中药足浴对缺血性脑卒中患者肢体功能障碍康复影响的研究

发布时间：2018-04-22 10:22

本文选题：缺血性脑卒中 + 肢体功能障碍　；参考：《南京中医药大学》2017年硕士论文

【摘要】：[目的]通过比较温水足浴和中药足浴对缺血性脑卒中患者患侧上、下肢运动功能及其肌力,中医症状及血压改善的效果,探索中药足浴对缺血性脑卒中患者肢体功能障碍康复的影响,旨在为缺血性脑卒中肢体功能障碍患者寻找安全有效、耐受性好的辅助康复方法,为临床护理提供参考,进一步拓宽中药足浴的应用领域。[方法]将符合本研究纳入、排除标准的170例急性缺血性脑卒中患者随机分为中药足浴组、温水足浴组各85例。两组患者均接受缺血性脑卒中常规药物治疗和常规护理。中药足浴组(试验组)予以中药足浴,每晚1次,每次20min,7天一个疗程,共两个疗程;温水足浴组(对照组)予以温水足浴,方法和疗程同中药足浴组。采用简化Fugl-Meyer运动功能评定量表(FMA)、肌力等级评估、"风痰瘀阻"型缺血性脑卒中患者中医证候量化分级表比较两组患者患侧上、下肢运动功能,患侧上、下肢肌力,中医症状及血压改善的情况。[结果](1)一般资料比较:两组性别、年龄、经济、卒中量表(NIHSS)评分、基础疾病、病程、偏瘫肢体方面比较,差异无统计学意义(P0.05)。(2)组内自身前后比较:①对照组干预1周后上肢FMA评分、下肢FMA评分与干预前比较,差异均无统计学意义(P0.05),干预2周后与干预前比较,差异有统计学意义(P0.05):试验组:干预1周及2周后上、下肢FMA评分与干预前比较,差异有统计学意义(P0.05),干预2周后与干预1周后比较,差异有统计学意义(P0.05)。②对照组干预2周后的上肢肌力、下肢肌力均明显高于干预前(P0.05),但是干预2周后与干预1周后、干预1周后与干预前比较,差异无统计学意义(P0.05);试验组干预2周后的上肢肌力、下肢肌力均明显高于干预前,差异有统计学意义(P0.05),干预1周后的上、下肢肌力高于干预前,但差异无统计学意义(P0.05)。③对照组干预1周后及干预2周后中医证候积分与干预前比较,差异均有统计学意义(P0.05),干预2周后与干预1周后比较,差异有统计学意义(P0.05);试验组干预1周后及2周后与干预前比较,差异均有统计学意义(P0.05),干预2周后与干预1周后比较,差异有统计学意义(P0.05)。④对照组干预2周后的平均收缩压、平均舒张压及平均血压均低于干预1周后、干预前(P0.05),但是干预1周后和干预前比较(P0.05);试验组干预2周后的血压明显低于干预1周后(P0.05),干预1周后的血压明显低于干预前(P0.05)。(3)两组干预后组间比较:①干预1周后及干预2周后试验组下肢FMA评分均显著高于对照组,差异有统计学意义(P0.05)。②干预1周后和干预2周后试验组下肢肌力均显著高于对照组,差异有统计学意义(P0.05)。③干预2周后试验组上肢FMA评分显著高于对照组,差异有统计学意义(P0.05);但干预1周后比较,差异无统计学意义(P0.05)。④干预1周后上肢肌力比较,差异无统计学意义(P0.05);但干预2周后比较,差异有统计学意义(P0.05)。⑤干预1周后和干预2周后试验组中医证候积分较对照组低,差异有统计学意义(P0.05)。⑥干预1周后和干预2周后试验组平均血压与对照组比较,差异有统计学意义(P0.05)。[结论]中药足浴法可促进缺血性脑卒中患者患侧肢体功能障碍康复,有益于增加患侧肢体肌力,改善其中医症状,稳定血压。该方法疗效确切、简单易行、绿色安全,可运用于缺血性脑卒中患者肢体功能障碍的康复。
[Abstract]:[Objective] to explore the effect of Chinese medicine foot bath on the rehabilitation of limb dysfunction in patients with ischemic stroke by comparing the effects of warm water foot bath and Chinese traditional medicine foot bath on the affected side of the patients with ischemic stroke, the function of lower extremity movement and muscle strength, the symptoms of traditional Chinese medicine and the improvement of blood pressure. Effective and well tolerated rehabilitation methods provide reference for clinical nursing and further widen the application field of Chinese medicine foot bath. [method] 170 patients with acute ischemic stroke were randomly divided into Chinese medicine foot bath group and 85 cases in warm water foot bath group. The two groups were treated with conventional medicine treatment for ischemic stroke. Treatment and routine nursing. Chinese medicine foot bath group (test group) was given Chinese medicine foot bath, 1 times a night, each time 20min, 7 days a course of treatment, a total of two courses, warm water foot bath group (control group) to give warm water foot bath, methods and course of treatment with the Chinese medicine foot bath group. The use of simplified Fugl-Meyer exercise function assessment scale (FMA), strength grade assessment, "wind phlegm stasis obstruction" ischemic brain brain The scale of TCM Syndromes of stroke patients was compared with the two groups of patients on the side of the affected side, lower limb motor function, upper limb, lower limb muscle strength, TCM symptoms and blood pressure improvement. [results] general data were compared: two groups of sex, age, economy, stroke scale (NIHSS) score, basic disease, course of disease, hemiplegia limbs, the difference was not statistically significant difference ( P0.05) (2) the comparison in the group itself: (1) the FMA score of the upper limb in the control group after 1 weeks, and the difference between the lower extremity FMA score and the prior intervention was not statistically significant (P0.05). The difference was statistically significant (P0.05) after the intervention for 2 weeks and before the intervention: the experimental group was compared with the