中西医结合康复方案对脑卒中后偏瘫患者运动功能、日常生活活动能力和生活质量的影响

Effect of Comprehensive Protocol of Integrative Medicine on Motor Function,Activity of Daily Living and Quality of Life in Hemiplegia Patients after Stroke

目的探讨中西医结合康复方案对脑卒中后偏瘫患者的运动功能、日常生活活动能力和生活质量的影响。方法将120例脑卒中后偏瘫患者通过抽密封的信封随机分配法分为康复组、中药组、针灸组、综合康复组,每组30例。中药组、针灸组、综合康复组在常规康复训练的基础上分别予规范化中医辨证治疗、石氏醒脑开窍针刺及中药结合针灸综合康复方案治疗,治疗周期为4周,随访到24周。在治疗前,治疗4周,随访第12、24周分别采用简式Fugl-Meyer评分量表(Fugl-Meyer assessment,FMA)、改良Barthel指数(modified Barthel index,MBI)、中风专用生活质量量表(stroke specific quality of life scale,SS-QOL)及安全性对患者进行评定。结果 4组患者治疗前FMA评分、MBI、SS-QOL评分差异无统计学意义(P>0.05);治疗4周,随访12、24周后与治疗前比较,4组患者FMA评分、MBI、SS-QOL评分均提高,差异均有统计学意义(P<0.05),且综合康复组FMA评分及SS-QOL评分各相应时间点较其他组显著提高(P<0.05)。结论中西医结合治疗脑卒中后偏瘫的综合康复方案能显著提高患者的运动功能和日常生活活动能力,改善患者的生活质量,其效果优于单一治疗方法。

Objective To explore the effects of integrative medicine（IM）rehabilitation protocol on motor function,activity of daily living,and quality of life（QOL）in hemiplegia patients after stroke.Methods Totally 120 patients with post-stroke hemiplegia were allocated to four groups using sealed envalope drawing,i.e.,the rehabilitation group,the Chinese medical treatment group,the acupuncture group,and the comprehensive rehabilitation group,30 cases in each group.Based on routine rehabilitative training,patients in the Chinese medical treatment group,the acupuncture group,and the comprehensive rehabilitation group received standardized treatment based on syndrome typing,Shi′s Consciousness-Restoring Resuscitation acupuncture,Chinese herbs＋acupuncture comprehensive rehabilitatino protocol,respectively.The treatmet cycle consisted of 4 weeks with24-week follow-ups.Fugl-Meyer motor assessment（FMA）,Modified Barthel Index（MBI）,and Stroke-Specific Quality of Life Scale（SS-QQL）,and safety assessment were taken as main effect indices before treatment,at week 4 of treatment,at week 12 and 24 of followups,respectively.Results There was no statistical difference in FMA score,MBl score,SS-QOL score among the four groups before treatment（P〉0.05）.These scores were significantly improved in the four groups at week 4 oftreatment,week 12 and 24 of follow-ups,respectively（P〈0.05）.Besides,FMA score and SS-QOL score were significantly improved in the comprehensive rehabilitation group at each corresponding time point,as compared with other treatment groups（P〈0.05）.Conclusions The comprehensive protocol could significantly improve motor function,activity of daily living in hemiplegia patients after stroke,and further improve their QOL.Its effect was better than other single treatment.