Efficacy of enhanced extracorporeal counterpulsation combined with atorvastatin in the treatment of cognitive impairment after stroke

BACKGROUND Cerebral apoplexy patients are prone to cognitive impairment,and it is very important to choose appropriate treatment methods to improve their cognitive impairment after stroke.AIM To evaluate the effects of enhanced external counterpulsation(EECP)in con-junction with atorvastatin on cognitive function,neurotransmitter levels,and the repair of brain tissue damage in patients with cognitive impairment due to stroke.METHODS In this retrospective study,data from 60 patients with poststroke cognitive impairment due to stroke who were treated in our hospital from February 2021 to July 2022 were analyzed and divided into a treatment group(n=30)and a control group(n=30)according to the different nursing methods applied.Patients in the treatment group received EECP in addition to atorvastatin,while those in the control group received atorvastatin alone.Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA)and activities of daily living(ADL)scale scores were compared between the two groups.Additionally,the two groups were compared in terms of serum acetylcholine(ACh),acetylcholin-esterase(AChE),nitric oxide(NO),endothelin-1(ET-1),β2-microglobulin(β2-MG),glial fibrillary acidic protein(GFAP),and visinin-like protein 1(VILIP-1)in the serum.Blood flow measurements from the anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA)were compared between the two groups before and after treatment,and the pulsatility index(PI)and resistance index(RI)of each artery were determined.RESULTS MMSE,MoCA,and ADL scores all improved in both groups following treatment,with the study group showing more improvement than the control group(P<0.05).After treatment,there were statistically significant increases in both ACh and NO levels,whereas decreases occurred in AChE,ET-1,β2-MG,VILIP-1,and GFAP,levels and the PI and RI of the left-ACA,right-ACA,left-MCA,right-MCA,left-PCA,and right-PCA.The study group showed greater gains in all metrics than the control group(P<0.05).CONCLUSION EECP combined with atorvastatin is effective in the treatment of cognitive impairment after stroke and can effectively improve the cognitive function,neurotransmitter levels,and brain tissue damage status of patients.

Reactive astrocytes promote axonal remodeling and neurological recovery after stroke

Stroke is a leading cause of death and disability in adults worldwide. For decades, the primary approach and goal of therapy for stroke has focused on neuroprotection, namely treating the injured tissue, with interventions designed to reduce the volume of cerebral infarction. Enormous effort in the laboratory has been devoted to the development of neuroprotective agents in an attempt to salvage ischemic neurons in the brain from irreversible injury; however, all these efforts have failed to demonstrate efficacy in clinical trials of stroke. In order to treat stroke, we have to re-con- ceptualize and redefine our therapeutic targets. Acute neu- roprotective treatments for stroke fight a temporal battle of salvaging cerebral tissue before the onset of death, as well as a physiological impediment of delivery of therapy to tissue which has inadequate blood flow.

Role and limitations of rehabilitation-induced neural network remodeling after stroke

There is plenty of evidence that proves the beneficial and reliable effects of rehabilitation therapy,making it the most common treatment for patients with chronic stroke.It is believed that rehabilitation improves functional recovery through neural network remodeling,which is observed as a motor map reorganization or functional connectivity change assessed by intracortical microstimulation or functional magnetic resonance imaging（MRI）.

