中医康复训练结合情志干预对脑卒中偏瘫患者跌倒的预防作用

Preventive Effect of Rehabilitation Training of Chinese Medicine Combined with Emotional Intervention on Falls of Patients with Hemiplegia after Stroke

目的:观察情志干预联合中医康复训练对脑卒中偏瘫患者跌倒的预防作用。方法:将130例脑卒中偏瘫住院患者纳为研究对象,采用随机数字表法分为2组各65例,对照组予以常规护理,观察组在对照组干预方案的基础上予以情志干预联合中医康复训练,2组均干预至出院。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、认知功能评定量表(LOTCA)、Berg平衡量表(BBS)、跌倒功效量表(MFES)、日常生活活动能力量表(Barthel指数)及Fugl-Meyer运动评分量表(FMA)分别评定患者治疗前后的负性情绪、平衡能力、生活能力及运动能力,于治疗前及出院前1天分发自拟调查问卷,评估2组对疾病相关知识及预防跌倒相关知识的掌握程度。结果:治疗后,观察组SAS及SDS评分低于对照组;观察组LOTCA、BBS、MFES、Barthel指数、FMA评分及疾病知识、预防跌倒知识得分均高于对照组,差异均有统计学意义(P<0.05)。结论:情志干预联合中医康复训练能改善患者的不良情绪,提高认知功能、平衡能力及运动能力,起到预防跌倒的作用。

Objective:To observe the preventive effect of emotional intervention combined with rehabilitation training of Chinese medicine on falls of patients with hemiplegia after stroke. Methods:A total of 130 cases of patients with hemiplegia after stroke were included as the study subjects,and were divided into two groups according to the random number table method,65 cases in each group. The control group was given routine nursing,and the observation group was additionally treated with emotional intervention combined with rehabilitation training of Chinese medicine based on the treatment of the control group. Both groups were given intervention until discharge. Before and after treatment, the negative emotions,balance ability, living ability and motor ability were evaluated by Self-Rating Anxiety Scale(SAS), Self-Rating Depressing Scale(SDS), Loewenstein Occupational Therapy Cognitive Assessment(LOTCA), Berg Balance Scale(BBS), Modified Falls Efficacy Scale(MFES),Activities of Daily Living Scale(Barthel Indexes) and Fugl-Meyer Assessment(FMA). Before treatment and one day before discharge, a self-designed questionnaire was distributed to the two groups to evaluate the mastery degree of the knowledge related to diseases and about fall prevention. Results:After treatment,the scores of SAS and SDS in the observation group were lower than those in the control group, and the scores of LOTCA, BBS, MFES, Barthel indexes,FMA,and the knowledge of diseases and fall prevention in the observation group were all higher than those in the control group, differences being significant(P<0.05). Conclusion: The therapy of emotional intervention combined with rehabilitation training of Chinese medicine can reduce the negative emotions of patients,and improve the cognitive function,balance ability and motor ability,thus can prevent falls.