桃红四物汤结合认知功能锻炼对脑卒中患者功能障碍恢复的效果观察
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摘要
目的:研究桃红四物汤结合认知功能锻炼对脑卒中患者功能障碍恢复的临床效果。方法:选取2014年11月至2016年10月惠州市中心人民医院收治的脑卒中认知功能障碍患者98例,按照随机抽签法随机分为观察组(n=50)和对照组(n=48)。对照组仅给接受知功能康复锻炼,观察组在对照组治疗的基础上给予桃红四物汤治疗,比较2组患者治疗前后的HAMD评分、血液流变学、MMSE评分、Fugl-Meyer评分及Barthel指数。结果:治疗后,观察组患者的HAMD评分显著低于对照组;观察组的血浆黏度、红细胞压积、全血高切黏度及全血低切黏度显著低于对照组;观察组患者的MMSE评分、Fugl-Meyer评分及Barthel指数均显著高于对照组;对照组的总有效率是64. 6%,观察组的总有效率是88. 0%,观察组显著高于对照组,差异有统计学意义(P <0. 05)。结论:对于伴有认知功能障碍的脑卒中患者而言,给予桃红四物汤结合认知功能锻炼治疗能有效改善临床症状。
Objective: To study the clinical effects of Taohong Siwu Decoction with cognitive function on recovery of dysfunction in stroke patients. Methods: A total of 98 patients with cognitive impairment treated in Department of Rehabilitative Medicine in Huizhou Muncicipal Central People' s Hospital from November 2014 to October 2016 were selected and divided into observation group( 50 cases) and control group( 48 cases) according to the random drawing method. The control group was treated with cognitive rehabilitation exercise. Based on the same treatment,the observation group was given Taohong Siwu Decoction. The data of HAMD score,MMSE score,Fugl-Meyer score and Barthel index in both groups before and after the treatment were compared. Results: After treatment,the HAMD score of the observation group was significantly lower than that of the control group. The plasma viscosity,erythrocyte backlog,whole blood high shear viscosity and low blood viscosity of the control group were significantly higher than the observation group. The MMSE score,Fugl-Meyer Score and Barthel index of the observation group were significantly higher than the control group. The total effective rate of the control group was 64. 6%,while the total effective rate of the observation group was 88. 0%. The effective rate of the observation group was significantly higher than the control group,and the difference between the two groups was statistically significant( P < 0. 05). Conclusion: For patients who had stroke with cognitive impairment,Taohong Siwu Decoction with cognitive function exercise can effectively improve the clinical symptoms.
Objective: To study the clinical effects of Taohong Siwu Decoction with cognitive function on recovery of dysfunction in stroke patients. Methods: A total of 98 patients with cognitive impairment treated in Department of Rehabilitative Medicine in Huizhou Muncicipal Central People' s Hospital from November 2014 to October 2016 were selected and divided into observation group( 50 cases) and control group( 48 cases) according to the random drawing method. The control group was treated with cognitive rehabilitation exercise. Based on the same treatment,the observation group was given Taohong Siwu Decoction. The data of HAMD score,MMSE score,Fugl-Meyer score and Barthel index in both groups before and after the treatment were compared. Results: After treatment,the HAMD score of the observation group was significantly lower than that of the control group. The plasma viscosity,erythrocyte backlog,whole blood high shear viscosity and low blood viscosity of the control group were significantly higher than the observation group. The MMSE score,Fugl-Meyer Score and Barthel index of the observation group were significantly higher than the control group. The total effective rate of the control group was 64. 6%,while the total effective rate of the observation group was 88. 0%. The effective rate of the observation group was significantly higher than the control group,and the difference between the two groups was statistically significant( P < 0. 05). Conclusion: For patients who had stroke with cognitive impairment,Taohong Siwu Decoction with cognitive function exercise can effectively improve the clinical symptoms.
引文
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[15]林强,李雪萍,程凯,等.早期认知康复训练对脑卒中患者认知功能、运动功能和日常生活活动能力的影响[J].中国康复医学杂志,2015,30(12):1286-1288.
[16]陈峤鹦,朱美红,徐学青,等.早期头皮针结合康复训练对脑卒中患者认知障碍的影响[J].中国中医药科技,2014,21(1):97-98.
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[18]陈爱萍,苑丽.加味桃红四物汤治疗脑卒中后抑郁症40例[J].河南中医,2014,34(10):1908-1909.
[19]赵治龙.桃红四物汤对脑卒中神经血管单元的保护作用研究[D].西南交通大学,2015.
[20]Moore SA,Hallsworth KJ,Djordje G. et al. Effects of Community Exercise Therapy on Metabolic, Brain, Physical, and Cognitive Function Following Stroke:A Randomized Controlled Pilot Trial[J]. Neurorehabilitation and neural repair,2015,29(7):623-635.
[21]刘卫民,王蕾,孙颖等.半夏白术天麻汤合桃红四物汤加减治疗缺血性脑卒中早期的临床疗效观察[J].光明中医,2017,32(19):2815-2817.
[22]唐汉平,蒋上润,方之勇等.疏肝活血法治疗脑卒中后焦虑症临床观察[J].湖北中医杂志,2012,34(7):3-4.
