循经推拿联合康复训练对脑中风患者运动功能恢复的效果及作用机制

On The Effect and Mechanism of Tuina along Meridians Combined with Rehabilitation Training on Motor Function Recovery of Stroke Patients

目的:采用循经推拿联合康复训练治疗脑中风患者,观察其对患者运动功能恢复的疗效及作用机制。方法:随机选取2014年9月至2016年4月,于我院康复医学科和神经内科就诊的脑中风患者60例,以就诊先后顺序编号,单盲随机数字表法分为治疗组和对照组,每组30例。对照组:基础治疗+康复训练;治疗组:对照组基础上,采用循经推拿法治疗。治疗前后参照《脑卒中诊断与疗效标准》中的病类评分进行疗效评定;采用Fugl-Mayer评估量表(Fugl-Mayer Assessment,FMA)和Berg平衡量表评估患者的偏瘫肢体运动功能;采用改良Barthel指数(modified Barthel Index,m BI)评估患者日常生活活动能力(Activities of Daily Living,ADL)包括独立生活的能力和技巧熟练程度。结果:2组治疗后FMA和Berg评分均高于治疗前(P<0.05);于对照组相比,治疗组治疗后FMA和Berg评分均较高(P<0.05)。治疗后,治疗组m BI量表评分明显提高,与治疗前和对照组治疗后比较,差异均有显著性统计学意义(P<0.01)。2组治疗后治疗组恢复率高于对照组,差异有统计学意义(χ2=14.634,P=0.0312<0.05)结论循经推拿联合康复训练治疗脑中风患者提高其运动能力的恢复,提高患者日常生活能力。

Objective：To observe the curative effect and movement recovery of Tuina along meridians combined with rehabilitation training in the treatment of stroke patients and to explore its mechanism.Methods：Sixty cases of stroke patients who received treatment in our hospital rehabilitation department and Department of neurology clinic and inpatient department from September 2014 to 2016 in April were selected and randomly divided into observation group and control group with 30 cases in each group by single blind randomized digital table method.Control group：basic treatment＋rehabilitation training;observation group：basic treatment ＋ rehabilitation training ＋ Tuina along meridians.Scores and classification in Criteria for Stroke Diagnosis and Curative Effect Evaluation were adopted as reference for assessing therapeutic effect before and after the treatment.Fugl-Mayer assessment （FMA） and Berg balance scale assessment were for assessing movement function of patients with hemiplegic limb and two scores of the two scales are higher the better the limb movement function.Modified Barthel Index （mBI） was used for the assessment of activities of daily living （ADL） of patients including independent living skills and proficiency.Results：After treatment,the scores of Berg and FMA in the two groups were all higher than those before treatment （P〈0.05）.Compared with the control group,the FMA and Berg scores of the observation group were higher （P〈0.05）.mBI scale scores of the observation group were significantly improved after the treatment,compared with those before the treatment and the difference was statistically significant （P〈0.01）.The recovery rate of the observation group after the treatment was higher than that of the control group,which showed statistically significant difference （x2=14.634,P=0.0312〈0.05）.Conclusion：Tuina along meridians combined with rehabilitation training in the treatment of patients with stroke may improve the recovery of movement function and enhance patients＇ quality of daily life.