愉快家庭康复治疗对血管性认知障碍的疗效观察

发布时间：2018-02-28 03:33

本文关键词： 血管性认知障碍愉快家庭康复认知训练　出处：《河北大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的血管性认知障碍(vascular cognitive impairment,VCI)是指由血管因素参与或导致的认知功能障碍,可单独发生或与阿尔茨海默病(Alzheimer disease,AD)伴发,是一类慢性进行性疾病,涵盖了从轻度认知障碍到痴呆的全部过程。愉快家庭康复治疗是以愉快因子为前提、以家庭为单位、以认知康复训练为主要内容的康复治疗方法。本研究探讨愉快家庭康复治疗对血管性认知障碍患者的认知功能及日常生活能力的改善情况,并评价其疗效,从而为血管性认知障碍患者提供方便、实用、有效的康复方法。方法选取2015年04月至2016年04月在河北大学附属医院神经内科门诊就诊及神经内科病房住院治疗的90例确诊的血管性认知障碍患者为研究对象,严格执行纳入标准及排除标准。对所有入组患者按照随机数字表随机分为愉快家庭康复组(A组)和对照组(B组),每组45例。实际完成整个康复疗程的患者共80例,其中愉快家庭康复组(A组)为40例,对照组(B组)为40例。血管性认知障碍诊断均符合2011年血管性认知功能障碍诊治指南标准。两组患者均给予常规口服药物治疗和常规运动功能康复训练,在此治疗基础上,愉快家庭康复组添加愉快家庭康复治疗。两组患者均于治疗开始时及治疗12周后进行蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)和日常生活能力量表(Activities of Daily Living,ADL)评分,通过对比统计分析两组的MoCA、ADL评分,从而评价两组患者认知功能及日常生活能力的改善情况。结果1.治疗前后MoCA评分的比较(1)愉快家庭康复组(A组)及对照组(B组)同一组内比较:治疗后MoCA评分均较治疗前有所提高(tA=15.637,P=0.000;tB=5.994,P=0.000),说明两组治疗均可提高MoCA评分,可有效改善患者认知功能。(2)愉快家庭康复组(A组)与对照组(B组)组间比较:治疗12周后,两组评分分别为20.95±1.358、18.1±1.837,愉快家庭康复组评分高于对照组,差异具有统计学意义(t=7.891,P=0.000),说明愉快家庭康复组较对照组改善患者认知功能疗效显著。2.治疗前后ADL评分的比较(1)愉快家庭康复组(A组)及对照组(B组)同一组内比较:治疗后ADL评分均较治疗前有所提高(tA=15.109,P=0.000;tB=11.195,P=0.000),说明两组治疗均可增加ADL评分,有效提高患者日常生活能力。(2)愉快家庭康复组与对照组组间比较:治疗12周后,两组评分分别为68.30±2.747、65.50±3.030,愉快家庭组评分高于对照组,差异具有统计学意义(t=4.330,P=0.000),说明愉快家庭康复组提高患者日常生活能力疗效好于对照组。结论愉快家庭康复治疗可有效改善血管性认知障碍患者的认知功能,同时明显提高其日常生活能力,为血管性认知障碍患者的康复治疗提供新思路。
[Abstract]:Objective: vascular cognitive impairment (VCI) refers to the cognitive dysfunction caused by vascular factors, which can occur alone or with Alzheimer's disease. It is a kind of chronic progressive disease. It covers the whole process from mild cognitive impairment to dementia. This study was designed to explore the improvement of cognitive function and daily life ability of vascular cognitive impairment patients after the treatment of pleasant family rehabilitation, and to evaluate the efficacy of the treatment. Thus providing convenience and practicality for patients with vascular cognitive impairment, Methods from April 2015 to April 2016, 90 patients with vascular cognitive impairment were selected from the Department of Neurology, Department of Neurology, affiliated Hospital of Hebei University and hospitalized in the Department of Neurology, Hebei University. According to the random digital table, all the patients were randomly divided into two groups: group A (group A) and group B (group B), with 45 cases in each group. There were 80 patients who had actually completed the whole course of rehabilitation. There were 40 cases in the happy family rehabilitation group (group A). The diagnosis of vascular cognitive impairment was in accordance with the guidelines for the diagnosis and treatment of vascular cognitive dysfunction in 2011. Both patients in both groups were given routine oral drug therapy and routine motor rehabilitation training. The patients in the happy family rehabilitation group were given Montreal cognitive assessment scale and activities of Daily living (ADL) scale at the beginning of treatment and 12 weeks after treatment. The scores of MoCAN ADL in the two groups were compared and analyzed. The improvement of cognitive function and ADL in the two groups were evaluated. Results 1. Comparison of MoCA scores before and after treatment (1) comparison of MoCA scores between group A (group A) and group B (control group): MoCA scores after treatment. Compared with before treatment, the MoCA score of the two groups was increased by 15.637 渭 g / L, 0.000 ~ 5.994g / L, indicating that the MoCA score could be improved in both groups, and there was no significant difference between the two groups. After 12 weeks of treatment, the scores of the two groups were 20.95 卤1.358 卤18.1 卤1.837, respectively. The score of the happy family rehabilitation group was higher than that of the control group. The difference was statistically significant, indicating that the cognitive function of the patients in the happy family rehabilitation group was significantly improved than that in the control group .2.Compared with the ADL score before and after treatment, there were 1) A) and B) comparison between the happy family rehabilitation group and the control group (B). The ADL scores after treatment were higher than those before treatment, indicating that the ADL score could be increased in both groups. After 12 weeks of treatment, the scores of the two groups were 68.30 卤2.747 and 65.50 卤3.030, respectively. The score of the happy family group was higher than that of the control group. The difference was statistically significant (P < 0.05), which indicated that the effect of improving the ability of daily life of patients in the happy family rehabilitation group was better than that in the control group. Conclusion the treatment of pleasant family rehabilitation can effectively improve the cognitive function of the patients with vascular cognitive impairment. At the same time, improve their ability of daily life, and provide a new idea for rehabilitation of patients with vascular cognitive impairment.
【学位授予单位】：河北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.1

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