potentials，MEP)、中枢运动传导时间(central motor conduction time，CMCT)]、运动功能[Fugl-Meyer 运动功能评分(Fugl-Meyer Assessment，FMA)]、生活质量及神经功能相关评分[脑卒中专用生活质量量表(Stroke Specific Quality of Life Scale，SS-QOL)、改良 Barthel 指数(modified Barthel Index，MBI)、美国国立卫生研究所卒中评分量表(National Insti-tutes of Health Stroke Scale，NIHSS)、临床神经功能缺损评分(China Stroke Scale，CSS)量表、抑郁自评量表(Self-Rating Depression Scale，SDS)]。结果 (1)血糖水平:治疗12周后，治疗组和对照组空腹血糖和餐后血糖均有所下降，降血糖效果明显;与对照组比较，治疗组血糖水平下降幅度更大(P＜0。05)。(2)运动神经电生理指标:两组各项指标(MEP、CM-CT)较治疗前均明显降低(P＜0。05)，且治疗组与对照组比较，治疗组降低幅度更大(P＜0。05)。(3)上肢、下肢FMA评分:治疗12周后，对照组和治疗组评分均有明显升高，且治疗组分值提升显著高于对照组(P＜0。05)。(4)生活质量评分:治疗后，对照组和治疗组各项评分(SS-QOL、MBI)均明显高于治疗前，且治疗组得分上升幅度显著优于对照组(P＜0。05)。(5)神经功能评分:治疗后，两组各项评分(NIHSS、CSS、SDS)均有明显降低(P＜0。05)，且治疗组比对照组各项评分降低幅度更为显著(P＜0。05)。结论 黄芪桂枝五物汤加味联合中频脉冲电刺激可有效治疗糖尿病合并脑卒中偏瘫患者的运动功能，有利于改善生活质量，值得临床推广。
Clinical Study on Modified Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤加味)Combined with Intermediate Frequency Pulse Electrical Stimulation in Treatment of Diabetes Mellitus Complicated with Hemiplegia Due to Stroke
Objective To explore the clinical efficacy of Modified Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤加味)combined with intermediate frequency pulse electrical stimulation in the treatment of diabetes mellitus complicated with hemiple-gia due to stroke.Methods From April 2019 to March 2022,120 elderly patients with diabetes mellitus complicated with hemiple-gia due to stroke in the hospital were randomly divided into control group(60 cases)and treatment group(60 cases).The control group was treated with intermediate frequency pulse electrical stimulation,while the treatment group was treated with Modified Huangqi Guizhi Wuwu Decoction on the basis of electrotherapy.The blood sugar level,motor electrophysiological indexes[motor evoked potentials(MEP),central motor conduction time(CMCT)],Fugl-Meyer Assessment(FMA),Stroke Specific Quality of Life Scale(SS-QOL),Modified Barthel Index(MBI),National Institutes of Health Stroke Scale(NIHSS),China Stroke Scale(CSS)and Self-Rating Depression Scale(SDS)were compared between the two groups before and after treatment.Results(1)Blood sugar level:After 12 weeks of treatment,both fasting blood sugar and postprandial blood sugar in the treatment group and the control group decreased,and the hypoglycemic effect was obvious.Compared with that in the control group,the blood sug-ar level in the treatment group decreased more obviously(P＜0.05).(2)Electrophysiological indexes of motor nerve:The inde-xes(MEP,CMCT)in the two groups were significantly lower than those before treatment(P＜0.05).and the decrease in the treatment group was greater than that in the control group(P＜0.05).(3)FMA score of upper limbs and lower limbs:After 12 weeks of treatment,the scores of the control group and the treatment group were significantly increased,and the score of the treat-ment group was significantly higher than that of the control group(P＜0.05).(4)Quality of life score:After treatment,the scores(SS-QOL,MBI)of the control group and the treatment group were significantly higher than those before treatment,and the score of the treatment group was significantly higher than that of the control group(P＜0.05).(5)Neurological function score:After treatment,all the scores(NIHSS,CSS,SDS)in the two groups decreased significantly(P＜0.05),and the scores in the treatment group decreased more significantly than those in the control group(P＜0.05).Conclusion Modified Huangqi Guizhi Wuwu De-coction combined with intermediate frequency pulse electrical stimulation can effectively treat the motor function of diabetic pa-tients with hemiplegia due to stroke,which is conducive to improving the quality of life and worthy of clinical promotion.
Modified Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤加味)medium-frequency pulse electrical stimu-lationdiabetes complicated with hemiplegia due to strokeelectrophysiologymotor functionneurological function
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