针灸联合不同时机的康复治疗对脊髓损伤患者恢复效果的影响

Influence of acupuncture and moxibustion combined with rehabilitation therapy at different times on the recovery effect of patients with spinal cord injury

目的探讨针灸联合不同时机的康复治疗对脊髓损伤患者恢复效果的影响。方法选择我院2017年12月至2020年12月收治的132例脊髓损伤患者作为研究对象,按照随机对照原则将其分为对照组、早期康复组、早期联合组,每组44例。对照组实施常规康复治疗(脊髓损伤2个月后开始康复训练),早期康复组在脊髓损伤2周内开始康复训练,早期联合组在早期康复组基础上加用针灸治疗。比较三组患者治疗前、后的功能独立性评定(FIM)、改良Barthel指数(MBI)、感觉功能、触觉功能、运动功能评分以及血清中脑源性神经营养因子(BDNF)、胰岛素样生长因子-1(IGF-1)水平。结果治疗后,三组患者的FIM、MBI评分显著高于治疗前,且早期联合组和早期康复组均显著高于对照组,早期联合组显著高于早期康复组,差异具有统计学意义(P<0.05)。治疗后,三组患者的感觉功能、触觉功能、运动功能评分均显著升高,且早期联合组和早期康复组均显著高于对照组,早期联合组显著高于早期康复组,差异具有统计学意义(P<0.05)。治疗后,三组患者的血清BDNF、IGF-1水平均显著高于对照组,且早期联合组和早期康复组均显著高于对照组,早期联合组显著高于早期康复组,差异具有统计学意义(P<0.05)。结论针灸联合早期康复治疗能够明显改善脊髓损伤患者的功能独立性,提升日常生活活动能力,改善患者的感觉、触觉、运动功能及BDNF、IGF-1水平,值得临床推广。

Objective To explore the influence of acupuncture and moxibustion combined with rehabilitation therapy at different times on the recovery effect of patients with spinal cord injury.Methods A total of 132 patients with spinal cord injury treated in our hospital from December 2017 to December 2020 were selected as the research objects.According to the principle of randomized control,the patients were divided into control group,early rehabilitation group and early combination group,with 44 cases in each group.The control group received routine rehabilitation treatment(rehabilitation training started after 2 months of spinal cord injury),the early rehabilitation group began rehabilitation training within 2 weeks of spinal cord injury,and the early combination group received acupuncture and moxibustion treatment on the basis of the early rehabilitation group.The scores of functional independence measure(FIM),modified Barthel index(MBI),sensory function,tactile function and motor function and the levels of brain-derived neurotrophic factor(BDNF)and insulin-like growth factor-1(IGF-1)in serum of the three groups were compared before and after treatment.Results After treatment,the FIM and MBI scores of the three groups were significantly higher than those before treatment,those of the early combination group and the early rehabilitation group were significantly higher than the control group,and those of the early combination group were significantly higher than the early rehabilitation group,the differences were statistically significant(P<0.05).After treatment,the scores of sensory function,tactile function and motor function of the three groups significantly higher than those before treatment,those of the early combination group and the early rehabilitation group were significantly higher than the control group,and those of the early combination group were significantly higher than the early rehabilitation group,the differences were statistically significant(P<0.05).After treatment,the levels of serum BDNF and IGF-1 in the three groups significantly higher than those before treatment,those of the early combination group and the early rehabilitation group were significantly higher than the control group,and those of the early combination group were significantly higher than the early rehabilitation group,the differences were statistically significant(P<0.05).Conclusion Acupuncture and moxibustion combined with early rehabilitation therapy can significantly ameliorate the functional independence of patients with spinal cord injury,improve the activities of daily living,ameliorate the sensory,tactile,motor functions and BDNF,IGF-1 levels,which is worthy of clinical promotion.