OBJECTIVE To determine the short- (4 weeks) and long-term (6 month) effectiveness of Tibetan medicated bathing therapy in patients with post-stroke limb spasticity. DESIGN Prospective, blinded, randomized controlled trial. SUBJECTS Post-stroke patients with limb spasticity were recruited between December 2013 and February 2017 and randomly assigned 1:1 to a control group that received conventional rehabilitation (n = 222) or an experimental group that received Tibetan medicated bathing therapy in combination with conventional rehabilitation (n = 222). METHODS All patients received conventional rehabilitation. In addition, the experimental group received Tibetan medicated bathing therapy. The interventions were conducted 5 times per week for 4 weeks. The primary endpoint was changes from baseline after 4 weeks of therapy in muscle tone in the spastic muscles (elbow flexors, wrist flexors, finger flexors, knee extensors, ankle plantar flexors), as measured by the Modified Ashworth Scale (MAS). RESULTS The mean change from baseline after 4 weeks of therapy in the MAS score for the elbow flexors (P = .017), wrist flexors (P < .001), and ankle plantar flexors (P < .001) was significantly greater in patients in the experimental group compared to the control group. The benefit was maintained for 3 muscle groups (elbow flexors P < .001, wrist flexors P = .001, and ankle plantar flexors P < .001) and 6 months (elbow flexors P < .001, wrist flexors P = .002, and ankle plantar flexors P < .001) after therapy. All adverse events were mild, and no serious adverse reactions to Tibetan medicated bathing therapy were recorded. CONCLUSIONS AND IMPLICATIONS Tibetan medicated bathing therapy, in combination with conventional rehabilitation, has potential as a safe, effective treatment for the alleviation of post-stroke upper limb spasticity. Tibetan medicated bathing therapy was most advantageous for patients who had a baseline muscle tone score of 1+ to 2 on the MAS in the affected limb and recent onset of stroke (duration of the disease of 1-3 months).

中文翻译：

---

中风后肢体痉挛患者的藏药沐浴疗法：一项随机对照临床试验

目的探讨藏药沐浴疗法治疗脑卒中后肢体痉挛患者的短期（4周）和长期（6个月）疗效。设计 前瞻性、盲法、随机对照试验。对象 2013 年 12 月至 2017 年 2 月期间招募肢体痉挛的脑卒中后患者，按 1:1 随机分为接受常规康复治疗的对照组（n = 222）或接受藏药沐浴疗法联合常规康复治疗的实验组(n = 222)。方法所有患者均接受常规康复治疗。此外，实验组接受藏药沐浴疗法。干预每周进行 5 次，持续 4 周。主要终点是治疗 4 周后痉挛肌肉（肘屈肌、腕屈肌、手指屈肌、膝伸肌、踝跖屈肌）的肌张力相对于基线的变化，通过改良 Ashworth 量表 (MAS) 测量。结果 治疗 4 周后，患者的肘部屈肌 (P = .017)、腕屈肌 (P < .001) 和踝跖屈肌 (P < .001) 的 MAS 评分相对于基线的平均变化显着更大实验组与对照组相比。3 个肌肉群（肘屈肌 P < .001，腕屈肌 P = .001，踝跖屈 P < .001）和 6 个月（肘屈肌 P < .001，腕屈肌 P = .002，和踝跖屈肌 P < .001) 治疗后。所有不良事件都是轻微的，藏药沐浴疗法未见严重不良反应。结论与启示 藏药沐浴疗法与常规康复疗法相结合，具有作为缓解中风后上肢痉挛的安全、有效疗法的潜力。对于患肢MAS基线肌张力评分为1+至2且近期中风​​（疾病持续时间为1-3个月）的患者，藏药沐浴疗法最有利。