Clinical Effect Of Combining Peiyuan Huanwu Decotion With Rehabilitation Training And The Influence On The Serum Proinflammatory Cytokines In Patients With Post-stroke Fatigue

ObjectiveTo investigate the clinical effect of combining Peiyuan huanwu decotion with rehabilitation training and the influence on the serum proinflammatory cytokines in patients with post-stroke fatigue. To try to afford an effective treatment combining Traditional Chinese and Western Medicine and a theoretical foundation of the mechanism about the effect in post-stroke fatigue patients.MethodsFifty patients who suffered from post-stroke fatigue were divided randomly into two groups according to the random number table(treatment group,n=25; control group, n=25). The patients in the treatment group received the Peiyang huanwu decotion and comprehensive rehabilitation training. The patients in the control group received the placebo of Chinese medicine and comprehensive rehabilitation training. Before treatment and after treatment in3weeks, two groups of patients were assessed by measures of fatigue(Fatigue Severily Scale[FSS], Fatigue Impactact Scale[FIS]) and activities of daily living(Modified Barthel Index[MBI]), while the concentration of CRP, TNF-a, IL-6in serum were tested. The adverse reaction cases were observed to evaluate the security of this treatment.Results1. Baseline comparison:Difference was not significant (P>0.05), including general information and the scores of Fatigue Severily Scale, Fatigue Impactact Scale, Modified Barthel Index before treatment in two groups of patients. Difference was not significant either(P>0.05), including the level of CRP, IL-6and TNF-a in serum. 2. Effect comparison in the same group before and after treatment:Before and after treatment, difference was significant (P<0.05), including the scores of Fatigue Severily Scale, Fatigue Impactact Scale, Modified Barthel Index in two groups of patients. The scores of Fatigue Impactact Scale and Fatigue Severily Scale were lower than those before treatment. The score of Modified Barthel Index was higher than that before treatment. Difference was significant (P<0.05), including the level of CRP, IL-6and TNF-a in serum before and after treatment. The serum proinflammatory cytokines were lower than those before treatment.3.Effect comparison after treatment:After treatment, difference was significant (P<0.05), including the scores of Fatigue Severily Scale, Fatigue Impactact Scale, and Modified Barthel Index in two groups of patients. Difference was significant (P<0.05), including the level of CRP, IL-6and TNF-a in serum in two groups of patients.4. Spearman correlation analysis:In two groups of patients, the concentration of CRP, IL-6, TNF-a in serum and the scores of Fatigue Impactact Scale, Fatigue Severily Scale were positively correlated(r>0), while the level of IL-6, TNF-a in serum and the socre of Modified Barthel Index were negatively correlated (r<0).However, the level of CRP in serum and the socre of Modified Barthel Index had no correlation.5. During the period of this study, the treatment group and the control group didn’t happen any adverse reaction case.ConelusionThis study found that the treatment of combining Peiyuan huanwu decotion with rehabilitation training may improve the ability of daily living and relieve the fatigue in post-stroke fatigue patients, which the mechanism may be related to reduce the concentration of serum proinflammatory cytokines.