后遗障碍分级分度的模糊评价

简述了模糊综合评判模型的基本概念和原理，并通过法医学实例介绍了该模型的应用．

后遗障碍的模糊评价

损伤给受损伤者带来或多或少的后遗障碍 ,在后遗障碍的评定中 ,又受很多因素的影响 ,特别是这些因素在目前无法进行定量判定。本研究利用模糊综合评判对后遗障碍进行分级分度 ,以求指导损害赔偿 ,笔者简述了模糊综合评判模型的基本概念和原理。同时 ,通过法医学实例介绍了该模型的应用。

息风通络活血针刺法治疗中风后遗症肢体功能障碍临床研究

目的评价息风通络活血针刺法对中风后遗症肢体功能障碍患者的临床疗效,为临床应用提供依据。方法自2016年10月~2017年03月,收集到符合研究标准的中风后遗症肢体功能障碍患者60例,随机分为治疗组(息风通络活血针刺法加常规西药治疗组)和对照组(常规西药治疗组),治疗组给予针刺加常规西药治疗,对照组给予单纯的常规西药治疗。2个疗程结束后对两组中风后遗症肢体功能障碍患者进行临床评价。结果两组在基线、第1、2疗程用神经功能缺损程度量表(NIHSS评分)、简式FUGL-MEYER运动功能评分法及改良Barthel指数临床量表进行评价并进行比较,治疗组和对照组的基线资料差异无统计学意义(P>0.05);两组在第一二疗程治疗后比较差异显著(P<0.05)。结论息风通络活血针刺法治疗有助于改善中风后遗症肢体功能障碍患者的神经功能缺损、肢体功能状态及提高患者的日常生活活动能力,且息风通络活血针刺法结合西药组的效果优于单纯西药组。

疏血通注射液联合补阳还五汤治疗脑梗塞后遗肢体活动障碍(气虚血瘀型)的疗效观察

目的:观察疏血通注射液联合补阳还五汤治疗脑梗塞后遗肢体活动障碍(气虚血瘀型)的临床疗效。方法:将110例脑梗塞后遗肢体活动障碍病人随机分为两组,每组55例,均给予疏血通注射液静滴,治疗组加用补阳还五汤口服,两组均以15d为1个疗程,比较两组治疗后的临床疗效、血脂及血液流变学的变化。结果:治疗组疗效明显优于对照组,血脂水平、血液流变学改善也较对照组明显(P<0.05)。结论:疏血通注射液联合补阳还五汤治疗脑梗塞后遗肢体活动障碍(气虚血瘀型)安全、有效。

疏血通注射液联合补阳还五汤治疗脑梗死后遗肢体活动障碍的效果分析

目的观察分析疏血通注射液联合补阳还五汤治疗脑梗死后遗肢体活动障碍的效果。方法选取2016年4月至2018年4月本院收治的脑梗死后遗肢体活动障碍患者100例作为研究对象,按照随机数字法分为两组,观察组和对照组,每组50例,对照组患者给予疏血通注射液治疗,观察组在同对照组疏血通治疗的基础上联合补阳还五汤治疗。两组患者均治疗15 d后,比较两组患者的临床疗效、血脂、血液流变学变化。结果治疗后两组患者症状均有所改善,但是观察组患者疗效比对照组显著,P<0.05,差异具有统计学意义。两组患者治疗后血液流变指标变化、血脂水平均明显优于对照组,P<0.05,差异具有统计学意义。结论疏血通注射液联合补阳还五汤治疗脑梗死后遗肢体活动障碍疗效确切,安全性高,值得在临床推广应用。

奥塔戈运动训练在老年脑出血后遗运动障碍病人护理中的应用

[目的]探究奥塔戈运动训练在老年脑出血后遗运动障碍病人护理中的应用对其肢体运动功能和跌倒效能的影响。[方法]选取2016年4月—2017年4月收治的给予常规护理的老年脑出血后遗运动障碍病人62例作为对照组,另选取2017年5月—2018年5月收治的给予奥塔戈运动训练的老年脑出血后遗运动障碍病人62例作为观察组,比较两组病人护理前后肢体运动功能、跌倒效能及护理满意度。[结果]观察组护理1个月后肢体运动功能评分高于对照组(P<0.05);观察组护理1个月后跌倒效能评分高于对照组(P<0.05);观察组护理1个月后护理满意度高于对照组(P<0.05)。[结论]奥塔戈运动训练应用于老年脑出血后遗运动障碍病人护理中可显著提高病人肢体运动功能及跌倒效能,并有效提高病人护理满意度。

