操作性肌电反馈联合常规康复治疗对脑梗死患者血清BDNF表达及运动功能的影响

Effects of operant-conditioning myofeedback therapy combined with conventional therapy on serum BDNF levels and motor function in patients with ischemic stroke

目的 观察操作性肌电反馈联合常规康复治疗对脑梗死患者血清中脑源性神经营养因子（BDNF）表达及肢体运动功能的影响.方法 将73例脑梗死患者随机分为治疗组（n=38）和对照组（n=35）,两组常规的药物治疗及康复治疗相同,治疗组在常规治疗基础上辅以操作性肌电生物反馈治疗,共8周.分别于治疗前、治疗8周后检测患者血中BDNF水平,采用美国国立卫生研究院卒中量表（NIHSS）和简化Fugl-Meyer运动功能评分（FMA）分别评估神经功能缺损程度及肢体运动功能水平.结果 两组患者治疗后NIHSS评分均低于治疗前,血中BDNF表达及FMA评分均较治疗前增加（均P〈0.01）,但治疗组的改善优于对照组（P〈0.05）.治疗组患者治疗前后的NIHSS评分变化值和FMA评分变化值与血中BDNF水平变化均呈正相关（r=0.405,0.672;P〈0.05）.结论 操作性肌电生物反馈疗法联合常规康复治疗可上调脑梗死患者BDNF表达,促进其功能康复.

Objective To evaluate the effects of operant-conditioning myofeedback therapy com-bined with conventional rehabilitation on serum brain-derived neurotrophic factor （BDNF） levels and motor function in patients with cerebral infarction.Methods A total of 73 patients with primary cerebral infarction were enrolled and were randomly divided into experimental group （EG） （n=38） and control group （CG） （n=35）. The subjects in EG group underwent an eight-week myofeedback training. Subjects in both groups followed the same treatment schedule for physical therapy and routine medication. Before the beginning of the experimental proto-col and 8 weeks later, serum BDNF levels were measured, neurological function was assessed with the National Institutes of Health Stroke Scale （NIHSS）, motor function was assessed with simplified Fugl-Meyer Motor As-sessment （FMA）.Results After 8 weeks, the NIHSS scores were reduced, the serum BDNF levels were elevated and the FMA were improved in the both groups （P〈0.01）. While the changes were more significant in the EG group when compared to the CG group（P〈0.05）. In addition, in EG group, the variations in NIHSS and FMA were both positively correlated with the changes of serum BDNF levels （r=0.405,0.672;P〈0.05）.Conclusions Operant-conditioning myofeedback therapy combined with conventional rehabilitation therapy may up-regulate the serum BDNF lev-els, which is beneficial to the recovery of neurological function and improve motor function of patients with cere-bral infarction.