脑卒中后胃肠功能紊乱应用推拿治疗价值

Application value of massage therapy of gastrointestinal dysfunction after stroke

目的探讨推拿对脑卒中后胃肠功能紊乱患者的胃肠动力及营养水平的影响。方法选取病程超过3个月的脑卒中后胃肠功能紊乱患者80例,随机分为研究组与对照组各40例,常规治疗基础上予以标准的胃肠营养方案治疗,研究组加推拿治疗42 d。观察2组治疗前、治疗第21天、第42天血清血红白蛋白(Hb)、白蛋白(ALB)、转铁蛋白(TRF)、前白蛋白(PA)、视黄醇结合蛋白(RBP)、胃泌素(GAS)、胃动素(MTL)水平及症状改善情况,以简易营养量表(MNA)调查患者营养状况。结果治疗第21天、第42天时均较治疗前升高(P<0.05),组内比较第42天时与治疗第21天时比较明显升高(P<0.05),治疗第21天、第42天时研究组高于对照组(P<0.05);研究组肠鸣音恢复时间、排便排气时间短于对照组(P<0.05);MNA量表调查显示,2组治疗第42天时均较治疗前好转(P<0.05),研究组较对照组改善程度更好(P<0.05)。结论推拿按摩治疗对脑卒中后胃肠功能紊乱患者能明显改善患者胃肠动力,改善患者营养状态。

Objective To study the influence of massage on gastrointestinal dynamics and nutrient levels in patients with gastrointestinal dysfunction after stroke. Methods Select 80 patients （course of more than 3 months） with gastrointestinal dysfunction after stroke, they were randomly divided into research group and control group, with 40 cases in each group, on the basis of conventional treatment, gastrointestinal nutrition regimen plus the 42 days of massage treatment. Hb, propagated,TRF, PA, RBP, GAS, MTL levels and symptoms were observed before treatment, and 21 days,42 days after treatment;nutritional status of patients were surveyed with MNA. Results The index of 21 d and 42 d treatment were higher than before treatment（P 〈0.05）, the index of 42 d was significantly higher that of 21 d （P 〈0.05 ）, the index of treatment of 21 d and 42 d was higher than that of the control group（P 〈0.05） ;clear bowel sounds recovery time,defecate exhaust was shorter than control group （ P 〈 0.05 ） ; MNA questionnaire investigation showed that both of the groups in 42 d improved than before treatment（ P 〈 0.05 ）, the research group improved better than the control group（ P 〈 0.05 ）. Conclusion Massage therapy in patients with gastrointestinal dysfunction after stroke can significantly improve patients with gastrointestinal dynamics and improve the patients nutritional status.