奥塔戈运动对脑出血后遗运动障碍患者肢体运动功能的影响

目的探讨奥塔戈运动对脑出血后遗运动障碍患者肢体运动功能的影响。方法选择2020年2月至2021年3月医院收治的98例脑出血后遗运动障碍患者,按单盲法分为两组,各49例。对照组行常规护理,观察组在对照组基础上进行奥塔戈运动,比较两组肢体运动功能和平衡能力。结果护理后,观察组肢体运动功能总分、下肢评分、上肢评分及Berg平衡量表(BBS)评分均高于对照组,差异有统计学意义(P<0.05)。结论奥塔戈运动可改善脑出血后遗运动障碍患者的肢体运动功能,提高平衡能力。

按摩治疗中风后遗症手功能障碍30例小结

目的 研究中医按摩对中风后遗症手功能障碍患者的治疗作用.方法 选取2012—2014年营口市中医医院收治的住院中风后遗症手功能障碍患者30例,采取中医按摩及简易器械锻炼,重建手功能.结果 经按摩治疗后,良12例、差10例、无效8例.结论 中风后遗症患者开展中医康复护理措施后,患者日常活动能力提高,生活质量得到改善.

Clinical observation of body acupuncture combined with FANG’s scalp acupuncture for limb dysfunction in the remission stage of stroke

Objective:To observe the clinical efficacy of body acupuncture combined with FANG’s scalp acupuncture in treating limb dysfunction in the remission stage of stroke and explore the mechanism.Methods:Sixty patients in the remission stage of stroke with limb dysfunction were divided into a control group and a treatment group using the random number table method,with 30 cases in each group.The control group was treated with ordinary acupuncture based on the conventional rehabilitation treatment,and the treatment group was additionally offered FANG’s scalp acupuncture.The interventions were conducted once daily with 10 sessions as 1 course.The Fugl-Meyer assessment(FMA)and Barthel index(BI)scores and serum malondialdehyde(MDA)and superoxide dismutase(SOD)levels were compared after 2 treatment courses,and the clinical efficacy was evaluated.Results:After treatment,the FMA and BI scores increased in both groups(P<0.05)and were higher in the treatment group than in the control group(P<0.05).Both groups showed a decreased MDA level and an increased SOD level after the intervention,all showing statistical significance(P<0.05);there were significant differences between the two groups(P<0.05).Conclusion:Based on the conventional rehabilitation treatment,ordinary acupuncture used alone or in combination with FANG’s scalp acupuncture can lower the oxidative stress level and improve limb function in treating limb dysfunction in the remission stage of stroke;body acupuncture plus FANG’s scalp acupuncture can produce better results.

Effect of long-time needle retaining at Baihui(GV 20) on cognitive impairment in post-stroke patients

Objective： To observe the clinical efficacy of long-time needle retaining at Baihui（GV 20） in treating post-stroke cognitive impairment. Methods： A total of 60 eligible patients with post-stroke cognitive impairment were randomized into a treatment group and a control group by random digital table, 30 cases in each group. The control group was intervened by basic treatment including routine therapy in Neurology department and Western medicine rehabilitation therapy, while the treatment group was intervened by same treatment in the control group combined with long-time needle retaining at Baihui（GV 20）. Mental state of patients was evaluated by National Institute of Health stroke scale（NIHSS） and mini-mental state examination（MMSE） after 4 weeks of treatment. Results： After 4-week treatment, the NIHSS score dropped in both groups, and intra-group comparisons showed statistical significances（both P〈0.05）, and the score in the treatment group was statistically lower than that in the control group（P〈0.01）; the MMSE score in the treatment group was significantly higher than that in the control group, there was a statistical inter-group difference（P〈0.01）; the total effective rate was 93.3%, and the marked effective rate was 50.0% in the treatment group, versus 76.7% and 20.0% in the control group, there were significant differences in the total effective rate and the marked effective rate between the two groups（all P〈0.05）. Conclusion： Long-time needle retaining at Baihui（GV 20） can produce a safe valid therapeutic efficacy in treating post-stroke cognitive impairment.

Clinical Study on Puncturing Renying （ST 9） to Treat Poststroke Dysphagia

Objective： To observe the clinical efficacy of puncturing Renying （ST 9） in the treatment of poststroke dysphagia. Methods： Sixty cases of poststroke dysphagia were randomized into two groups, a control group in which 30 cases were given rehabilitation training, and a treatment group in which 30 cases were treated by puncturing Renying （ST 9） and rehabilitation training, with a course of four weeks. Results： The total effective rate for dysphagia was higher in the treatment group than in the control group （P〈0.05）. Conclusion： Puncturing Renying （ST 9） is quite effective for poststroke dysphagia.

