BACKGROUND: Transplanted mononuclear cell (MNC) of umbilical blood can survive in central nervous system (CNS) of host through blood brain barrier, differentiate into nerve cells, migrate to damaged site and integrate...BACKGROUND: Transplanted mononuclear cell (MNC) of umbilical blood can survive in central nervous system (CNS) of host through blood brain barrier, differentiate into nerve cells, migrate to damaged site and integrate morphological structure and function with nerve cells of host so as to improve deficiencies of sensatory function, motor function and cognitive function and influence on stroke sequela. OBJECTIVE: To observe the vein transplantation of human umbilical cord blood stem cells (HUCBSC) for improving neurological function, limb function and activity of daily living of patients with stroke and evaluate the reliability. DESIGN: Self-controlled study. SETTING: Department of Neurosurgery, the Second People's Hospital of Zhengzhou City; Red-crossed Blood Center of Henan Province; Department of Neurosurgery, the Fist Affiliated Hospital of Zhengzhou University. PARTICIPANTS: A total of 10 patients with stroke sequela were selected from Department of Cerebral Surgery, the Second People's Hospital of Zhengzhou City from April to December 2005. There were 9 males and 1 female aged from 35 to 75 years with the mean age of 56 years. All of them were diagnosed with CT and MRI examination and coincidence with diagnostic criteria of stroke established by the Fourth National Academic Meeting for Cerebrovascular Disease. All patients provided informed consent. METHODS: 80-140 mL umbilical blood of term birth of newborn was selected hermetically and maintained in sterile plastic bag. And then, the blood was centrifugated at the speed of 1 500 r/min for 30 minutes at 22 ℃ in order to separate MNC, i.e., HUCBSC. In addition, after final diagnosis during hospitalization, stroke patients were perfused with HUCBSC through superficial vein of back of the hand. Each patient was averagely perfused with 6 portions of HUCBSC (cellular numbers ≥ 1×108/portion) and the interval between each portion was 1-7 days with the mean interval of 4 days. MAIN OUTCOME MEASURES: ① Neurological function of stroke patients was evaluated with neurological function deficiency (NFD) before treatment and at 3 months after treatment. The scale includes consciousness, level fix function, facial paralysis, language, muscle force of upper limbs, muscle force of lower limb and step function. The total scores ranged from 0 to 45; meanwhile, the lower the scores were, the better the neurological function was. ② Motor function of injured limbs was evaluated with Fugl-Meyer Assessment (FMA), including motor function of upper limbs, motor function of lower limbs, balance ability, sensory function and motion of joint. The total scores ranged from 0 to 226; meanwhile, the higher the scores were, the better the motor function of limbs was. ③ Activities of daily living (ADL) was evaluated with Barthel Index (BI), including having meals, taking a bath, dressing oneself, putting on clothes, walking in balance and stair activity. The total scores ranged from 0 to 100; meanwhile, the higher the scores were, the stronger the ADL was. RESULTS: A total of 10 patients were involved in the final analysis. After treatment, NFD of stroke patients was (10.9±5.09) points, which was lower than that before treatment [(25.4±6.09) points, t =8.213, P < 0.01]. In addition, after treatment, FMA and BI of stroke patients were (80.9±25.00) points and (81.1±15.93) points, respectively, which were higher than those before treatment [(31.9±21.85) points, (36.2±19.41) points, t =13.024, 13.670, P < 0.01]. Immuno-suppressive drugs were not used during the whole therapeutic procedure; moreover, immunological rejection and allergic reaction were not observed during the same period. CONCLUSION: Transplanting HUCBSC through superficial vein of back of the hand is regarded as a simple and safe method for the treatment of stroke sequela.展开更多
