血栓通联合肌肉电刺激对脑卒中偏瘫疗效及NGF、BNDF的影响研究
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摘要
目的:探讨血栓通结合肌肉电刺激对脑卒中偏瘫患者的肢体功能和血清脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、血清神经生长因子(nerve growth factor,NGF)影响。方法:选取120例脑卒中偏瘫患者随机分为观察组(常规康复治疗+肌肉电刺激)和对照组(对照组+血栓通)。观察两组患者临床治疗疗效;评价患者的肢体功能恢复情况;检测患者治疗前后血清NGF、BNDF改变。结果:观察组患者临床治疗的有效率为86.67%显著高于对照组68.33%(P<0.05)。两组患者治疗后NIHSS评分显著下降、MAS总评分和ADL评分Barthel指数显著上升,BDNF和NGF含量显著上升(P<0.05)。与治疗后相比,对照组患者治疗后NIHSS评分下降更加明显,MAS总评分和ADL评分Barthel指数上升更加明显,观察组患者BDNF和NGF含量上升更加明显(P<0.05)。结论:血栓通结合肌肉电刺激对脑卒中偏瘫患者可明显提高脑卒中偏瘫患者的肢体运动和生活能力,明显提高患者血清内BDNF和NGF含量。
Objective: To investigate the effects of Xueshuantong combined with muscle electrical stimulation on limb function and serum-derived neurotrophic factor(BDNF) and serum growth factor(NGF) in stroke patients with hemiplegia. Methods: A total of 120 patients with hemiplegia due to were randomly divided into observation group(conventional rehabilitation+muscle electrical stimulation) and control group(control group+ Xueshuantong). The clinical therapeutic effects of the two groups were observed. The recovery of limb function was evaluated. The changes of serum NGF and BNDF were detected before and after treatment. Results: The effective rate of clinical treatment in the observation group was 86.67%, which was significantly higher than that in the control group(68.33%)(P<0.05). After treatment, the NIHSS scores decreased significantly, the MAS total score and the ADL score Barthel index increased significantly, and the BDNF and NGF levels increased significantly(P<0.05). Compared with the post-treatment, the NIHSS scores of the control group decreased more significantly after treatment, and the MAS total score and the ADL score Barthel index increased more significantly. The BDNF and NGF levels in the observation group increased more significantly(P<0.05). Conclusion: Xueshuantong combined with muscle electrical stimulation can significantly improve the limb movement and living ability of stroke patients with hemiplegia, and significantly increase the serum BDNF and NGF levels.
Objective: To investigate the effects of Xueshuantong combined with muscle electrical stimulation on limb function and serum-derived neurotrophic factor(BDNF) and serum growth factor(NGF) in stroke patients with hemiplegia. Methods: A total of 120 patients with hemiplegia due to were randomly divided into observation group(conventional rehabilitation+muscle electrical stimulation) and control group(control group+ Xueshuantong). The clinical therapeutic effects of the two groups were observed. The recovery of limb function was evaluated. The changes of serum NGF and BNDF were detected before and after treatment. Results: The effective rate of clinical treatment in the observation group was 86.67%, which was significantly higher than that in the control group(68.33%)(P<0.05). After treatment, the NIHSS scores decreased significantly, the MAS total score and the ADL score Barthel index increased significantly, and the BDNF and NGF levels increased significantly(P<0.05). Compared with the post-treatment, the NIHSS scores of the control group decreased more significantly after treatment, and the MAS total score and the ADL score Barthel index increased more significantly. The BDNF and NGF levels in the observation group increased more significantly(P<0.05). Conclusion: Xueshuantong combined with muscle electrical stimulation can significantly improve the limb movement and living ability of stroke patients with hemiplegia, and significantly increase the serum BDNF and NGF levels.
引文
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[2] 史静,王晶,石梦丹,等.神经功能重建系统治疗同时结合运动意念对早期脑卒中偏瘫患者运动功能恢复的影响[J].临床医药文献电子杂志,2017,4(28):5366-5367.
