中药穴位贴敷配合康复训练在出血性脑卒中患者术后下肢运动功能恢复中的应用

Application of Traditional Chinese Medicine Acupoint Application Combined with Rehabilitation Training in the Recovery of Postoperative Lower Limb Motor Function for Patients with Hemorrhagic Stroke

目的:探究中药穴位贴敷配合康复训练在出血性脑卒中(气虚血瘀型)患者术后下肢运动功能恢复中的应用。方法:选取我院2020年1月-2021年12月收治的出血性脑卒中患者作为研究对象,采用随机数字表法随机分为对照组(n=56)和试验组(n=56),对照组给予康复训练干预,试验组给予中药穴位贴敷配合康复训练干预。比较干预前和干预4周后两组患者中医症状评分(肌肉萎缩、下肢瘫软无力、足膝浮肿、手足拘挛)、神经缺损情况[中国脑卒中患者临床神经功能缺损评分标准(CSS)]、下肢肌力[徒手肌力评定量表(MMT)]、血清因子水平[神经生长因子(NGF)、神经营养因子(NTF)、肌肉生成抑制素(MSTN)]、下肢运动功能[简化下肢Fugl-Meyer运动功能评定量表(FMA)、Berg平衡量(BBS)]。结果:干预4周后,两组患者中医症状评分、CSS评分、MSTN水平均较干预前降低,试验组低于对照组(P均<0.05);MMT评分、部分血清因子(NGF、NTF)水平、FMA、BBS评分均较干预前升高,试验组高于对照组(P均<0.05)。结论:中药穴位贴敷配合康复训练可以减轻出血性脑卒中术后患者神经损伤,改善患者下肢肌力和血清因子水平,提高患者下肢运动功能。

Objective:To explore the application of combining traditional Chinese medicine acupoint application and rehabilitation training on postoperative lower limb motor function recovery for patients with hemorrhagic stroke with of blood stasis due to Qi deficiency syndrome.Methods:Patients with hemorrhagic stroke who were treated in the hospital from January 2020 to December 2020 were selected as the research subjects,and were randomly divided into a controlled group(n=56)and an experimental group(n=56)by the sealed envelope method.The controlled group was given rehabilitation training intervention while the experimental group was given traditional Chinese medicine acupoint application combined with rehabilitation training intervention.The scores of TCM symptoms(muscle atrophy,lower limb paralysis,foot and knee edema,hand-foot spasm),neurological defect[Chinese stroke scale(CSS)of clinical neurological function defect],lower limb muscle strength[manual muscle test(MMT)],serum factors[nerve growth factor(NGF),neurotrophic factor(NTF),myostatin(MSTN)],lower limb motor function[simplified lower limb Fugl-Meyer motor function assessment(FMA),Berg balance scale(BBS)]were compared between the two groups before intervention and after 4 weeks of treatment.Results:After 4 weeks of intervention,the TCM symptoms,CSS scores and MSTN level of the two groups were reduced compared with those before intervention,and the scores and level in the experimental group were lower than those in the controlled group(P<0.05).The MMT scores,and levels of partial serum factors(NGF,NTF),FMA score and BBS score were enhanced compared to before intervention,and the scores and levels in the experimental group were higher than those in the controlled group(all P<0.05).Conclusion:Acupoint application of traditional Chinese medicine combined with rehabilitation training can relieve the neurological injury,improve the lower limb muscle strength and serum factors levels,and enhance the lower limb motor function in patients with hemorrhagic stroke.