Clinical Study On Lower Limb Spasticity After Stroke By Using Gua Lou Gui Zhi Decoction

Objective:To observe the therapeutic efficacy on lower limb spasticity after stroke by using Gua Lou Gui Zhi Decoction(in brief "GLGZD"). And provide clinical evidence to Chinese medicine treatment for lower limb spasticity after stroke.Methods:60patients were randomly divided to two groups, treatment group and control group.There were30patients in each group.Patients in treatment group were treated by GLGZD combined with rehabilitation training, while those in the control group treated just by rehabilitation training.We observed the clinical symptoms in the whole treatments.All patients were assessed before and after training period. The evaluating items included:Clinic Spasticity Index(CSI) for the level of the convulsion of the lower limb.Fugl-Meyer (FMA)assessment scale for the motor function of the lower limb.Modified Barthel Index(MBI) scales for activities of daily life.And surface electromyography recode the integrated electromyogram (IEMG).And co-contraction ratio during maximum isometric voluntary contraction (MIVC) of the ankle dorsi-flexion and knee-flexion. Every evaluation were carried out by the same physician.(1) After the treatment, the TCM Syndrome integral of all patients were decreased. There was significant difference in both groups before and after training period(P<0.05).The treatment group was better than the control group, the difference between two groups was statistically significant (P<0.05).(2) After the treatment, the CSI scores for treatment group and control group were decreased, There was significant difference in both groups before and after training period(P<0.05).The treatment group was better than the control group, the difference between two groups was statistically significant (P<0.05).(3) After the treatment, the FMA scores and MBI scores for treatment group and control group were increased, There were significant differences in both groups before and after training period(P<0.05).The treatment group was better than the control group, the differences between two groups were statistically significant (P<0.05).(4) After the treatment, patients in both two groups during maximum isometric voluntary contraction(MIVC) of the ankle dorsi-flexion and knee-flexion in the control group,the IEMG of quadriceps rectus femoris and gastrocnemius muscle were all decreased, Sartorius muscle and tibialis anterior muscle were all increased, Co-contraction ratio were all decreased (P<0.05).Conclusion:(1) GLGZD combined with rehabilitation training and rehabilitation training, have certain effects for lower limb spasticity after stroke.(2) GLGZD has a good clinical effect on lower limb spasticity after stroke due to disharmony bwteen ying and wei、body fluid deficiency、tendon and vessel malnutrition. And has a facilitatory role for rehabilitation training methods. GLGZD combined with rehabilitation training is more effective than rehabilitation training on improving lower limb spasticity、campaign features and daily life activities capacity.