intervention of the lower extremities after 1 and 2 weeks, and the difference was statistically significant. P0.05, after intervention for 2 weeks and 1 weeks after intervention, the difference was statistically significant (P0.05). (2) the upper limb muscle strength of the control group after 2 weeks of intervention was significantly higher than that before intervention (P0.05), but after 2 weeks of intervention and intervention for 1 weeks, the difference was not statistically significant after intervention for 1 weeks and before intervention (P0.05); the experimental group intervened for 2 weeks after the upper limb muscle. Strength and lower limbs muscle strength were significantly higher than before intervention, the difference was statistically significant (P0.05), 1 weeks after intervention, lower limb muscle strength was higher than before the intervention, but there was no significant difference (P0.05). 3. After intervention for 1 weeks and 2 weeks after intervention, the difference was statistically significant (P0.05), after intervention for 2 weeks and after intervention 1 weeks after intervention. The difference was statistically significant (P0.05). The difference was statistically significant (P0.05) after intervention for 1 weeks and 2 weeks after intervention. After intervention for 2 weeks, the difference was statistically significant (P0.05). (4) the mean systolic pressure, mean diastolic pressure and mean blood pressure in the control group after 2 weeks were lower than that of the intervention for 1 weeks, before intervention, before intervention. (P0.05), but after intervention for 1 weeks and before intervention (P0.05), the blood pressure of the experimental group was significantly lower than that of 1 weeks after intervention (P0.05), the blood pressure of the intervention group was significantly lower than that before intervention (P0.05) after 1 weeks (P0.05). (3) the two groups were compared with the intervention group: (1) after 1 weeks and after 2 weeks, the lower extremities FMA scores were significantly higher than the control group, the difference was statistically significant Significance (P0.05). After intervention for 1 weeks and after 2 weeks of intervention, the lower limb muscle strength of the experimental group was significantly higher than that of the control group (P0.05). (3) after 2 weeks of intervention, the FMA score of the upper limb of the experimental group was significantly higher than that of the control group (P0.05), but the difference was not statistically significant (P0.05) after 1 weeks of intervention (P0.05). 4. After intervention, the upper limb muscles were treated with the intervention of 1 weeks. The difference was not statistically significant (P0.05), but after 2 weeks of intervention, the difference was statistically significant (P0.05). After intervention for 1 weeks and after 2 weeks of intervention, the TCM syndrome score was lower than the control group, the difference was statistically significant (P0.05). 6. After intervention for 1 weeks and after 2 weeks, the average blood pressure in the experimental group was compared with the control group, the difference was statistically significant. [Conclusion] [Conclusion] [Conclusion] foot bath method can promote the rehabilitation of limb dysfunction in patients with ischemic stroke. It is beneficial to increase the muscle strength of the affected limbs, improve the symptoms of the Chinese medicine and stabilize the blood pressure. This method is effective, simple and safe, and can be used for the rehabilitation of limb dysfunction in patients with ischemic stroke.

【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R248.9

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