1.北京中医药大学第二临床医学院,北京市朝阳区北三环东路11号,100029
2.上海医大医院
3.中国中医科学院针灸研究所
4.北京中医药大学东方医院
chenzhigang64@126. com,(010)67689776
收稿:2022-05-09,
修回:2022-09-25,
纸质出版:2022-12-02
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黄晶晶,朱心怡,王雨晴等.活络益脑方辅助治疗血管源性脑白质高信号伴步态障碍患者52例临床观察[J].中医杂志,2022,63(23):2246-2251.
HUANG Jingjing,ZHU Xinyi,WANG Yuqing,et al.Clinical Effect of Adjuvant Huoluo Yinao Formula(活络益脑方)on White Matter Hyperintensity of Presumed Vascular Origin with Gait Disorder in 52 Cases[J].Journal of Traditional Chinese Medicine,2022,63(23):2246-2251.
黄晶晶,朱心怡,王雨晴等.活络益脑方辅助治疗血管源性脑白质高信号伴步态障碍患者52例临床观察[J].中医杂志,2022,63(23):2246-2251. DOI: 10.13288/j.11-2166/r.2022.23.009.
HUANG Jingjing,ZHU Xinyi,WANG Yuqing,et al.Clinical Effect of Adjuvant Huoluo Yinao Formula(活络益脑方)on White Matter Hyperintensity of Presumed Vascular Origin with Gait Disorder in 52 Cases[J].Journal of Traditional Chinese Medicine,2022,63(23):2246-2251. DOI: 10.13288/j.11-2166/r.2022.23.009.
目的
2
观察活络益脑方治疗血管源性脑白质高信号(WMH)伴步态障碍患者的临床疗效。
方法
2
将90例WMH伴步态障碍患者分为治疗组54例和对照组36例。对照组患者进行基础病的常规治疗(包括口服西药控制血压、血糖、血脂)和运动指导,治疗组在对照组的基础上加用活络益脑方免煎颗粒剂口服,每日1剂。两组疗程均为3个月。治疗前后比较两组单任务步行速度及双任务步行速度,采用Berg平衡量表(BBS)评分、Tinetti 步态和平衡测试量表评分、简易体能状况量表(SPPB)评分评价患者平衡功能和躯体功能。
结果
2
治疗组患者治疗后SPPB评分、BBS评分、Tinetti步态和平衡测试量表总分、Tinetti步态评分、单任务步行速度及双任务步行速度均较治疗前提高(
P
<0.05)。对照组患者治疗后双任务步行速度较治疗前下降(
P
<0.05)。两组患者治疗前后差值比较,治疗组SPPB评分、BBS评分、Tinetti步态和平衡测试量表总分、Tinetti平衡评分、Tinetti步态评分、单任务步行速度及双任务步行速度差值与对照组比较差异均具有统计学意义(
P
<0.05)。
结论
2
活络益脑方可有效提高WMH伴步态障碍患者步行速度,可一定程度上改善患者的步态与平衡功能。
Objective
2
To observe the clinical effect of
Huoluo Yinao Formula
(活络益脑方) on white matter hyperintensity of presumed vascular origin (WMH) with gait disorder.
Methods
2
Ninety patients of WMH with gait disorder were included and divided into treatment group (54 cases) and control group (36 cases). Routine treatment including oral western medicine to control blood pressure, blood sugar and lipids plus exercise instruction was given to both groups, and granulated
Huoluo Yinao Formula, one dose daily,
was orally administered in addition in the treatment group. The course of treatment in both groups was 3 months. Walking speed under single-/dual-task walking conditions were compared between groups before and after treatment. Berg Balance Scale (BBS), Tinetti Balance and Gait Assessment, and Short Physical Performance Battery (SPPB) were used to evaluate patients' balance function and physical function.
Results
2
In the treatment group, the SPPB score, the BBS score, Tinetti total balance and gait score, Tinetti gait score, single-task and dual-task walking speed were improved after treatment (
P
<0.05). In the control group, the dual-task walking speed decreased after treatment (
P
<0.05).As for the changes after treatment, there were significant differences between groups in SPPB score, BBS score, Tinetti total balance and gait score, Tinetti gait score, single-task and dual-task walking speed (
P
<0.05).