Objective: to investigate the clinical significance, statistical intervention effect, and evaluate the quality of life of patients with stroke sequelae treated with Pentagon in rehabilitation care. Methods: in this ho...Objective: to investigate the clinical significance, statistical intervention effect, and evaluate the quality of life of patients with stroke sequelae treated with Pentagon in rehabilitation care. Methods: in this hospital, patients with stroke sequelae hospitalized from January 2021 to December 2021 were divided into two groups, including 40 cases as the control group and 40 cases as the control group, which underwent rehabilitation using pentatone therapy. Results: compared with the control group, the scores of SAS and SDS scales were significantly lower;Scores on the SF-36 were higher than in the control group;The NIHSS score of the observation group was lower than that of the control group, the Fugl Meyer score was higher than that of the control group, and the Barthel index was higher than that of the control group;Lower PSQI score than control group, P < 0.05;In terms of satisfaction, the study group had a higher rating of the nurses satisfaction with their work, P < 0.05;Conclusion: in the clinical care of patients with post-stroke disabilities, the five sound therapy combined with rehabilitation care can effectively improve their neurological and limb functions, alleviate their negative emotions and improve their quality of survival.展开更多
Post-stroke swallowing disorder is an important factor affecting the rehabilitation of stroke patients.There are many clinical treatment methods such as physical therapy and acupuncture.From the literature in recent y...Post-stroke swallowing disorder is an important factor affecting the rehabilitation of stroke patients.There are many clinical treatment methods such as physical therapy and acupuncture.From the literature in recent years,acupuncture points,acupuncture manipulation,acupuncture amount,combined with other treatment methods,and acupoint selection based on syndrome differentiation are reviewed.It is clinically proved that acupuncture is effective in treating stroke accompanied by swallowing disorder.Different acupuncture methods need to select different acupoints,and different doctors have different acupuncture techniques,which reflects the syndrome differentiation and treatment of traditional Chinese medicine.Summarizing the literature is convenient in guiding patients to select acupoints more precisely and easily in treatment.In the future,more patient samples,multiple clinical centers and more standardized controlled clinical trials will be adopted to find out the theoretical basis of traditional Chinese medicine for acupuncture treatment of post-stroke swallowing disorder and the specific effective acupoints in acupuncture treatment,so as to facilitate learning,communication,popularization and application in primary clinical practice.展开更多
The research progress of brain-derived neurotrophic factor (BDNF) in the treatment of sequelae of stroke is an important topic. Stroke is among the diseases with the highest mortality and disability rates among the el...The research progress of brain-derived neurotrophic factor (BDNF) in the treatment of sequelae of stroke is an important topic. Stroke is among the diseases with the highest mortality and disability rates among the elderly in China. BDNF plays an important role in the development and functional maintenance of the nervous system. In recent years, the application value of BDNF in rehabilitation therapy has gradually received attention. This study has adopted a systematic literature review method, searched Chinese and English databases, screened relevant studies, and conducted data extraction and quality evaluation. This review systematically introduced the research progress of BDNF in the correlation with post-stroke sequelae, with special attention to its application in post-stroke depression, motor dysfunction, and cognitive dysfunction. The results showed that a decrease in BDNF levels is closely related to the exacerbation of depressive symptoms, limited recovery of motor dysfunction, and the occurrence of cognitive dysfunction. BDNF, as a key neurobiological factor, has shown significant potential in the rehabilitation treatment of stroke. By exploring the potential of BDNF as a therapeutic target to prevent and treat sequelae of ischemic stroke, the current research bottlenecks, and the development trends of future treatment strategies.展开更多
