神经反射刺激对脑出血急性期患者疗效及CSS和上下肢Fugl-Meyer评分的变化

Changes of Neurologic Reflex Irritation on Effectiveness and Neurologic Functional Impairment and Fugl-Meyer Scores of Upper and Lower Limbs of Patients with Acute Cerebral Hemorrhage

目的研究神经反射刺激治疗脑出血急性期患者的效果及对神经功能缺损程度评分(CSS)、上下肢Fugl-Meyer评分的影响。方法选取武警后勤学院附属医院2015年6月—2016年10月间收治的脑出血急性期患者88例,根据治疗方法不同分为对照组和观察组,每组44例。对照组接受常规治疗干预,观察组在对照组基础上接受神经反射刺激治疗。比较两组的治疗效果,治疗前后各时间点的上下肢Fugl-Meyer评分、CSS评分及焦虑和抑郁评分。结果治疗后1个月,观察组总有效率明显高于对照组(P<0.05)。治疗后2周,观察组上下肢Fugl-Meyer评分高于治疗前(P<0.05)。治疗后1个月,两组上下肢Fugl-Meyer评分高于治疗前,且观察组明显高于对照组(P<0.05,P<0.01)。治疗后1周、2周和1个月,两组CSS评分均低于治疗前,且观察组明显低于对照组(P<0.05,P<0.01)。治疗后1个月,两组汉密尔顿抑郁和焦虑量表评分低于治疗前,且观察组明显低于对照组(P<0.05,P<0.01)。结论神经反射刺激能够提高脑出血急性期患者的治疗效果,促进神经功能及肢体运动能力恢复,并能改善负面情绪。

Objective To study the effect of neurologic reflex irritation therapy in treatment of patients with acute cerebral hemorrhage and its effects on neurologic functional impairment score,FuglMeyer score of upper and lowerlimbs. Methods A total of 88 patients with acute cerebral hemorrhage admitted during June 2015 and October 2016were divided into control group （ n = 44）and observation group （ n = 44）according to different treatment methods. Control group was treated with conventional intervention,while observation group was treated with neurologic reflex irritationon the basis of treatment for control group. Therapeutic effect,FuglMeyer scores,neurologic functional impairmentscores,anxiety and depression scores of upper and lower limbs at different time points before and after treatment werecompared in two groups. Results The total effective rate in observation group was significantly higher than that in controlgroup in 1 month after treatment （ P 〈 0. 05） . In observation group FuglMeyer scores of upper and lower limbs were significantly higher in 2 weeks after treatment than those before treatment （ P 〈 0. 05） . In 1 month after treatment,FuglMeyer scores of upper and lower limbs in two groups were significantly higher than those before treatment,and the scoresin observation group were significantly higher than those in control group （ P 〈 0. 05,P 〈 0. 01） . In 1 week, 2 weeks and1 months after treatment,neurologic functional impairment scores in two groups were significantly lower than those beforetreatment,and the scores in observation group were significantly lower than those in control group （ P 〈 0. 05,P 〈0 01） . In 1 month after treatment,hamilton rating scale for depression （ HAMD）and Hamilton anxiety （ HAMA）scores were lower than those before treatment in two groups,and the scores in observation group were significantly lower thanthose in control group （ P 〈 0. 05,P 〈 0. 01） . Conclusion Neurologic reflex irritation can improve the therapeuticeffect,promote recovery of neurological function and motor ability of limbs and improve the negative emotions of patientswith acute cerebral hemorrhage.