Effect of row needling in muscle regions combined with seven-star needle tapping on cognitive function and quality of life in patients with post-stroke upper limb spasticity

Objective：To observe the effect of row needling in muscle regions combined with seven-star needle tapping on cognitive function and quality of life （QOL） in patients with post-stroke upper limb spasticity. Methods： A total of 448 eligible cases were randomly allocated into a treatment group and a control group, 244 in each group. Based on standard conventional treatment, cases in the treatment group received row needling in muscle regions combined with seven-star needle tapping, whereas cases in the control group took oral Western medication. After 3 weeks of treatment, the cognitive functions were assessed using comprehensive functional assessment （CFA） and mini-mental state examination （MMSE）. The O,OL was evaluated using the Chinese-version 36-item short-form health survey （SF-36）. Results： After treatment, the CFA and MMSE scores were significantly improved in both groups （P〈0.05）; and there were between-group statistical differences （P〈0.05）, showing a better effect in the treatment group than that in the control group. In addition, there were between-group statistical significances in scores of QOL （P〈0.05, P〈0.01）. Conclusion： Row needling in muscle regions combined with seven-star needle tapping can significantly improve the cognitive function and O, OL of patients with post-stroke upper limb spasticity.

Clinical study on Jin's three-needle therapy for post-stroke cognitive impairment

Objective:To observe the clinical efficacy of Jin's three-needle therapy on post-stroke cognitive impairment(PSCI)and the effect on neuroelectrophysiology(event-related potentials).Methods:A total of 60 PSCI patients were selected and divided into a treatment group and a control group according to the method of random number table,with 30 cases in each group.The patients in the control group received routine treatment while the patients in the treatment group received additional Jin's three-needle therapy.The treatment for both groups lasted four weeks.Mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores as well as amplitude and latency of potential 300(P300)were adopted to compare the between-group results before and after treatment.Results:Before treatment,there were no significant differences(all P>0.05)in MMSE and MoCA scores,P300 latency and P300 amplitude between the two groups.After 4 weeks of treatment,the MMSE and MoCA scores and P300 amplitudes were improved in both groups,and the P300 latencies became shorter.The results showed significant intra-group and between-group differences(all P<0.05).Conclusion:Based on the routine treatment,Jin's three-needle therapy is effective for PSCI.The mechanism is probably through its regulation on the patients'neuroelectrophysiology.

Treatment of Swallowing Dysfunction after Cerebral Apoplexy by Acupuncture:A Report of 56 Cases

Fifty-six patients with swallowing dysfunction after cerebral apoplexy were treated by acupuncture and swallowing function training. The curative effect is satisfactory and the total effective rate was 96.4%.

Acupuncture for Chronic Dysphagic Stroke Evaluated by Fiberoptic Endoscopic Evaluation of Swallowing: A Case Report

Objective： To describe the effect of acupuncture with a new acupoint prescription in treating dysphagia from a chronic stroke patient by fiberoptic endoscopic evaluation of swallowing （FEES）. Methods： A case of chronic dysphagic stroke patient was treated by acupuncture with 5 established acupoints, and assessed by FEES before and after 4-week treatments. Results： There is improvement in swallowing and speech function after acupuncture treatment. Conclusion： There is evidence showing that new acupuncture points maybe beneficial for dysphagic stroke patients.

Efficacy evaluation of acupuncture plus rehabilitation training for post-stroke deglutition disorders of qi-deficiency blood stasis pattern

Objective:To observe the clinical efficacy of acupuncture plus rehabilitation training in treating post-stroke deglutition disorders of qi-deficiency blood stasis pattern.Methods:Sixty-six patients with post-stroke deglutition disorders of qi-deficiency blood stasis patter were divided into an observation group and a rehabilitation group using the random number table method.The two groups both received conventional medications and supportive treatment for stroke.In addition,the observation group received acupuncture plus rehabilitation training while the rehabilitation group only received the same rehabilitation training.The interventions were conducted 3 times a week for a total of 4 weeks in both groups.They were evaluated using Kubota water swallowing test(KWST),Fujishima Ichiro food intake level scale(FILS)and symptoms score of traditional Chinese medicine(TCM)before and after treatment,and at the 1-month follow-up.The therapeutic efficacy was assessed at the 1-month follow-up.Results:The KWST grading and FILS result after treatment and at the follow-up were significantly different from those before treatment in both groups(all P<0.001);the results of these two items at the follow-up were not significantly different from those after treatment in the two groups(all P>0.05).There were significant differences in the KWST grading and FILS result between the two groups after treatment and at the follow-up(all P<0.05).The TCM symptoms score changed significantly after treatment and at the follow-up compared with that before treatment in both groups(all P<0.001).The TCM symptoms grading efficacy at the follow-up was significantly different from that after treatment in the observation group(P<0.05),while the difference was statistically insignificant in the rehabilitation group(P>0.05).The TCM symptoms grading efficacy in the observation group was significantly different from that in the rehabilitation group after treatment and at the follow-up(both P<0.05).Conclusion:Based on the conventional treatment for stroke,acupuncture plus rehabilitation training or use of rehabilitation training alone both can improve the clinical symptoms in post-stroke deglutition disorders of qi-deficiency blood stasis pattern,but acupuncture plus rehabilitation training can produce more significant efficacy and better long-term efficacy in improving TCM symptoms.