Objective:To explore the effects of standardized rehabilitation on quality of life (QOL) of stroke patients at convalescence and sequelae stages. Method:A total of 251 stroke patients were randomly divided into a stan...Objective:To explore the effects of standardized rehabilitation on quality of life (QOL) of stroke patients at convalescence and sequelae stages. Method:A total of 251 stroke patients were randomly divided into a standardized rehabilitation group and a control group. The simplified Fugl-Meyer assessment(FMA) scale, the 36-item short-form health survey questionnaire (SF-36) and functional comprehensive assessment (FCA) were administered before as well as after 3, 6 and at 12 months a follow-up study respectively. Statistical analysis was conducted based on the evaluations at 4 testing time points. Result:There was no significant difference in FMA,SF-36 and FCA scores of the two groups before and after 3 months treatments, while FMA,SF-36 and FCA scores of the rehabilitation group were obviously higher than those of the control group either after 6 months treatments or of followup study. Moreover, after 6 months treatments FMA score was apparently higher than the score at the beginning and after 3 months treatments. The FMA, SF36 and FAC scores during the followup visit decreased when compared with scores after 6 months treatments, but increased significantly when compared with the scores at the beginning and after 3 months treatments. Conclusion:Standardized tertiary rehabilitation (STR) at convalescence and sequelae stages can significantly improve motor functions and QOL of stroke patients.展开更多
Background and Objective: The knowledge about risk of falls in patients with sequelae of stroke by applying a scale constitutes an important factor fort nurses since it allows planning for quality care and consequentl...Background and Objective: The knowledge about risk of falls in patients with sequelae of stroke by applying a scale constitutes an important factor fort nurses since it allows planning for quality care and consequently improves the quality of life of such patients. The present study aimed to assess the risk of falls of patients with sequelae of stroke using Tinetti Index. Methods: Transversal descriptive study with 61 hospitalized patients. The data were collected through the application of Tinetti Index, the total score of which is 28 points. Results: The index evaluation shows que 47.9% had 19 points under the ideal score, indicating a high risk of falls, 41.7% from 24 to 28, indicating moderate risk and 10.4% from 19 to 23 points, indicating low risk of falls. The final average was (15.23), the median (16.50) and standard deviation (±11.034). Conclusions: There is a high risk of falls in this population, a quantification of impaired balance and gait anticipate the future risk of falls. The use of assessment instruments has important implications for improving the quality of life in patients with symptomatic stroke.展开更多
目的观察灵龟八法联合益气调神针法治疗卒中后认知障碍的临床疗效。方法将62例气虚血瘀型卒中后认知障碍患者随机分为观察组和对照组,每组31例。治疗过程中,对照组剔除1例,故最终纳入统计30例。两组均予常规治疗。对照组予认知训练,观...目的观察灵龟八法联合益气调神针法治疗卒中后认知障碍的临床疗效。方法将62例气虚血瘀型卒中后认知障碍患者随机分为观察组和对照组,每组31例。治疗过程中,对照组剔除1例,故最终纳入统计30例。两组均予常规治疗。对照组予认知训练,观察组在对照组治疗基础上予灵龟八法联合益气调神针法治疗。比较两组治疗前后简易精神状态检查表(mini-mental state examination,MMSE)评分、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分、日常生活能力量表(activity of daily living scale,ADL)评分和中医证候积分的变化,比较两组治疗前后血清超敏C反应蛋白(hypersensitive C reactive protein,hs-CRP)和同型半胱氨酸(homocystine,Hcy)水平的变化。结果治疗后,两组MMSE和MoCA评分均较治疗前升高(P<0.05),且观察组上述评分均高于对照组(P<0.05)。治疗后,两组ADL评分和中医证候积分均较治疗前降低(P<0.05),且观察组上述评分均低于对照组(P<0.05)。治疗后,两组血清hs-CRP和Hcy水平均较治疗前降低(P<0.05),且观察组上述指标水平均低于对照组(P<0.05)。结论在认知训练基础上,灵龟八法联合益气调神针法治疗气虚血瘀型卒中后认知障碍可改善患者的认知功能,提高日常生活能力,改善临床症状,可能与降低血清hs-CRP及Hcy水平有关。展开更多