Related factors of cognitive impairment after stroke

BACKGROUND: Cognitive impairment after stroke associates with various factors, such as age, educational years, etc. Besides concerning about the recovery of limb function after stroke, we should also focus on the rehabilitation of cognition. Moreover, we’d better pay attention to the control of all the risk factors of stroke, and improve the quality of life in stroke patients. OBJECTIVE: To analyze the factors that affect cognitive impairment after stroke. DESIGN: A related factors analysis. SETTINGS: Department of Neurology of Dalian Port Hospital and Dalian Second People’s Hospital. PARTICIPANTS: Totally 148 stroke inpatients were selected from Department of Neurology, Dalian Port Hospital and Dalian Second People’s Hospital from April 2004 to December 2005, including 100 males and 48 females, aging 45-75 years with an average age of (67±8) years; Their educational years ranged 2-10 years with an average of (6.1±3.7) years; The disease course ranged 15-30 days; All were right-handed. Inclusive criteria: All were accorded with the diagnostic standard set by the Fourth National Academic Meeting for Cerebrovascular Disease; Confirmed by CT or MRI; Informed consents were obtained from all the subjects. METHODS: After the disease conditions were stable, the patients were assessed with Wechsler memory scale (WMS) and Wisconsin card sorting test (WCST). WMS included forward and backward recitation of numbers and short-term memory (verbal memory, visual recognition). The number of times for correct and wrong classifications in WCST and the time to complete the trail making tests A and B were recorded. The focal volume, area and layer were recorded at 24 hours after admission. The general data of the patients were recorded, including name, sex, age, educational years, history of hypertension, history of diabetes mellitus. Electroencepalograph (EEG) was examined to record the wave shape, blood lipids were detected, and the cognition related indexes were analyzed with the Pearson correlation analysis. The correlation between cognitive indexes after stroke and the influencing factors were analyzed with multiple linear regression analysis. MAIN OUTCOME MEASURES: ① Correlation between cognitive indexes and imaging indexes; ② Influencing factors for cognitive indexes after stroke. RESULTS: All the 148 stroke patients were involved in the analysis of results. ① Correlation between cognitive indexes and CT indexes: There were obvious negative correlations between numerical symbol and focal layer (r =-0.234, P < 0.05), as well as between verbal memory and the focal area and volume (r =-0.363, -0.279, P < 0.05); Trail making test A had obvious positive correlation with focal area and volume (r =0.256, 0.256, P < 0.05). Results of multiple linear regression analysis: Correct classification was correlated with triglyceride (partial wave and θ wave (partial regression coefficient=0.231-0.908, P < 0.05); Verbal memory was correlated with EEG α wave, focal volume, sex, educational years and diabetes mellitus (partial regression coefficient=0.219-1.017, P < 0.05-0.01). Visual recognition had correlation with educational years and hypertension (partial regression coefficient=0.326, -1.163, P < 0.01). Trail making tests A and B were correlated with focal volume (partial regression coefficient=4.680, -18.561, P < 0.05). CONCLUSION: The factors that affect the cognitive function after stroke include sex, age, educational years, hypertension, diabetes mellitus, triglyceride, EEG wave shape, and the focal area, volume and layer.

Study on the medication rules of traditional Chinese medicine in the treatment of sleep disorder after stroke based on data mining

Objective:To explore the medication rule of Traditional Chinese Medicine(TCM)in the treatment of sleep disorder after stroke by using data mining technology.Methods:A computer search was used to search the electronic database of clinical literature on the treatment of sleep disorders after stroke by TCM from January 2000 to January 2021.Excel was used to establish the database,and the prescription information was described and analyzed statistically.Using IBM SPSS Modeler 18.0 software,Apriori algorithm was used for TCM association analysis,and IBM SPSS 22.0 software was used for systematic cluster analysis of high-frequency TCM.Results:A total of 67 literatures were included,covering 131 traditional Chinese medicines.The medecines with a higher frequency of sodium use include Ziziphi Spinosae Semen(Suanzaoren),Angelicae Sinensis Radix(Danggui),Ligusticum(Chuanxiong),liquorice(Gancao),Poria cocos(Fuling),and so on.From the effect point of view,deficiency-tonifying medicine,sedative medicine and blood-activating and stasis-removing medicine are commonly used.The medicinal properties are mainly cold,mild and warm.The main medicine flavor are sweet and bitter.The medicines mostly belong to the liver,heart and spleen Meridian.Thirty-three association rules were obtained for medicine pairs and medicine groups from the correlation analysis,and the core combinations were"Ziziphi Spinosae Semen(Suanzaoren)-Tuber fleeceflower stem(Yejiaoteng)","Ziziphi Spinosae Semen(Suanzaoren)-Polygala(Yuanzhi)","Ziziphi Spinosae Semen(Suanzaoren)-Cortex albiziae(Hehuanpi)"and"Angelicae Sinensis Radix(Danggui)-Radix bupleuri(Chaihu)-Radix Paeoniae Alba(Baishao)"and so on.Seven medicine aggregation groups were obtained by medicine cluster analysis.Conclusion:In the treatment of sleep disorder after stroke by TCM,the main method is to calm the heart and mind.Meanwhile,according to different syndrome types,the treatment methods of tonifying the heart and spleen,nourishing the liver and kidney,soothing the liver and softening the liver,clearing heat and resolving phlegm,nourishing the blood and promoting blood circulation are selected,which provide certain reference for clinical treatment.

Characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions

OBJECTIVE: To introduce the characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions. DATA SOURCES: Articles related to stroke, subcortical aphasia, basal ganglia aphasia and language rehabilitation published in Chinese from January 1988 to December 2005 were searched in Chinese journal full-text database (CJFD) using the Keywords of 'stroke, basal ganglia aphasia, language rehabilitation' in Chinese. Meanwhile, English articles about aphasia published from January 1982 to December 2005 were searched in and Pubmed database. Besides, several books associated with the contents were looked through manually. STUDY SELECTION: The data were checked primarily, the articles about the pathomechanism and neurolinguistic characteristics of basal ganglia aphasia, diagnostic methods of aphasia and language rehabilitation were selected, and those had no obvious relation with the above contents were excluded. Inclusive criteria: literatures explain the clinical characteristics of basal ganglia aphasia, neurolinguistic pathogenesis and methods of rehabilitation therapy in details. The repetitive studies were excluded. DATA EXTRACTION: Totally 95 literatures about basal ganglia aphasia were collected, including 31 about the clinical characteristics of basal ganglia aphasia, 45 about its neurolinguistic pathogenesis, 5 about the evaluation and classification of aphasia, and 14 about its rehabilitation therapy. Thirty accorded with the inclusive criteria were used for review, and the other 65 were excluded. DATA SYNTHESIS: Concisely introduced the definition, past investigation of basal ganglia aphasia after stroke, then dwelled on the multiplicity neurolinguistics characteristics. Aphasia evaluation was dependent upon clinical aphasic symptoms. The relationship between symptom and focus of infection was explored, and the mechanism of pathosis language behavior on basal ganglia aphasia patients was understood to provide consequence data that could authenticate the processing of language in brain. On the other hand, the method of rehabilitation on basal ganglia aphasia after stroke was explained. CONCLUSION: Basal ganglia aphasia is manifested as atypical aphasic symptom, the mechanism for the structure of basal ganglia in the speech formation should be further confirmed. It is effective to select pertinent language rehabilitation for basal ganglia aphasia after stroke.

Clinical observation of the effect of acupuncture on constipation after stroke

Objective： To observe the differences in therapeutic effects of acupuncture and lactulose oral solution on constipation after stroke. Method： Sixty patients with constipation after stroke were divided into an acupuncture group and a western medicine group by a random number method, with 30 cases in each group. Based on the the conventional treatment and rehabilitation for function recovery, the acupuncture group was treated at the selected the bilateral acupoints： Daheng （SP15）, Fujie （SP14）, Zhigou （TE6）, Zhaohai （KI6）, Yingxiang （LI20）, and Shaoshang （LU11） while the western medicine group was treated with 30 ml of lactulose oral solution. The clinical symptoms score and clinical efficacy of the treatment provided for constipation in both groups were recorded pre-treatment, at one week of treatment, after treatment for two weeks, and one month after discharge respectively. Results： The clinical symptom scores of constipation in the two groups after one week of treatment, two weeks of treatment, and one month of treatment were significantly lower than those before treatment （P 〈 0.001）. The treatment efficacy in the acupuncture group showed significant improvement when compared with the western medicine group, at one week, two weeks and one month （1.03 ± 1.19 vs 1.43 ± 1.19, P 〉 0.05 ; 0.73 ± 1.01 vs 1.33 ± 1.18, P 〈 0.05; 0.53 ± 0.82 vs 1.27 ± 1.14, P 〈 0.05, respectively）. The efficacy rate was statistically significant at two weeks after treatment and one month after follow-up （86.67% vs 70%,P 〈 0.05; 93.33% vs 73.33%, P 〈 0.05, respectively）. Conclusion： The short-term and long-term efficacy of acupuncture on constipation after stroke is better thanthat of treatment with lactulose oral solution. This method is safe, free of side effects, durable, has high feasibility, and is suitable for clinical application.

