Objective To investigate the efficacy of Fumai Zhuyu Decoction combined with radial shock wave therapy(RSWT)in treating convalescent stroke patients with lower limb spasm,and to observe its effect on serum neuron-specific enolase(NSE)and transforming growth factor-β1(TGF-β1).Methods From January 2022 to January 2024,a total of 111 convalescent stroke patients with lower limb spasm of qi deficiency and blood stasis syndrome were selected from the First Affiliated Hospital of Hebei North University.According to the treatment method,the patients were divided into two groups.The 55 patients in the western medicine(WM)group were treated with RSWT,and 56 patients in the traditional Chinese medicine(TCM)group were treated with Fumai Zhuyu Decoction orally and RSWT.The course of treatment for the two groups covered 6 months.Before and after treatment,the two groups were observed in the changes of modified Ashworth Scale(MAS)score for the evaluation of muscle tone of hemiplegic limbs,Clinical Spasticity Index(CSI)score,Barthel Index(BI)score for the evaluation of activities of daily living,three-dimensional gait parameters(velocity,cadence,step length),serum levels of NSE and TGF-β1,and hemorheological indicators of plasma viscosity(PV),low-shear blood viscosity(LBV),high-shear blood viscosity(HBV)and platelet aggregation rate(PAR).After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 6 months of treatment,the total effective rate of the TCM group was 94.64%(53/56),and that of the WM group was 76.36%(42/55).The intergroup comparison(tested by chi-square test)showed that the efficacy of the TCM group was significantly superior to that of the WM group(P＜0.01).(2)After treatment,the MAS and CSI scores of the two groups were lowered(P＜0.05)and the BI scores were increased compared with those before treatment(P＜0.05).The decrease of MAS and CSI scores and the increase of BI scores in the TCM group were significantly superior to those in the WM group(P＜0.01).(3)After treatment,the three-dimensional gait parameters of velocity,cadence,and step length in the two groups were increased compared with those before treatment(P＜0.05),and the increase of gait parameters in the TCM group was significantly superior to that in the WM group(P＜0.01).(4)After treatment,the serum NSE level of the two groups was significantly decreased that before treatment(P＜0.05),and the serum TGF-β1 level was significantly increased compared with that before treatment(P＜0.05).The decrease of serum NSE level and the increase of serum TGF-β1 level in the TCM group were significantly superior to those in the WM group(P＜0.01).(5)After treatment,the hemorheological indexes such as PV,LBV,HBV and PAR in the two groups were significantly lowered compared with those before treatment(P＜0.05),and the decrease in the TCM group was significantly superior to that in the WM group(P＜0.01).Conclusion Fumai Zhuyu Decoction combined with RSWT can effectively improve the limb spasm degree and walking function,reduce serum NSE level,increase serum TGF-β1 level,and correct the abnormal blood hemorheology in convalescent stroke patients with lower limb spasm of qi deficiency and blood stasis syndrome.The curative effect of the combined treatment is significantly superior to that of RSWT alone.

Objective To evaluate the effects of Qitan Decoction(QTD)combined with radial shockwave therapy(RSWT)on walking ability,balance function,and neural injury markers in stroke patients with lower limb spasticity during convalescence.Methods A retrospective study was conducted on 100 stroke patients with lower limb spasticity of qi deficiency and blood stasis type treated at the First Affiliated Hospital of Hebei North University from December 2021 to December 2023.Patients were divided into a conventional group(n=49,receiving RSWT alone)and an trial group(n=51,receiving RSWT plus QTD)based on treatment protocols.Both groups received standard stroke care(including cerebral metabolism improvement,neurotrophic support,and antiplatelet therapy).The intervention lasted 6 months.The changes in Modified Ashworth Scale(MAS)scores,Functional Gait Assessment(FGA)scores,Berg Balance Scale(BBS)scores,Stroke-Specific Quality of Life(SS-QOL)scores,serum neural injury markers[gama-aminobutyric acid(GABA),brain-derived neurotrophic factor(BDNF)],and kinematic parameters(peak knee flexion,peak hip flexion)were observed,and the clinical efficacy was compared between groups.Results(1)After 6 months of treatment,the total effective rate of the trial group was 94.12％(48/51),and that of the conventional group was 75.51％(37/49),and the intergroup(by chi-square test)comparison showed that the efficacy of the trial group was significantly superior to that of the conventional group(P＜0.01).(2)After treatment,the MAS scores of patients in the two groups were lower than before treatment(P＜0.05),and the FGA,BBS,and SS-QOL scores were higher than before treatment(P＜0.05),and the reduction of the MAS scores and the increase of the FGA,BBS,and SS-QOL scores of the trial group were significantly superior to those of the conventional group(P＜0.01).(3)After treatment,the serum GABA and BDNF levels of patients in the two groups were higher than those before treatment(P＜0.05),and the increase in serum GABA and BDNF levels in the trial group was significantly superior to that in the conventional group(P＜0.01).(4)After treatment,the peak knee flexion and peak hip flexion of patients in the two groups were elevated compared with those before treatment(P＜0.05),and the trial group's elevation of peak knee flexion and peak hip flexion was significantly superior to that of the conventional group(P＜0.01).Conclusion QTD combined with RSWT effectively alleviates spasticity,enhances walking/balance function,mitigates neural injury,and improves quality of life in stroke patients with lower limb spasticity of qi deficiency and blood stasis syndrome during convalescence.