目的观察针药并用治疗卒中恢复期自主神经功能障碍的临床疗效,并观察对24 h心率变异性(heart rate variability,HRV)指标的影响。方法将60例卒中恢复期自主神经功能障碍患者随机分为治疗组和对照组,每组30例。对照组采用对症药物治疗,...目的观察针药并用治疗卒中恢复期自主神经功能障碍的临床疗效,并观察对24 h心率变异性(heart rate variability,HRV)指标的影响。方法将60例卒中恢复期自主神经功能障碍患者随机分为治疗组和对照组,每组30例。对照组采用对症药物治疗,治疗组在对照组治疗基础上采用针刺治疗。观察两组治疗前后临床特征量表(clinical feature scale,CFS)评分、24 h HRV指标[窦性R-R间期标准差(standard deviation of normal-to-normal intervals,SDNN)、窦性R-R间期平均值标准差(standard deviation of the average of normal-to-normal intervals,SDANN)、连续差值的均方根(root mean square of successive differences,RMSSD)、相邻两个窦性R-R间期差值>50 ms的个数所占的百分率(percentage of normal-to-normal intervals differing by more than 50 milliseconds,PNN50)、低频(low frequency,LF)功率、高频(high frequency,HF)功率及LF/HF]的变化,并比较两组临床疗效。结果治疗组总有效率为93.3%,高于对照组的73.3%(P<0.05)。治疗后,两组CFS评分均降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组SDNN、RMSSD、日间及夜间LF、HF水平较治疗前升高,且治疗组高于对照组,差异有统计学意义(P<0.05);两组SDANN、日间及夜间LF/HF、PNN50水平与治疗前比较差异无统计学意义(P>0.05),组间比较差异无统计学意义(P>0.05)。结论针药并用能够调节卒中恢复期自主神经功能障碍患者的自主神经平衡,有利于患者自主神经功能的恢复。展开更多
Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-str...Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-stroke patients with upper limb spasticity were randomly divided into two groups at the ratio of 1： 1, the group of meridian sinew row needling combined with dermal needling （group A, 244 cases） and western medication group （group B, 244 cases）. Coupled with rehabilitation, the patients in the group A were given meridian sinew row needling combined with dermal needling where five shu points were specifically selected, and three yang meridians of the hand were treated with acupuncture with muscle region, and three yin meridians of the hand were treated with dermal needles; the patients in the group B was treated with conventional western medication with piracetam injection and cerebroprotein hydrolysate included. Clinical efficacy was evaluated among patients in the two groups after three weeks of continuous treatment, and upper limb spasticity and motor functions were observed through modified Asworth Scale and FugI-Meyer Assessment Scale （FMA） before and after treatment. Results For Asworth Scale, group A was significantly superior to group B （3.04 ± 1.29 vs 3.88 ± 1.54, P〈0.05）; for FMA scale, group A was also significantly superior to group B （48.67± 15.64 vs 42.96±14.72, P〈0.05）; mitigations of motor status of upper limb joints in group A, such as remission of shoulder adduction （90.5%）, pronation of forearm （70.7%）, elbow joint flexion （73.1%）, wrist joint flexion （80.9%） and finger flexion （88.1%）, were superior to those of group B （70.0%, 60.0%, 61.9%, 57.4%, 63.2%, all P〈0.05）. Conclusion Good clinical efficacy of the treatment with combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis is achieved.展开更多
目的观察调神益智针刺治疗痰瘀闭阻型卒中后痴呆(post-stroke dementia,PSD)的临床疗效及对氧化应激激素水平和血流变的影响。方法将94例痰瘀闭阻型PSD患者随机分为基础治疗组(31例)、对照组(32例)和观察组(31例)。基础治疗组给予内科...目的观察调神益智针刺治疗痰瘀闭阻型卒中后痴呆(post-stroke dementia,PSD)的临床疗效及对氧化应激激素水平和血流变的影响。方法将94例痰瘀闭阻型PSD患者随机分为基础治疗组(31例)、对照组(32例)和观察组(31例)。基础治疗组给予内科常规治疗,对照组在基础治疗组的基础上采用常规针刺治疗,观察组在基础治疗组的基础上采用调神益智针法治疗。观察3组治疗前后蒙特利尔认知评估(Montreal cognitive assessment,MoCA)和简易精神状态检查(mini-mental state examination,MMSE)评分、中医证候积分、日常生活活动(activities of daily living,ADL)量表评分、氧化应激水平[超氧化物歧化酶(superoxide dismutase,SOD)和丙二醛(malondialdehyde,MDA)]、血脂水平[甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)和低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)]、血流变学指标[全血高切黏度、全血低切黏度和血浆黏度]变化,并比较3组临床疗效。结果观察组总有效率优于其余两组,差异有统计学意义(P<0.05)。3组治疗后MoCA和MMSE评分较治疗前提高(P<0.05),且观察组高于其余两组(P<0.05)。观察组和对照组治疗后中医证候各项积分较治疗前显著降低(P<0.05);基础治疗组除体态臃肿外,中医证候各项积分均较前显著降低(P<0.05)。3组治疗后中医证候各项积分除体态臃肿外,中医证候各项积分低于其余两组(P<0.05)。3组治疗后ADL评分较治疗前均升高,差异具有统计学意义(P<0.05);3组治疗后ADL评分比较,差异无统计学意义(P>0.05)。3组治疗后血清SOD水平较治疗前均升高(P<0.05),且观察组SOD水平高于其余两组(P<0.05);3组治疗后MDA水平较治疗前均降低(P<0.05),且观察组MDA水平低于其余两组(P<0.05)。3组治疗后血清TG、TC、LDL-C水平较治疗前均降低(P<0.05),且观察组低于其余两组(P<0.05)。3组治疗后全血高切黏度、全血低切黏度、血浆黏度均低于治疗前(P<0.05),且观察组低于其余两组(P<0.05)。结论在内科常规治疗的基础上,调神益智针法治疗痰瘀闭阻型PSD可改善患者MoCA和MMSE评分、中医证候积分、氧化应激激素水平、血脂水平以及血流变学指标。展开更多