Research Progress of Acupuncture and Moxibustion in Treating Constipation After Stroke

Constipation is one of the common gastrointestinal complications of stroke,which not only affects the quality of life of patients,but also easily induces and aggravates the primary disease and delays the recovery of the disease.At present,most of the treatments for constipation after stroke are oral medicine and enema,but the curative effect is poor and unstable.Acupuncture has the advantages of simple operation,remarkable effect,high patient acceptance and a little toxic effect.It is one of the non-drug treatment ways to prevent and treat constipation after stroke,as well as widely used in the treatment of constipation after stroke.Therefore,the clinical research on acupuncture treatment of constipation after stroke in recent years is summarized to provide reference for the subsequent clinical treatment of constipation after stroke.

Bibliometric and visual analysis of limb spasm after stroke based on Citespace software

Background:To apply CiteSpace software to the hotspot,trend and cutting-edge dynamics of limb spasm after stroke in nearly 20 years.Methods:From 2000 to 2018,spasming literature in the Web of Science database were searched,and cooperative analysis of authors'national institutions was conducted by using CiteSpace software,keyword analysis and cluster analysis,citation analysis of authors'literature journals,and visual map.Results:2005 articles were retrieved,and the number of articles increased year by year,and the country with the most articles was the United States.Keyword analysis shows that mechanistic research and clinical treatment of spasticity are research hotspots in this field.The most posts are Northwestern Univ and Univ Verona.Conclusion:Through the CiteSpace software analysis of spasticity literature,it is found that the research focus is embodied in the nerve regeneration technology and the standardized clinical study of botulinum toxin type A application,which has certain reference significance for the future research direction of spasticity.

Gabapentinoids for the treatment of stroke

Gabapentinoid drugs(pregabalin and gabapentin) have been successfully used in the treatment of neuro pathic pain and in focal seizure prevention.Recent research has demonstrated their potent activities in modulating neurotransmitter release in neuronal tissue,oxidative stress,and inflammation,which matches the mechanism of action via voltage-gated calcium channels.In this review,we briefly elaborate on the medicinal history and ligand-binding sites of gabapentinoids.We systematically summarize the preclinical and clinical research on gabapentinoids in stroke,including ischemic stro ke,intracerebral hemorrhage,subarachnoid hemorrhage,seizures after stro ke,cortical spreading depolarization after stroke,pain after stroke,and nerve regeneration after stro ke.This review also discusses the potential to rgets of gabapentinoids in stroke;however,the existing results are still unce rtain regarding the effect of gabapentinoids on stroke and related diseases.Further preclinical and clinical trials are needed to test the therapeutic potential of gabapentinoids in stroke.Therefore,gabapentinoids have both opportunities and challenges in the treatment of stroke.

Warm needling on the four knee acupoints combined with Chinese herb in the treatment of knee pain after stroke