Observation on mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus for deglutition disorder of stroke patients in the convalescent stage

Objective： To observe the clinical effect of mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus for deglutition disorder of stroke patients in convalescence stage. Methods： A total of 136 patients conforming to the inclusion criteria were randomized into three groups by the random number table, including group A of 46 cases, group B of 44 cases and group C of 46 cases. Patients in group A received swallowing disorder therapeutic apparatus treatment, patients in group B received mind-refreshing and orifice-opening needling method treatment, and patients in group C received mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus treatment. The treatment was given once a day for 10 d as a course, the whole treatment lasted for 4 courses. Therapeutic evaluation items including water-swallowing test （WST）, standardized swallowing assessment （SSA） and modified Barthel index （MBI） were measured before treatment, after treatment and at follow-up visit （2 months after treatment）. Results： After treatment, scores of WST and MBI in all three groups increased significantly （all P〈0.05）, while the SSA score dropped significantly （all P〈0.05）. After treatment and during follow-up visit period, score of WST in group C was significantly higher than that in group A and group B （both P〈0.05）, while the difference between group A and group B showed no statistical significance （P〉0.05）; the SSA score in group C was substantially lower than that in group A and group B （all P〈0.05）, the difference between group A and group B showed no statistical significance （P〉0.05）; the MBI scores in group B and group C were substantially higher than that in group A （all P〈0.05）, the difference between group B and group C showed no statistical significance （P〉0.05）. After treatment and during follow-up visit period, the differences in overall therapeutic effect between group A and group B showed no statistical significance （P〉0.05）, while the overall therapeutic effect in group C was substantially better than that in group A and group B （all P〈0.05）. Conclusion： Both mind-refreshing and orifice-opening needling method and swallowing disorder therapeutic apparatus can alleviate symptoms of deglutition disorder of stroke patients respectively, and the combination of two methods can improve the therapeutic effect.

Clinical observation on acupoint massage plus Vitalstim electrical stimulation for deglutition disorder after stroke

Objective:To observe the effect of acupoint massage plus Vitalstim electrical stimulation on deglutition function and surface electromyography(SEMG)of deglutition muscle groups.Methods:A total of 60 patients with deglutition disorder after stroke were selected and divided into an electrical stimulation group,a massage group and an integrated group according to the random number table method,with 20 cases in each group.Patients in these three groups were given the same routine rehabilitation training for deglutition.In addition,patients in the electrical stimulation group were given extra Vitalstim electrical stimulation,patients in the massage group were given extra acupoint massage on the head,face and neck,and patients in the integrated group were given extra acupoint massage plus Vitalstim electrical stimulation.Fujishima Ichiro food intake level scale(FILS)was scored before and after treatment.The swallowing duration and maximal amplitude of masseter muscle in SEMG were evaluated before and after treatment.Results:After treatment,the FILS score and the maximal amplitude of recruitment potential generated by muscular contraction of masseter muscle group in the three groups were higher than those before treatment(all P<0.05),and the swallowing duration of masseter muscle group was shortened compared with that in the same group before treatment(all P<0.05).After treatment,the FILS score in the integrated group was higher than that in the electrical stimulation group and the massage group(both P<0.05).The swallowing duration of masseter muscle group measured by SEMG was lower than that in the electrical stimulation group and the massage group(both P<0.05),while the maximal amplitude was higher than that of the electrical stimulation group and the massage group(P<0.05).After treatment,there were no significant differences in the FILS score,swallowing duration and maximal amplitude of masseter muscle group between the electrical stimulation group and the massage group(all P>0.05).Conclusion:Both acupoint massage and electrical stimulation can improve the deglutition function in patients with deglutition disorder after stroke,and improve the coordination and flexibility of masseter muscle.The integration of the two is more effective.