文摘BACKGROUND: Transplanted mononuclear cell (MNC) of umbilical blood can survive in central nervous system (CNS) of host through blood brain barrier, differentiate into nerve cells, migrate to damaged site and integrate morphological structure and function with nerve cells of host so as to improve deficiencies of sensatory function, motor function and cognitive function and influence on stroke sequela. OBJECTIVE: To observe the vein transplantation of human umbilical cord blood stem cells (HUCBSC) for improving neurological function, limb function and activity of daily living of patients with stroke and evaluate the reliability. DESIGN: Self-controlled study. SETTING: Department of Neurosurgery, the Second People's Hospital of Zhengzhou City; Red-crossed Blood Center of Henan Province; Department of Neurosurgery, the Fist Affiliated Hospital of Zhengzhou University. PARTICIPANTS: A total of 10 patients with stroke sequela were selected from Department of Cerebral Surgery, the Second People's Hospital of Zhengzhou City from April to December 2005. There were 9 males and 1 female aged from 35 to 75 years with the mean age of 56 years. All of them were diagnosed with CT and MRI examination and coincidence with diagnostic criteria of stroke established by the Fourth National Academic Meeting for Cerebrovascular Disease. All patients provided informed consent. METHODS: 80-140 mL umbilical blood of term birth of newborn was selected hermetically and maintained in sterile plastic bag. And then, the blood was centrifugated at the speed of 1 500 r/min for 30 minutes at 22 ℃ in order to separate MNC, i.e., HUCBSC. In addition, after final diagnosis during hospitalization, stroke patients were perfused with HUCBSC through superficial vein of back of the hand. Each patient was averagely perfused with 6 portions of HUCBSC (cellular numbers ≥ 1×108/portion) and the interval between each portion was 1-7 days with the mean interval of 4 days. MAIN OUTCOME MEASURES: ① Neurological function of stroke patients was evaluated with neurological function deficiency (NFD) before treatment and at 3 months after treatment. The scale includes consciousness, level fix function, facial paralysis, language, muscle force of upper limbs, muscle force of lower limb and step function. The total scores ranged from 0 to 45; meanwhile, the lower the scores were, the better the neurological function was. ② Motor function of injured limbs was evaluated with Fugl-Meyer Assessment (FMA), including motor function of upper limbs, motor function of lower limbs, balance ability, sensory function and motion of joint. The total scores ranged from 0 to 226; meanwhile, the higher the scores were, the better the motor function of limbs was. ③ Activities of daily living (ADL) was evaluated with Barthel Index (BI), including having meals, taking a bath, dressing oneself, putting on clothes, walking in balance and stair activity. The total scores ranged from 0 to 100; meanwhile, the higher the scores were, the stronger the ADL was. RESULTS: A total of 10 patients were involved in the final analysis. After treatment, NFD of stroke patients was (10.9±5.09) points, which was lower than that before treatment [(25.4±6.09) points, t =8.213, P < 0.01]. In addition, after treatment, FMA and BI of stroke patients were (80.9±25.00) points and (81.1±15.93) points, respectively, which were higher than those before treatment [(31.9±21.85) points, (36.2±19.41) points, t =13.024, 13.670, P < 0.01]. Immuno-suppressive drugs were not used during the whole therapeutic procedure; moreover, immunological rejection and allergic reaction were not observed during the same period. CONCLUSION: Transplanting HUCBSC through superficial vein of back of the hand is regarded as a simple and safe method for the treatment of stroke sequela.