Objective To observe the clinical efficacy of warm needling on the four knee acupoints in the treatment of knee pain after stroke on the basis of Chinese herb. Methods Sixty patients with knee pain after stroke were divided into a group A and a group B by random allocation, with 30 patients in each group. Patients in the group B only received the treatment by Chinese herb, which called Dúhuó Jìshēng Tāng（独活寄生汤 Pubescent Angelica and Mistletoe Decoction, add or remove ingredients depending on conditions）; patients in the group A additionally received warm needling on the basis of Chinese herb. Four knee acupoints were selected as master acupoints and Hèd ng（鹤顶 EXLE 2）, Yánglíngquán（阳陵泉 GB 34） and Zúsānl（足三里 ST 36） as combining acupoints. Perpendicular insertion was conducted on Xuèh i（血海 SP 10） and Liángqiū（梁丘 ST 34） for approximately 1 cun, and oblique insertion on Nèixīy n（内膝眼 EX-LE 4） and Dúbí（犊鼻 ST 35） for approximately 1 cun at 45° in inner and upper direction to push needle tip into joint cavity. After deqi, moxibustion stick was cut to 1.5 cm long, ignited, and inserted into the needle handles in the four knee acupoints. 1–2 strips were applied. After the moxa cones were burned up, needles were retained for 10 min. 7 d was a course of treatment and observation lasted for consecutive four courses. Visual analogue scale（VAS） and Barthel Index（BI） were adopted as observational indices. Clinical efficacy was classified as clinical cured, markedly effective, effective and ineffective according to the standards described in Guidelines of Clinical Research on Chinese New Herbal Medicine. Results After treatment, total effective rate was 93.3% in the group A, including full recovery in 8 cases, markedly effective in 15 cases, effective in 5 cases, and ineffective in 2 cases; while the total effective rate was 73.3% in the group B. The difference between the two groups was statistically significant（P0.05）. In the group A, VAS scores were 6.53 ± 1.39 before treatment and 1.53 ± 0.80 after treatment and BI scores were 58.38±8.67 before treatment and 67.55 ± 12.99 after treatment; in the group B, VAS scores were 6.63 ± 1.81 before treatment and 3.33 ± 0.96 after treatment and BI scores were 57.89 ± 9.65 before treatment and 64.87 ± 12.18 after treatment. Both VAS and BI scores were improved significantly in the two groups after treatment and the improvements were statistically significant（all P0.05）. Furthermore, both VAS and BI scores of group A were superior to that of group B（P0.05）. Conclusion Additional treatment of warm needling on the four knee acupoints on the basis of Chinese herb can enhance the clinical efficacy in treatment of knee pain after stroke, contribute to the rapid recovery of knee function and improve the life quality of stroke patients.

Observation on the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke

Objective To evaluate the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke. Methods Sixty cases were randomly divided into an acupuncture rehabilitation group （33 cases） and a routine treatment group （27 cases）. Both two groups received rehabilitation exercise, acupuncture rehabilitation group was treated with scalp acupuncture and body acupuncture, and in body acupuncture, Pishu（脾俞 BL 20）, Weishu （胃俞 BE 21）, Zusanli （足三里 ST 36）, Fenglong （丰隆 ST 40）, Xuehai （血海 SP 10）, and accompanying points according to the symptoms were selected; in scalp acupuncture, Baihui （百会 GV 20）, Sishencong （四神聪EX-HN 1）, motor area, vascular dilation and constriction area were selected. Routine treatment group was treated with western drugs, including dehydration with mannitol to reduce intracranial pressure, control blood pressure, and brain cell protective agent was given, triamcinolone acetate solution for shoulder pain or cortisone acetate solution for blocking treatment. The treatment was given once a day, four weeks were one course, and four courses were given in all. The hemorheological indices and the clinical effect of two groups were compared. Results The effective rate of acupuncture rehabilitation group was 90.9% （30/33）, better than that of 70.4% （19/27） in routine treatment group （P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment became lowered than those before the treatment in acupuncture rehabilitation group （all P〈0.05）; whole blood viscosity and plasma viscosity after the treatment was also lowered than those before the treatment in routine treatment group （both P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment in acupuncture rehabilitation group were obviously lowered than those of routine treatment group （all P〈0.05）. Conclusion With good therapeutic effect and better efficacy than routine medical treatment, scalp acupuncture and body acupuncture in combination with rehabilitation exercise can improve the movement, sensation and hemorheology of extremities of patients with hemiplegia and shoulder pain after stroke.

Acupuncture of lifting and pressing manipulation for upper limb paralysis after stroke

Objective To compare the difference of clinical efficacy between acupuncture of lifting and pressing manipulation and conventional acupuncture in motor function recovery of hemiplegic upper limb after stroke, so as to provide referential support for clinical application. Method Fifty-nine patients with upper limb hemiplegia after stroke were selected and divided into group A （conventional acupuncture ± lifting and pressing manipulation, 30 cases} and group B （conventional acupuncture, 29 cases} according to random number table method. Upper limb motor function and activity of daily living of patients in the two groups were scored before and after treatment, and the results were analyzed and compared. Results The score of upper limb FugI-Meyer motor function of patients was 22.4 ± 2.83 and 32.97 ± 2.92 before and after treatment in group A, and was 19.89 ± 3.13 and 26.62 ± 3.31 before and after treatment in group B, and the difference between the two groups before and after treatment was significant （P〈0.01}. The score of Barthel index of patients was 60.67 ± 4.65 and 73.00 ± 3.82 before and after treatment in group A, and was 50.52 ± 5.15 and 60.17 ± 4.89 before and after treatment in group B, and the difference between the two groups before and after treatment was not statistcally significant {P〉0.05）. Conclusion Lifting and pressing manipulation combined with conventional acupuncture can better improve upper limb motor function of upper limb paralysis of patients after stroke.

