摘要
目的观察综合康复训练联合穴位按摩干预脑卒中偏瘫患者的康复效果。方法选取2019年1月—2020年1月南京脑科医院收治的112例脑卒中偏瘫患者,按照随机数字表法分为对照组和观察组,各56例。对照组患者给予常规康复训练,观察组患者给予综合康复训练(镜像疗法+神经促通+悬吊训练+呼吸训练)联合穴位按摩干预,1周为1个疗程,连续干预4个疗程。对比两组患者的康复效果,观察患者运动、步行、平衡能力及神经功能变化,测定血清中相关因子水平。结果观察组、对照组的有效率分别为92.86%、78.57%(χ2=8.106,P<0.05);治疗2、4周后,观察组患者的Fugl-Meyer运动功能(FMA)评分、Wolf运动功能测试量表(WMFT)评分均显著高于对照组(P<0.05),美国国立卫生研究院卒中量表(NIHSS)评分显著低于对照组(P<0.05);观察组患者步行、平衡能力改善更明显,10 m步行测试速度、Brunel平衡量表(BBA)总分与对照组相比均显著升高(P<0.05);与对照组相比,观察组患者治疗后血清中神经生长因子(NGF)、γ-氨基丁酸(GABA)、甘氨酸(Gly)、脑源性神经营养因子(BDNF)水平均显著升高(P<0.05)。结论综合康复训练联合穴位按摩干预脑卒中偏瘫患者的康复效果确切,利于促进患者肢体运动功能的恢复,强化步行能力、平衡功能,减轻患者的神经功能缺损程度,其原因可能与提高血清中NGF、GABA、Gly、BDNF水平以促进神经功能重建、缓解肌痉挛有关,值得进行临床推广。
Objective To observe the rehabilitation effect of comprehensive rehabilitation training combined with acupoint massage in stroke patients with hemiplegia.Methods A total of 112 stroke patients with hemiplegia admitted to Nanjing brain hospital from January 2019 to January 2020 were selected and divided into control group and observation group according to the random number table,56 patients in each group.Patients in the control group were given conventional rehabilitation training,while patients in the observation group were given comprehensive rehabilitation training(mirror therapy+neurotonation+suspension training+breathing training)and acupoint massage combined intervention,with 1 course of treatment for 1 week and 4 consecutive courses of intervention.The rehabilitation effects of the two groups of patients were compared,the changes of the patients’movement,walking,balance ability and nerve function were observed,and the levels of nerve function related factors in the serum were measured.Results The effective rates of the observation group and the control group were 92.86%and 78.57%respectively(χ2=8.106,P<0.05).After 2 weeks and 4 weeks of treatment,the Fugl-Meyer motor function(FMA)score and wolf motor function test(WMFT)score of the patients in the observation group were significantly higher than those in the control group(P<0.05),National Institute of Health stroke scale(NIHSS)score was significantly lower than that in the control group(P<0.05).The walking and balance abilities of the patients in the observation group were significantly improved,and the walking speed and Brunel balance scale total score were significantly increased compared with the control group(P<0.05).Compared with the control group,the serum levels of nerve growth factor(NGF),gamma-aminobutyric acid(GABA),glycine(Gly)and brain-derived neurotrophic factor(BDNF)in the observation group were significantly increased after treatment(P<0.05).Conclusion Comprehensive rehabilitation training combined acupuncture point massage intervention in stroke patients with hemiplegia rehabilitation effect is exact,it is conducive to promoting the limb motor function recovery,strengthen the ability to walk,balance function,reducing the level of nerve function defect in patients,the reason may be related to improve NGF plays in serum,GABA,Gly,BDNF levels to promote nerve function reconstruction and alleviate muscle spasm,which is worth clinical promotion.
作者
张玲玲
张羽
ZHANG Lingling;ZHANG Yu(Nanjing Brain Hospital,Nanjing 210029,Jiangsu,China)
出处
《辽宁中医药大学学报》
CAS
2021年第10期194-198,共5页
Journal of Liaoning University of Traditional Chinese Medicine
基金
南京医科大学科技发展基金项目(NMUB2019113,NMUB2019105)
关键词
综合康复训练
穴位按摩
脑卒中
偏瘫
comprehensive rehabilitation training
point massage
stroke
hemiplegia
作者简介
张玲玲(1992-),女,江苏淮安人,主管技师,学士,研究方向:神经康复;通讯作者:张羽(1992-),女,江苏南京人,主管技师,学士,研究方向:神经康复。