文摘Objective: to investigate the clinical significance, statistical intervention effect, and evaluate the quality of life of patients with stroke sequelae treated with Pentagon in rehabilitation care. Methods: in this hospital, patients with stroke sequelae hospitalized from January 2021 to December 2021 were divided into two groups, including 40 cases as the control group and 40 cases as the control group, which underwent rehabilitation using pentatone therapy. Results: compared with the control group, the scores of SAS and SDS scales were significantly lower;Scores on the SF-36 were higher than in the control group;The NIHSS score of the observation group was lower than that of the control group, the Fugl Meyer score was higher than that of the control group, and the Barthel index was higher than that of the control group;Lower PSQI score than control group, P < 0.05;In terms of satisfaction, the study group had a higher rating of the nurses satisfaction with their work, P < 0.05;Conclusion: in the clinical care of patients with post-stroke disabilities, the five sound therapy combined with rehabilitation care can effectively improve their neurological and limb functions, alleviate their negative emotions and improve their quality of survival.
基金Supported by Graduate Innovation Program of Bengbu Medical University(BYYCX1981).
文摘Post-stroke swallowing disorder is an important factor affecting the rehabilitation of stroke patients.There are many clinical treatment methods such as physical therapy and acupuncture.From the literature in recent years,acupuncture points,acupuncture manipulation,acupuncture amount,combined with other treatment methods,and acupoint selection based on syndrome differentiation are reviewed.It is clinically proved that acupuncture is effective in treating stroke accompanied by swallowing disorder.Different acupuncture methods need to select different acupoints,and different doctors have different acupuncture techniques,which reflects the syndrome differentiation and treatment of traditional Chinese medicine.Summarizing the literature is convenient in guiding patients to select acupoints more precisely and easily in treatment.In the future,more patient samples,multiple clinical centers and more standardized controlled clinical trials will be adopted to find out the theoretical basis of traditional Chinese medicine for acupuncture treatment of post-stroke swallowing disorder and the specific effective acupoints in acupuncture treatment,so as to facilitate learning,communication,popularization and application in primary clinical practice.
文摘The research progress of brain-derived neurotrophic factor (BDNF) in the treatment of sequelae of stroke is an important topic. Stroke is among the diseases with the highest mortality and disability rates among the elderly in China. BDNF plays an important role in the development and functional maintenance of the nervous system. In recent years, the application value of BDNF in rehabilitation therapy has gradually received attention. This study has adopted a systematic literature review method, searched Chinese and English databases, screened relevant studies, and conducted data extraction and quality evaluation. This review systematically introduced the research progress of BDNF in the correlation with post-stroke sequelae, with special attention to its application in post-stroke depression, motor dysfunction, and cognitive dysfunction. The results showed that a decrease in BDNF levels is closely related to the exacerbation of depressive symptoms, limited recovery of motor dysfunction, and the occurrence of cognitive dysfunction. BDNF, as a key neurobiological factor, has shown significant potential in the rehabilitation treatment of stroke. By exploring the potential of BDNF as a therapeutic target to prevent and treat sequelae of ischemic stroke, the current research bottlenecks, and the development trends of future treatment strategies.
基金supported by the Key Projects of Shanghai Science and Technology on Biomedicine(NO.10DZ1950800)the 12th Five-year Plan supporting project of Ministry of Science and Technology of the Peo-ple's Republic of China (NO: 2013BAI10B03)the Major project of Shanghai Zhabei District Health Bureau(No. 2011ZD01)
文摘Objective:To explore the effects of standardized rehabilitation on quality of life (QOL) of stroke patients at convalescence and sequelae stages. Method:A total of 251 stroke patients were randomly divided into a standardized rehabilitation group and a control group. The simplified Fugl-Meyer assessment(FMA) scale, the 36-item short-form health survey questionnaire (SF-36) and functional comprehensive assessment (FCA) were administered before as well as after 3, 6 and at 12 months a follow-up study respectively. Statistical analysis was conducted based on the evaluations at 4 testing time points. Result:There was no significant difference in FMA,SF-36 and FCA scores of the two groups before and after 3 months treatments, while FMA,SF-36 and FCA scores of the rehabilitation group were obviously higher than those of the control group either after 6 months treatments or of followup study. Moreover, after 6 months treatments FMA score was apparently higher than the score at the beginning and after 3 months treatments. The FMA, SF36 and FAC scores during the followup visit decreased when compared with scores after 6 months treatments, but increased significantly when compared with the scores at the beginning and after 3 months treatments. Conclusion:Standardized tertiary rehabilitation (STR) at convalescence and sequelae stages can significantly improve motor functions and QOL of stroke patients.
