悬吊运动训练联合中药熏蒸对老年缺血性脑卒中偏瘫患者血管活性物质及预后的影响

Effect of Suspension Exercise Training Combined with Chinese Medicine Fumigation on Vasoactive Substances and Prognosis in Elderly Ischemic Stroke Patients with Hemiplegia

目的:探究悬吊运动训练联合中药熏蒸对老年缺血性脑卒中偏瘫患者血管活性物质及预后的影响。方法:纳入老年缺血性脑卒中偏瘫患者82例,采用随机数字表法分为对照组和治疗组各41例。对照组患者予悬吊运动训练及相应常规治疗,在此基础上,治疗组患者加用中药熏蒸进行治疗,所有受试者均连续治疗4周。记录两组患者临床疗效,并在治疗前及治疗后4周分别对血管活性物质进行测定并比较,另外对所有受试者进行为期6个月的有效随访,并于治疗前、治疗后4周,以及随访1、3、6个月,对受试者神经功能缺损程度、基础运动功能、平衡功能、躯干控制能力及生活质量进行评定。结果:治疗组治疗总有效率显著高于对照组(P<0.05)。治疗后两组患者血管内皮生长因子(VEGF)、血管紧张素-1(Ang-1)均显著升高,且治疗组患者高于对照组(P<0.01)。治疗后4周以及随访1、3、6个月等时间点NIHSS评分、GLFS-25评分、Sheikh评分、BBS评分、SS-QOL评分比较,差异均有统计学意义(P<0.05)。同时两组患者治疗后的NIHSS、GLFS-25评分随着时间的推移,下降程度不相等,但以治疗组的改善程度最大,组间效应、时间效应及交互效应差异均有统计学意义(P<0.01);两组患者治疗后的Sheikh、BBS、SS-QOL评分随着时间的推移,上升程度不相等,但以治疗组的改善程度最大,组间效应、时间效应及交互效应差异均有统计学意义(P<0.01)。结论:悬吊运动训练联合中药熏蒸能够明显促进老年缺血性脑卒中偏瘫患者神经功能恢复,进一步改善其运动功能,促进日常生活行为能力的恢复,提高生活质量,考虑原因可能与增加血管活性物质表达并改善患者机体微循环有关。

Objective:To explore the effect of suspension exercise training combined with Chinese medicine fumigation on vasoactive substances and prognosis of elderly ischemic stroke patients with hemiplegia.Methods:Totally 82 elderly patients with ischemic stroke hemiplegia were selected and divided into control and treatment g roups,41 cases in each group.Patients were given suspension exercise training and corresponding routine treatment in control group.On this basis,patients were treated with Chinese medicine fumigation in treatment group.And all patients were treated continuously for four weeks in two groups.The clinical efficacy was recorded in the two groups.The vasoactive substances were measured and compared before treatment and four weeks after treatment.In addition,all patients were followed up for six months,and the neurological deficits,basic motor function,balance function,trunk control ability and quality of life were assessed before treatment,four weeks after treatment as well as follow-up for one,three and six months.Results:The treatment group showed higher total effective rate than control group(P<0.05).The vascular endothelial growth factor(VEGF)and angiotensin-1(Ang-1)increased in two groups after treatment,and the treatment group showed higher VEGF and Ang-1 than control group(P<0.01).There was significant differences in NIHSS score,GLFS-25 score,Sheikh score,BBS score and SS-QOL score,four weeks after treatment as well as one,three and six months follow-up,etc.(P<0.05).At the same time,the NIHSS and GLFS-25 scores decreased with time in two groups after treatment,and treatment group showed higher improvement than control group.There were significant differences in inter group effect,time effect and interaction effect(P<0.01).The Sheikh,BBS and SS-QOL scores increased with time in two groups after treatment,and treatment group showed higher improvement than control group.There were significant differences in inter group effect,time effect and interaction effect(P<0.01).Conclusion:Suspension exercise training combined with Chinese medicine fumigation can obviously promote the recovery of neurological function in elderly patients with ischemic stroke and hemiplegia,improve the recovery of their motor function and daily life behavior ability and improve the quality of life.The reason may be related to increasing the expression of vasoactive substances and improving patients’microcirculation.