脑卒中偏瘫后康复训练联合药物预防继发性骨质疏松

Combined drug and rehabilitation training to preservation of secondary osteoporosis in hemiplegic paralysis by stroke

目的通过对脑卒中后偏瘫患者进行康复训练,并使联合使用降钙素和碳酸钙D3抗骨质疏松治疗,分析对预防骨质疏松的疗效。方法选择脑卒中后偏瘫患者132例,实验组72例,对照组60例,按Brunnstrom分期治疗,两组均进行正规康复训练,实验组采用降钙素联合碳酸钙D3抗骨质疏松治疗,对照组未进行任何抗骨质疏松药物治疗,测定患侧股骨Ward三角、桡骨远端、第1腰椎三部位骨密度并进行分析比较。结果 Brunnstrom I～Ⅱ期两组三部位均相当(P>0.05),Ⅲ～IV期、VI～V期实验组三部位骨密度均高于对照组(P<0.05),说明中晚期预防骨质疏松疗效显著。结论脑卒中后偏瘫极易继发骨质疏松,在正规康复训练的基础上,使用联合抗骨质疏松药物治疗,可明确预防继发性骨质疏松。

Objective To investigate the curative effect of preservation of secondary osteoporosis in stroke hemiplegic paralysis by rehabilitation training and combined drug, which calcitionin and calcium carbonate with alpha vitamin D3. Methods Total 132 patients with post-stroke hemiplegia were selected,who were divided into 2 groups randomly, inexpenment group and 60 cases were in control group.The management was by Brunnstrom Staging. And all the patients were got rehabilitation training.Then the experiment group patients be treated by combined grug ,but the control without any grug of preservation osteoporosis.We determined the bone density of the first lumbar and the femoral Ward triangle and the distal radius of the hemiparalysis limbs,by using the dualenergy X-ray absorptiometr,and the analysis and contrast by stages. Results The values of the bone mineral density of the three place is equivalency in 2 groups when the Brunnstrom I to Ⅱ stages（ P 0.05）.And the all data of the experiment group patients is obviously super than the chtrol group when Brunnstrom Ⅲ to Ⅳ and VI to V stage（ P 0.05）.This means that the curative effect of preservation of secondary osteoporosis in stroke hemiplegic paralysis by rehabilitation training and combined drug is predominance. Conclusion The secondary osteoporosis is easily happened after stroke, and the treatment of Combined drug and rehabilitation training can significantly reduce bone loss and prevent to the osteoporosis.