文摘Background and Objective: The knowledge about risk of falls in patients with sequelae of stroke by applying a scale constitutes an important factor fort nurses since it allows planning for quality care and consequently improves the quality of life of such patients. The present study aimed to assess the risk of falls of patients with sequelae of stroke using Tinetti Index. Methods: Transversal descriptive study with 61 hospitalized patients. The data were collected through the application of Tinetti Index, the total score of which is 28 points. Results: The index evaluation shows que 47.9% had 19 points under the ideal score, indicating a high risk of falls, 41.7% from 24 to 28, indicating moderate risk and 10.4% from 19 to 23 points, indicating low risk of falls. The final average was (15.23), the median (16.50) and standard deviation (±11.034). Conclusions: There is a high risk of falls in this population, a quantification of impaired balance and gait anticipate the future risk of falls. The use of assessment instruments has important implications for improving the quality of life in patients with symptomatic stroke.
文摘目的观察灵龟八法联合益气调神针法治疗卒中后认知障碍的临床疗效。方法将62例气虚血瘀型卒中后认知障碍患者随机分为观察组和对照组,每组31例。治疗过程中,对照组剔除1例,故最终纳入统计30例。两组均予常规治疗。对照组予认知训练,观察组在对照组治疗基础上予灵龟八法联合益气调神针法治疗。比较两组治疗前后简易精神状态检查表(mini-mental state examination,MMSE)评分、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分、日常生活能力量表(activity of daily living scale,ADL)评分和中医证候积分的变化,比较两组治疗前后血清超敏C反应蛋白(hypersensitive C reactive protein,hs-CRP)和同型半胱氨酸(homocystine,Hcy)水平的变化。结果治疗后,两组MMSE和MoCA评分均较治疗前升高(P<0.05),且观察组上述评分均高于对照组(P<0.05)。治疗后,两组ADL评分和中医证候积分均较治疗前降低(P<0.05),且观察组上述评分均低于对照组(P<0.05)。治疗后,两组血清hs-CRP和Hcy水平均较治疗前降低(P<0.05),且观察组上述指标水平均低于对照组(P<0.05)。结论在认知训练基础上,灵龟八法联合益气调神针法治疗气虚血瘀型卒中后认知障碍可改善患者的认知功能,提高日常生活能力,改善临床症状,可能与降低血清hs-CRP及Hcy水平有关。
文摘目的观察针药并用治疗卒中恢复期自主神经功能障碍的临床疗效,并观察对24 h心率变异性(heart rate variability,HRV)指标的影响。方法将60例卒中恢复期自主神经功能障碍患者随机分为治疗组和对照组,每组30例。对照组采用对症药物治疗,治疗组在对照组治疗基础上采用针刺治疗。观察两组治疗前后临床特征量表(clinical feature scale,CFS)评分、24 h HRV指标[窦性R-R间期标准差(standard deviation of normal-to-normal intervals,SDNN)、窦性R-R间期平均值标准差(standard deviation of the average of normal-to-normal intervals,SDANN)、连续差值的均方根(root mean square of successive differences,RMSSD)、相邻两个窦性R-R间期差值>50 ms的个数所占的百分率(percentage of normal-to-normal intervals differing by more than 50 milliseconds,PNN50)、低频(low frequency,LF)功率、高频(high frequency,HF)功率及LF/HF]的变化,并比较两组临床疗效。结果治疗组总有效率为93.3%,高于对照组的73.3%(P<0.05)。治疗后,两组CFS评分均降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组SDNN、RMSSD、日间及夜间LF、HF水平较治疗前升高,且治疗组高于对照组,差异有统计学意义(P<0.05);两组SDANN、日间及夜间LF/HF、PNN50水平与治疗前比较差异无统计学意义(P>0.05),组间比较差异无统计学意义(P>0.05)。结论针药并用能够调节卒中恢复期自主神经功能障碍患者的自主神经平衡,有利于患者自主神经功能的恢复。
基金Supported by Hebei Administration of Traditional Chinese Medicine(2009180)