热敏灸治疗老年原发性肌少症及老年脑卒中后继发性肌少症的临床研究

目的探讨热敏灸在治疗老年原发性肌少症、老年脑卒中后继发性肌少症患者中的应用价值。方法选取2018年7月至2022年7月江西省人民医院/南昌医学院第一附属医院收治的80例老年原发性肌少症、老年脑卒中后继发性肌少症患者作为研究对象,采用随机数字表法将其分为对照组和观察组,每组40例。对照组采用常规康复治疗,观察组在对照组基础上采用热敏灸治疗,两组均治疗3个月。比较两组四肢骨骼肌指数(ASMI)、肌肉活动功能、手臂最大握力、血液流变学。结果观察组治疗后的ASMI、简易体能状况量表(SPPB)评分、手臂最大握力高于对照组,全血黏度高切、全血黏度低切、血浆黏度(PV)、红细胞压积(PCV)低于对照组,差异有统计学意义(P<0.05)。结论热敏灸应用于老年原发性肌少症、老年脑卒中后继发性肌少症患者中可调节机体血液流变学,提高其四肢骨骼肌肉质量及手臂握力,改善肌肉活动功能,临床应用价值更高。

交感神经兴奋性与醒后脑卒中发生发展的相关性研究

目的 分析交感神经兴奋性与醒后脑卒中发生发展的相关性。方法 选取2020年7月至2022年1月我院收治的100例急性脑卒中住院患者,依据是否发生醒后脑卒中将患者分为醒后脑卒中组和非醒后脑卒中组。采用Logistic回归分析交感神经兴奋与醒后脑卒中发生发展的关系。结果 多因素分析显示,血压变异性、心率变异性、血糖变异性、电解质紊乱、25-羟维生素D_(3)、尿香草苦杏仁酸、儿茶酚胺是醒后脑卒中发生发展的危险因素(均P<0.05)。结论 交感神经兴奋性与醒后脑卒中发生发展具有相关性,血压变异性、心率变异性、血糖变异性、电解质紊乱、25-羟维生素D3、尿香草苦杏仁酸、儿茶酚胺是醒后脑卒中发生发展的危险因素。

悬吊训练结合功能电刺激对脑卒中偏瘫上肢功能的影响

目的分析悬吊训练(SET)结合功能电刺激(FES)对脑卒中偏瘫上肢功能的影响。方法选取杭州市红十字会医院2020年11月至2022年12月脑卒中偏瘫患者70例,采用随机抽签法分为3组:实验组24例、对照组A 23例、对照组B 23例。3组均接受常规康复治疗,对照组A给予FES治疗,对照组B给予SET治疗,实验组给予SET联合FES治疗。4周后,比较3组Brunnstrom分期,上肢运动功能(FMA-UE)评分,视觉模拟评分(VAS),改良Barthel指数(MBI),肩关节活动度(前屈、外展、外旋、内旋),肩手肌群平均肌电值(三角肌前束、斜方肌上束)。结果治疗后实验组Brunnstrom V期改善程度大于对照组A、对照组B(P<0.05);治疗后实验组FMA-UE评分、MBI高于对照组A、对照组B,VAS低于对照组A、对照组B(P<0.05);治疗后实验组前屈、外展、外旋、内旋角度大于对照组A、对照组B(P<0.01);治疗后实验组三角肌前束、斜方肌上束平均肌电值高于对照组A、对照组B(P<0.01)。结论SET联合FES治疗脑卒中偏瘫可改善关节活动度,增强肌力,还可减轻患者疼痛程度,改善上肢功能,提升生活活动能力。

