神经肌肉促进技术对脑卒中后偏瘫患者肢体骨质疏松的疗效及作用机制

Therapeutic effect and mechanism of neuromuscular facilitation techniques in treatment of hemiplegic stroke patients' osteoporosis

目的通过检测脑卒中后偏瘫患者的骨密度(BMD)及血清瘦素(LP)、碱性磷酸酶(ALP)、骨钙素(BGP)、白介素-6(IL-6)水平,观察神经肌肉促进技术(NFT)对其肢体骨质疏松的影响。方法将52例脑卒中偏瘫患者随机分为治疗组和对照组,对照组行常规治疗,治疗组在常规治疗基础上早期给予NFT治疗。采用双能X线吸收法检测两组入院第2天及治疗6个月后的BMD,采用ELISA法检测两组血清LP、ALP、BGP、IL-6水平,并进行比较。结果 6个月后两组患肢BMD、对照组健肢与患肢BMD比较差异均有统计学意义(P均<0.05);两组血清LP、ALP、BGP、IL-6水平比较差异均有统计学意义(P<0.05或<0.01)。结论 NFT能影响脑卒中后偏瘫患者骨代谢指标,增加偏瘫肢体BMD;NFT对防治脑卒中后偏瘫患者的骨质疏松有效。

Objective To observe the therapeutic effect of neuromuscular facilitation techniques （NFT） on hemiplegic stroke patients＆#39;osteoporosis through the detections of serum leptin （LP）, alkaline phosphatase （ALP）, bone gla-protein （BGP）, interleukin-6 （IL-6） and bone mineral density （BMD）.Methods Fifty-two hemiplegic stroke patients were randomly divided into 2 groups：the control group which received conventional treatment, and the treatment group which received NFT early be-sides conventional treatment.The serum LP, ALP, BGP, IL-6 and BMD of all cases in the second day of admission and 6 months after the treatment were detected by using ELISA method and double X-ray absorption method, and then contrastive analysis was conducted.Results The BMD of hemiplegic limbs between the two groups 6 months later, and the BMD between the hemiplegic limbs and the healthy limbs in the control group 6 months later all had statistically significant differences （all P〈0.05）.The se-rum ALP, BGP, IL-6 and LP levels 6 months later all had statistically significant differences between the two groups （ all P〈0.05 or P〈0.01）.Conclusions NFT can affect the patients＇ bone metabolic markers and increase the BMD of hemiplegic limbs;NFT should be given to the hemiplegic stroke patients for the prevention and treatment of osteoporosis .