文摘Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-stroke patients with upper limb spasticity were randomly divided into two groups at the ratio of 1： 1, the group of meridian sinew row needling combined with dermal needling （group A, 244 cases） and western medication group （group B, 244 cases）. Coupled with rehabilitation, the patients in the group A were given meridian sinew row needling combined with dermal needling where five shu points were specifically selected, and three yang meridians of the hand were treated with acupuncture with muscle region, and three yin meridians of the hand were treated with dermal needles; the patients in the group B was treated with conventional western medication with piracetam injection and cerebroprotein hydrolysate included. Clinical efficacy was evaluated among patients in the two groups after three weeks of continuous treatment, and upper limb spasticity and motor functions were observed through modified Asworth Scale and FugI-Meyer Assessment Scale （FMA） before and after treatment. Results For Asworth Scale, group A was significantly superior to group B （3.04 ± 1.29 vs 3.88 ± 1.54, P〈0.05）; for FMA scale, group A was also significantly superior to group B （48.67± 15.64 vs 42.96±14.72, P〈0.05）; mitigations of motor status of upper limb joints in group A, such as remission of shoulder adduction （90.5%）, pronation of forearm （70.7%）, elbow joint flexion （73.1%）, wrist joint flexion （80.9%） and finger flexion （88.1%）, were superior to those of group B （70.0%, 60.0%, 61.9%, 57.4%, 63.2%, all P〈0.05）. Conclusion Good clinical efficacy of the treatment with combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis is achieved.
文摘目的观察调神益智针刺治疗痰瘀闭阻型卒中后痴呆(post-stroke dementia,PSD)的临床疗效及对氧化应激激素水平和血流变的影响。方法将94例痰瘀闭阻型PSD患者随机分为基础治疗组(31例)、对照组(32例)和观察组(31例)。基础治疗组给予内科常规治疗,对照组在基础治疗组的基础上采用常规针刺治疗,观察组在基础治疗组的基础上采用调神益智针法治疗。观察3组治疗前后蒙特利尔认知评估(Montreal cognitive assessment,MoCA)和简易精神状态检查(mini-mental state examination,MMSE)评分、中医证候积分、日常生活活动(activities of daily living,ADL)量表评分、氧化应激水平[超氧化物歧化酶(superoxide dismutase,SOD)和丙二醛(malondialdehyde,MDA)]、血脂水平[甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)和低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)]、血流变学指标[全血高切黏度、全血低切黏度和血浆黏度]变化,并比较3组临床疗效。结果观察组总有效率优于其余两组,差异有统计学意义(P<0.05)。3组治疗后MoCA和MMSE评分较治疗前提高(P<0.05),且观察组高于其余两组(P<0.05)。观察组和对照组治疗后中医证候各项积分较治疗前显著降低(P<0.05);基础治疗组除体态臃肿外,中医证候各项积分均较前显著降低(P<0.05)。3组治疗后中医证候各项积分除体态臃肿外,中医证候各项积分低于其余两组(P<0.05)。3组治疗后ADL评分较治疗前均升高,差异具有统计学意义(P<0.05);3组治疗后ADL评分比较,差异无统计学意义(P>0.05)。3组治疗后血清SOD水平较治疗前均升高(P<0.05),且观察组SOD水平高于其余两组(P<0.05);3组治疗后MDA水平较治疗前均降低(P<0.05),且观察组MDA水平低于其余两组(P<0.05)。3组治疗后血清TG、TC、LDL-C水平较治疗前均降低(P<0.05),且观察组低于其余两组(P<0.05)。3组治疗后全血高切黏度、全血低切黏度、血浆黏度均低于治疗前(P<0.05),且观察组低于其余两组(P<0.05)。结论在内科常规治疗的基础上,调神益智针法治疗痰瘀闭阻型PSD可改善患者MoCA和MMSE评分、中医证候积分、氧化应激激素水平、血脂水平以及血流变学指标。