[23]Cumming TB,Tyedin K,Churilov L. et al. The effect of physical activity on cognitive function after stroke:A systematic review[J].International psychogeriatrics,2012,24(4):557-567.
[24]Lin YY,Dong J,Yan T,et al. Involuntary,forced and voluntary exercises are equally capable of inducing hippocampal plasticity and the recovery of cognitive function after stroke[J]. Neurological Research:An Interdisciplinary Quarterly Journal,2015,37(10):893-901.
[2]刘晶,金香兰,郑宏,等.缺血性脑卒中患者认知功能障碍的影响因素研究[J].中国全科医学,2015,18(12):1361-1365.
[3]Havasi K,Domsik P,Kalapos A,et al. Left Atrial Deformation Analysis in Patients with Corrected Tetralogy of Fallot by 3D Speckle-Tracking Echocardiography from the MAGYAR-Path Study[J]. Arq Bras Cardiol,2017,108(2):129-134.
[4]Mica lli D. Therapeutic education of children who are victims or at risk of a stroke[J]. Soins Pediatr Pueric,2017,38(295):32-33.
[5]Wang H,Li P,Xu N. et al. Paradigms and mechanisms of inhalational anesthetics mediated neuroprotection against cerebral ischemic stroke[J]. Med Gas Res,2016,6(4):194-205.
[6]Saver JL,Goyal M,Hill MD. et al. Time to Endovascular Thrombectomy for Acute Stroke-Reply[J]. JAMA,2017,317(11):1175-1176.
[7]曹承兰,余年,林兴建,等.脑卒中高危人群的相关危险因素[J].临床神经病学杂志,2014,27(05):335-337.
[8]Déziel RA,Tasker RA. Effects of endothelin-induced prefrontal cortical lesions on delay discounting in the rat[J]. Behav Neurosci,2017,131(1):11-19.
[9]刘春红,梁华峰,冯丽娜,等.脑梗死后认知功能障碍的相关性分析[J].中国老年学杂志,2012,32(03):456-459.
[10]van Rijsbergen MW,Mark RE,Kop WJ. et al. The role of objective cognitive dysfunction in subjective cognitive complaints after stroke[J]. Eur J Neurol,2017,24(3):475-482.
[11]Pi HC,Xu YF,Xu R. et al. Cognitive Impairment and Structural Neuroimaging Abnormalities Among Patients with Chronic Kidney Disease[J]. Kidney Blood Press Res,2016,41(6):986-996.
[12]刘立,段金廒,刘培,等.桃红四物汤及配伍药对桃仁-红花与四物汤用于原发性痛经作用的比较研究[J].中药药理与临床,2012,28(01):2-6.
[13]Li X,Li DY,Chen WN,et al. Effect of ASO Blood Stasis Syndrome Serum on Vascular Endothelial Cell Injury and Regulation of Taohong Siwu Decoction on it[J]. Chinese Journal of Integrated Traditional and Western Medicine,2015,35(11):1373-1377.
[14]于梅青,袁栋才,魏琰,等.早期强化认知功能训练结合运动想象疗法对脑卒中康复的促进作用[J].中国康复医学杂志,2014,29(3):267-269.
[15]林强,李雪萍,程凯,等.早期认知康复训练对脑卒中患者认知功能、运动功能和日常生活活动能力的影响[J].中国康复医学杂志,2015,30(12):1286-1288.
[16]陈峤鹦,朱美红,徐学青,等.早期头皮针结合康复训练对脑卒中患者认知障碍的影响[J].中国中医药科技,2014,21(1):97-98.
[17]Liu A,Teresa E,Janice J. Exercise Training and Recreational Activities to Promote Executive Functions in Chronic Stroke:A Proofof-concept Study[J]. Journal of stroke and cerebrovascular diseases:The official journal of National Stroke Association,2015,24(1):130-137.
[18]陈爱萍,苑丽.加味桃红四物汤治疗脑卒中后抑郁症40例[J].河南中医,2014,34(10):1908-1909.
[19]赵治龙.桃红四物汤对脑卒中神经血管单元的保护作用研究[D].西南交通大学,2015.
[20]Moore SA,Hallsworth KJ,Djordje G. et al. Effects of Community Exercise Therapy on Metabolic, Brain, Physical, and Cognitive Function Following Stroke:A Randomized Controlled Pilot Trial[J]. Neurorehabilitation and neural repair,2015,29(7):623-635.
[21]刘卫民,王蕾,孙颖等.半夏白术天麻汤合桃红四物汤加减治疗缺血性脑卒中早期的临床疗效观察[J].光明中医,2017,32(19):2815-2817.
[22]唐汉平,蒋上润,方之勇等.疏肝活血法治疗脑卒中后焦虑症临床观察[J].湖北中医杂志,2012,34(7):3-4.
[23]Cumming TB,Tyedin K,Churilov L. et al. The effect of physical activity on cognitive function after stroke:A systematic review[J].International psychogeriatrics,2012,24(4):557-567.
[24]Lin YY,Dong J,Yan T,et al. Involuntary,forced and voluntary exercises are equally capable of inducing hippocampal plasticity and the recovery of cognitive function after stroke[J]. Neurological Research:An Interdisciplinary Quarterly Journal,2015,37(10):893-901.