[3] 丁兆日,张江,吕明良,等.进展性缺血性脑卒中患者血清肝细胞生长因子水平及其相关影响因素[J].中国老年学杂志,2013,33(6):1408-1410.
[4] 陈沫,董璐洁,刘雅丽.对侧控制型功能性电刺激在脑卒中偏瘫康复中应用与研究[J].中国康复,2018,33(1):56-59.
[5] 弓自玉,廖之明,冯慧.降钙素原监测在指导脑卒中合并肺部感染患者抗生素使用中的作用[J].现代医学,2016,44(2):194-197.
[6] 郭晓婷.早期康复护理用于缺血性脑卒中患者的效果[J].检验医学与临床,2017,19(14):2939-2941.
[7] 周季兰,华玮,戴晓勇,等.血栓通注射液联合阿托伐他汀对急性脑梗死患者血脂和血液流变学的影响[J].现代生物医学进展,2016,16(24):4680-4683.
[8] 赵小磊,冯晓东.火针联合NMES疗法治疗脑卒中后肢体痉挛临床研究[J].中医学报,2016,31(6):902-905.
[9] 中华神经科学会.各类脑血管疾病的诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[10] 郑全成,符海燕.针灸结合现代康复治疗对脑卒中偏瘫患者总有效率、残损及残疾水平的影响[J].中华中医药学刊,2017,35(9):2462-2464.
[11] 黄晓琳,燕铁斌.康复医学[M].北京:人民卫生出版社,2013:38-39,271-272.
[12] 全国第四届脑血管学术会议.脑卒中患者临床神经功能缺损程度评分标准[S].中华神经科杂志,1996,29 (6):381-383
[13] 王海霞,荣阳.针灸治疗脑卒中偏瘫的疗效分析与临床研究[J].中国医药指南,2018,16(7):190-191.
[14] 周丽萍,乔羲,刘毓刚,等.血清同型半胱氨酸及其代谢相关基因MTHFR多态性与缺血性脑卒中发生及预后的关系[J].标记免疫分析与临床,2017,24(3):241-246.
[15] 邢玉微,邹俊杰,石勇铨,等.复方血栓通胶囊对糖尿病大鼠视网膜氧化应激损伤的保护作用[J].医学研究杂志,2016,45(1):40-43.
[16] 李建鹏,王峥.血栓通联合前列地尔治疗下肢动脉硬化闭塞症的有效性及对其血液流变学的影响[J].中国实验方剂学杂志,2016,22(6):159-162.
[17] 胡伟,刘丹荣,刘雨银,等.复方血栓通胶囊辅治缺血性脑卒中的疗效及其对神经功能和血清PARK7、GFAP的影响[J].疑难病杂志,2016,15(2):116-118,122.
[18] 余玉兰,王旭.血栓通结合高压氧舱治疗脑外伤后遗症疗效观察[J].中国继续医学教育,2016,8(6):194-195.
[19] 周文忠,王海波,杨少华.NMES疗法及单纯吞咽训练对脑卒中后吞咽障碍的疗效观察[J].脑与神经疾病杂志,2016,24(2):75-78.
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[21] 刘有山.神经肌肉电刺激联合吞咽康复训练治疗脑卒中后吞咽障碍的疗效及其对舌骨喉复合体动度的影响[J].中华全科医学,2017,15(10):1782-1785.
[22] 李启金,林洁玲,罗超敏.强制性运动疗法结合神经肌肉电刺激在脑卒中偏瘫患者上肢功能康复中的临床疗效[J].中国医学创新,2017,14(16):38-41.
[23] 卢艳丽.神经肌肉电刺激治疗脑卒中后吞咽障碍的疗效观察[J].内蒙古医学杂志,2017,49(1):66-67.
[24] 刘燕平,宋庆军.神经肌肉电刺激结合康复疗法治疗膝关节骨性关节炎的疗效观察[J].双足与保健,2017,26(16):9-10
[25] 刘经纬,赵哲,李雪松,等.神经肌肉电刺激预防髋关节置换术后下肢深静脉血栓形成的临床观察[J].中国骨与关节损伤杂志,2017,32(6):615-616.