针灸结合康复治疗对卒中后患者神经功能恢复及生活质量的影响
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摘要
目的:探讨针灸结合康复治疗对卒中后患者神经功能恢复及生活质量的影响。方法:将初次急性脑卒中患者132例按随机数字表法分为2组各66例。对照组患者进行急性脑卒中一般药物治疗及康复治疗;治疗组在对照组治疗基础上进行针灸辅助康复治疗。观察2组患者临床疗效、神经功能恢复情况、血清B型脑钠肽(BNP)、C反应蛋白(CRP)、神经特异性烯醇酶(NSE)水平及1年内患者脑卒中复发生率、生活质量。结果:总有效率治疗组为92.4%,高于对照组的78.8%(P<0.05);1年内治疗组复发率为4.5%,低于对照组的13.6%(P<0.05);与治疗前及治疗后对照组比较,治疗组患者FM、WHOQOL-BREF评分升高,神经缺损水平、FAQ水平及血清BNP、CRP、NSE水平降低(P<0.05)。结论:针灸结合康复治疗能有效提高卒中后患者治疗效果,减轻功能障碍、促进神经功能恢复、降低脑卒中复发率、提高生活质量,效果优于一般药物加康复治疗。
Objective: To discuss the effects of acupuncture combined with rehabilitation therapy on quality of life and neurological function recovery of the patients after stroke. Methods: All 132 patients who were diagnosed as acute stroke initially were allocated to two groups according to random number table method, 66 cases each group.The patients in the control group were treated by the common drugs of acute stroke and rehabilitation therapy; and the treatment group accepted acupuncture as adjunctive therapy(AT) on the foundation of the therapy the control group received. Quality of life, the recurrence rate of stroke within one year, the levels of BNP, CRP and NSE, neurological function recovery conditions and clinical effects of both groups were observed. Results: Total effective rate of the treatment group was 92.4%, higher than 78.8% of the control group(P<0.05); the recurrence rate within one year of the treatment group was 4.5%, lower than 13.6% of the control group(P<0.05); compared with before treating and the control group after treating, the scores of FM and WHOQOL-BREF of the treatment group rose, the levels of neurologic defect and FAQ, the levels of BNP, CRP and NSE lowered(P<0.05). Conclusion: Acupuncture combined with rehabilitation therapy could effectively raise therapeutic effects of the patients, reduce functional disorder, promote the recovery of neurological function, decrease the recurrence rate of stroke and improve quality of life, and the effects are superior to these of the common drugs of acute stroke and rehabilitation therapy.
Objective: To discuss the effects of acupuncture combined with rehabilitation therapy on quality of life and neurological function recovery of the patients after stroke. Methods: All 132 patients who were diagnosed as acute stroke initially were allocated to two groups according to random number table method, 66 cases each group.The patients in the control group were treated by the common drugs of acute stroke and rehabilitation therapy; and the treatment group accepted acupuncture as adjunctive therapy(AT) on the foundation of the therapy the control group received. Quality of life, the recurrence rate of stroke within one year, the levels of BNP, CRP and NSE, neurological function recovery conditions and clinical effects of both groups were observed. Results: Total effective rate of the treatment group was 92.4%, higher than 78.8% of the control group(P<0.05); the recurrence rate within one year of the treatment group was 4.5%, lower than 13.6% of the control group(P<0.05); compared with before treating and the control group after treating, the scores of FM and WHOQOL-BREF of the treatment group rose, the levels of neurologic defect and FAQ, the levels of BNP, CRP and NSE lowered(P<0.05). Conclusion: Acupuncture combined with rehabilitation therapy could effectively raise therapeutic effects of the patients, reduce functional disorder, promote the recovery of neurological function, decrease the recurrence rate of stroke and improve quality of life, and the effects are superior to these of the common drugs of acute stroke and rehabilitation therapy.
引文
[1]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
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[3]盛晗,邵圣文,王惠琴,等.脑卒中患者康复锻炼依从性动态变化的研究[J].中华护理杂志,2016,51(6):712-715.
[4]杨成,钱捷,唐迅,等.阿司匹林单独或与氯吡格雷联合用药治疗缺血性脑卒中及短暂性脑缺血发作疗效和不良反应的Meta分析[J].中华流行病学杂志,2015,36(12):1430-1435.
[5]苏镇培.评“缺血性卒中诊治三重奏---危险因素、病因和发病机制”[J].中国神经精神疾病杂志,2011,37(7):446-448.