Conclusion
2
Huoluo Yinao Formula
can improve the walking speed effectively, and improve the gait and balance function to some extent for patients with WMH and gait disorder.
WARDLAW JM , SMITH EE , BIESSELS GJ , et al . Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration [J]. Lancet Neurol , 2013 , 12 ( 8 ): 822 - 838 .
中华医学会神经病学分会 . 中国脑小血管病诊治共识 [J]. 中华神经科杂志 , 2015 , 48 ( 10 ): 838 - 844 .
任蓉蓉 , 李梦园 , 屈永才 . 脑白质高信号与步态障碍的研究进展 [J]. 江苏医药 , 2021 , 47 ( 4 ): 420 - 423 .
朱心怡 . 脑小血管病相关白质病变的中医证候学及活络益脑方的初步干预研究 [D]. 北京 : 北京中医药大学 , 2021 .
MAHLKNECHT P , KIECHL S , BLOEM BR , et al . Prevalence and burden of gait disorders in elderly men and women aged 60-97 years: a population-based study [J]. PLoS One , 2013 , 8 ( 7 ): e69627 .
万霞 , 李赞华 , 刘建平 . 临床研究中的样本量估算:(1)临床试验 [J]. 中医杂志 , 2007 , 48 ( 6 ): 504 - 507 .
GURALNIK JM , SIMONSICK EM , FERRUCCI L , et al . A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission [J]. J Gerontol , 1994 , 49 ( 2 ): 85 - 94 .
HAUSDORFF JM , BALASH J , GILADI N . Effects of cognitive challenge on gait variability in patients with Parkinson's disease [J]. J Geriatr Psych Neur , 2003 , 16 ( 1 ): 53 - 58 .
BERG KO , WOOD-DAUPHINEE SL , WILLIAMS JI , et al . Measuring balance in the elderly: validation of an instrument [J]. Can J Public Health , 1992 , 83 ( 7-8 ): S7 - 11 .
TINETTI ME . Performance-oriented assessment of mobi-lity problems in elderly patients [J]. J Am Geriatr Soc , 1986 , 34 ( 2 ): 119 - 126 .
VAN-DER HOLST HM , VAN-UDEN IW , TULADHAR AM , et al . Factors associated with 8-year mortality in older patients with cerebral small vessel disease: the radboud university nijmegen diffusion tensor and magnetic resonance cohort (run dmc) study [J]. JAMA Neurol , 2016 , 73 ( 4 ): 402 - 409 .
ALEXANDER NB . Gait disorders in older adults [J]. J Am Geriatr Soc , 1996 , 44 ( 4 ): 434 - 451 .
WILSON J , ALLCOCK L , ARDLE RMC , et al . The neural correlates of discrete gait characteristics in ageing: a structured review [J]. Neurosci Biobehav Rev , 2019 , 100 ( 5 ): 344 - 369 .
ROSSO AL , STUDENSKI SA , LONGSTRETH WT , et al . Contributors to poor mobility in older adults: integrating white matter hyperintensities and conditions affecting other systems [J]. J Gerontol A Biol Sci Med Sci , 2017 , 72 ( 9 ): 1246 - 1251 .
WARDLAW JM . Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The rotterdam scan study [J]. J Neurol Neurosurg Psychiatry , 2001 , 70 ( 1 ): 9 - 14 .
SCHMIDT R , BERGHOLD A , JOKINEN H , et al . White matter lesion progression in LADIS: frequency, clinical effects, and sample size calculations [J]. Stroke , 2012 , 43 ( 10 ): 2643 - 2647 .
陈烁 , 冯娟 . 脑小血管病变患者脑白质病变程度与步态平衡功能障碍关系分析 [J]. 社区医学杂志 , 2020 , 18 ( 21 ): 1471 - 1474 .
VAN DER HOLST HM , TULADHAR AM , ZERBI V , et al . White matter changes and gait decline in cerebral small vessel disease [J]. Neuro Image Clin , 2018 , 17 ( 12 ): 731 - 738 .
WANG LY , TAO Z , ZHAO HP , et al . Huoluo yinao decoction mitigates cognitive impairments after chronic cerebral hypoperfusion in rats [J]. J Ethnopharmacol , 2019 , 238 ( 6 ): 111846 .
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