透穴针刺联合体外冲击波治疗脑卒中后偏瘫患者的临床观察

目的:透穴针刺联合体外冲击波治疗对脑卒中后偏瘫患者的临床观察。方法:选取82例卒中后偏瘫患者,根据随机数字表法分为常规组和透穴组各41例。常规组予以体外冲击波治疗;透穴组在给予体外冲击波治疗的基础上予以透穴针刺治疗,1个月为1个疗程,共治疗3个疗程。比较两组治疗前后的患侧表面肌电图(sEMG)[腓肠肌、股四头肌、胫骨前肌的肌电积分值(iEMG)]、平衡能力[Berg平衡量表(BBS)]及运动耐力[峰值功率(PP)、运动持续时间(ED)]。结果:治疗后,透穴组股四头肌、腓肠肌、胫骨前肌的iEMG均较常规组显著提高(P<0.05);两组治疗前BBS评分无明显差异(P>0.05),治疗后两组BBS评分均升高,而透穴组较常规组高(P<0.05);治疗前,两组PP、ED无明显差异(P>0.05),治疗后两组PP、ED均升高,而透穴组较常规组高(P<0.05)。结论:透穴针刺联合体外冲击波治疗脑卒中后偏瘫患者可促进其腓肠肌、股四头肌、胫骨前肌功能的恢复,同时改善其平衡能力,增强其运动耐力,疗效较好。

超声引导下针刺八髎穴联合通督调神针法治疗脑卒中后尿失禁临床观察

目的观察超声引导下针刺八髎穴联合通督调神针法治疗脑卒中后尿失禁的疗效。方法将60例脑卒中后尿失禁患者随机分为试验组和对照组,每组30例,试验组采用通督调神针法联合超声引导下针刺八髎穴治疗,对照组采用通督调神针法联合传统方法针刺八髎穴治疗,每日1次,每周治疗6 d,共治疗4周。采用国际尿失禁咨询委员会尿失禁问卷简表(the International Consultation on incontinence questionnaire-short form,ICI-Q-SF)评价漏尿情况和排尿次数,采用排尿日记观察日间和夜间的尿失禁次数和排尿次数,基于治疗后ICI-Q-SF评分下降率判定临床疗效。结果与治疗前比较,两组患者治疗后ICI-Q-SF评分,日间、夜间排尿次数和尿失禁次数均显著降低(P<0.05),且试验组上述指标下降程度显著大于对照组(P<0.05)。试验组基于ICI-Q-SF评分的疗效显著优于对照组(P<0.05)。结论超声引导有助于八髎穴定位,提高八髎穴针刺联合通督调神针法治疗脑卒中后尿失禁的疗效。

基于Bobath理念下的康复训练改善脑卒中偏瘫患者步态的临床研究

目的探究基于Bobath理念下的康复训练在脑卒中偏瘫患者中的应用。方法选取惠州市中心人民医院2021年1月至2023年4月104例脑卒中偏瘫患者作为研究对象,依照康复方式分为常规康复组和Bobath技术组。两组均行低频重复经颅磁刺激。常规康复组给予常规康复训练,Bobath技术组给予基于Bobath理念下的康复训练,对比两组步态状态、运动能力、平衡能力。结果治疗12周后,Bobath技术组10 m最快步行速度(MWS)(0.73±0.17)m/min、步长(42.21±4.07)cm及Fugl-Meyer上肢运动功能评定量表(FMA-UE)(53.24±4.13)分、Fugl-Meyer下肢运动功能评定量表(FMA-LE)(28.32±2.95)分、Berg平衡量表(BBS)(49.16±3.24)分、脑卒中姿势评定量表(PASS)(25.81±3.06)分高于常规康复组(0.61±0.12)m/min、(37.76±3.82)cm、(45.93±3.51)分、(24.17±2.72)分、(40.25±3.13)分、(21.24±1.82)分;威斯康星步态量表(WGS)(15.83±1.43)分低于常规康复组(24.21±1.75)分(P<0.05)。结论基于Bobath理念下的康复训练可调控脑卒中偏瘫患者平衡能力,改善其步态状态,调节运动能力。