针刺疗法联合早期综合康复训练对脑外伤术后运动障碍患者的影响

Effect of Acupuncture Therapy Combined with Early Comprehensive Rehabilitation Training on Patients with Motor Dysfunction After Brain Trauma Surgery

目的探讨针刺疗法联合早期综合康复训练对脑外伤术后运动障碍患者的影响。方法选取南阳市中心医院2020年1月至2022年8月收治的103例脑外伤术后运动障碍患者为研究对象,按照康复方案分为早期康复训练组(51例)和针刺联合康复训练组(52例)。早期康复训练组接受早期综合康复训练,针刺联合康复训练组在早期综合康复训练的基础上接受针刺疗法。康复治疗2个月后,对比两组临床疗效、治疗前后三维步态参数(步速、步频、左右步长差、患肢摆动相)、神经功能指标[神经元烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、C反应蛋白(CRP)]、跌倒效能[修订版跌倒效能量表(MFES)]、平衡能力[Berg平衡量表(BBS)]、日常生活能力[改良Barthel指数评定量表(MBI)]。结果康复治疗后,针刺联合康复训练组总有效率为90.38%,高于早期康复训练组的72.55%(P<0.05);康复治疗后,针刺联合康复训练组步速、步频、患肢摆动相高于早期康复训练组,左右步长差低于早期康复训练组(P<0.05);康复治疗后,针刺联合康复训练组血清NSE、GFAP、CRP水平低于早期康复训练组(P<0.05);康复治疗后,针刺联合康复训练组MFES、BBS、MBI评分高于早期康复训练组(P<0.05)。结论针刺疗法联合早期综合康复训练康复治疗脑外伤术后运动障碍患者的疗效确切,可改善三维步态、跌倒效能,提高日常生活能力,促进神经功能、运动功能恢复。

Objective To investigate the effect of acupuncture therapy combined with early comprehensive rehabilitation training on patients with motor dysfunction after brain trauma surgery.Methods A total of 103 patients with postoperative motor dysfunction after brain trauma admitted to Nanyang Central Hospital from January 2020 to August 2022 were selected as the research subjects.They were divided into an early rehabilitation training group(51 cases)and an acupuncture combined rehabilitation training group(52 cases)according to the rehabilitation program.The early rehabilitation training group received early comprehensive rehabilitation training,while the acupuncture combined rehabilitation training group received acupuncture therapy on the basis of early comprehensive rehabilitation training.After 2 months of rehabilitation treatment,the clinical efficacy,the three-dimensional gait parameters(step speed,step frequency,left-right step length difference,affected limb swing phase),neurofunctional indicators[neuronal enolase(NSE),glial fibrillary acidic protein(GFAP),C-reactive protein(CRP)],fall efficacy[modified fall efficacy scale(MFES)],balance ability[Berg balance scale(BBS)]and activities of daily living[modified Barthel index(MBI)]before and after treatment were compared between the two groups.Results After rehabilitation treatment,the total effective rate of the acupuncture combined with rehabilitation training group was 90.38%,which was higher than that of the early rehabilitation training group(72.55%)(P<0.05).After rehabilitation treatment,the walking speed,step frequency and swing phase of the affected limb in the acupuncture combined with rehabilitation training group were higher than those in the early rehabilitation training group,and the difference between left and right step lengths was lower than that in the early rehabilitation training group(P<0.05).After rehabilitation treatment,the serum NSE,GFAP,and CRP levels in the acupuncture combined with rehabilitation training group were lower than those in the early rehabilitation training group(P<0.05).After rehabilitation treatment,the MFES,BBS,and MBI scores in the acupuncture combined with rehabilitation training group were higher than those in the early rehabilitation training group(P<0.05).Conclusion Acupuncture therapy combined with early comprehensive rehabilitation training has a precise therapeutic effect on patients with motor dysfunction after brain trauma surgery,which can improve three-dimensional gait,fall efficacy,daily living ability,and promote the recovery of neurological and motor functions.