[6]王班,关天嘉,尤莉莉,等.我国缺血性脑卒中残疾情况及其影响因素分析[J].中国全科医学,2016,19(2):216-219.
[7]沈惠,李亚楠,李子付,等.脑卒中康复治疗知识基础及研究热点:一项基于Web of Science的分析研究[J].第二军医大学学报,2016,37(8):1043-1048.
[8]郑薏,柳维林,上官豪,等.针灸治疗脑卒中患者肢体运动功能障碍疗效的Meta分析[J].中国康复医学杂志,2016,31(2):217-221.
[9]姬少珍,张允岭,张志辰,等.脑卒中(含短暂性脑缺血发作)伴/不伴颅外动脉狭窄患者危险因素比较及中医证候要素分析[J].北京中医药大学学报,2015,38(1):63-67.
[10]周末,林爱翠.脑卒中患者早期康复需求情况的调查研究[J].中国康复医学杂志,2015,30(8):820-821.
[11]荣积峰,吴毅,路微波,等.四肢联动对脑卒中偏瘫患者平衡功能和步行能力的影响[J].中国康复医学杂志,2015,30(10):1063-1065.
[12]谢荣,殷春,马璟,等.规范化康复治疗脑卒中患者的临床疗效观察[J].中华物理医学与康复杂志,2015,37(5):371-373.
[13]杜小正,王金海,秦晓光,等.“三位一体”针法治疗缺血性脑卒中偏瘫的效果[J].中国康复理论与实践,2015,21(9):1087-1090.
[14]冯怡墨,马素兰.针灸结合红外线穴位照射及康复训练治疗126例脑卒中后肩手综合征疗效观察[J].激光杂志,2015,36(4):195-197.
[15]姚涛,任明山,李淮玉.缺血性脑卒中急性期超敏C-反应蛋白水平变化与进展性卒中的相关性[J].实用医学杂志,2016,32(5):735-738.
[2]缪朝玉.脑卒中治疗靶点和药物研究[J].中国药理学与毒理学杂志,2016,30(12):1264-1272.
[3]盛晗,邵圣文,王惠琴,等.脑卒中患者康复锻炼依从性动态变化的研究[J].中华护理杂志,2016,51(6):712-715.
[4]杨成,钱捷,唐迅,等.阿司匹林单独或与氯吡格雷联合用药治疗缺血性脑卒中及短暂性脑缺血发作疗效和不良反应的Meta分析[J].中华流行病学杂志,2015,36(12):1430-1435.
[5]苏镇培.评“缺血性卒中诊治三重奏---危险因素、病因和发病机制”[J].中国神经精神疾病杂志,2011,37(7):446-448.
[6]王班,关天嘉,尤莉莉,等.我国缺血性脑卒中残疾情况及其影响因素分析[J].中国全科医学,2016,19(2):216-219.
[7]沈惠,李亚楠,李子付,等.脑卒中康复治疗知识基础及研究热点:一项基于Web of Science的分析研究[J].第二军医大学学报,2016,37(8):1043-1048.
[8]郑薏,柳维林,上官豪,等.针灸治疗脑卒中患者肢体运动功能障碍疗效的Meta分析[J].中国康复医学杂志,2016,31(2):217-221.
[9]姬少珍,张允岭,张志辰,等.脑卒中(含短暂性脑缺血发作)伴/不伴颅外动脉狭窄患者危险因素比较及中医证候要素分析[J].北京中医药大学学报,2015,38(1):63-67.
[10]周末,林爱翠.脑卒中患者早期康复需求情况的调查研究[J].中国康复医学杂志,2015,30(8):820-821.
[11]荣积峰,吴毅,路微波,等.四肢联动对脑卒中偏瘫患者平衡功能和步行能力的影响[J].中国康复医学杂志,2015,30(10):1063-1065.
[12]谢荣,殷春,马璟,等.规范化康复治疗脑卒中患者的临床疗效观察[J].中华物理医学与康复杂志,2015,37(5):371-373.
[13]杜小正,王金海,秦晓光,等.“三位一体”针法治疗缺血性脑卒中偏瘫的效果[J].中国康复理论与实践,2015,21(9):1087-1090.
[14]冯怡墨,马素兰.针灸结合红外线穴位照射及康复训练治疗126例脑卒中后肩手综合征疗效观察[J].激光杂志,2015,36(4):195-197.
[15]姚涛,任明山,李淮玉.缺血性脑卒中急性期超敏C-反应蛋白水平变化与进展性卒中的相关性[J].实用医学杂志,2016,32(5):735-738.