头枕部推拿治疗脑梗死后轻度认知障碍合并睡眠障碍的临床观察

发布时间：2018-03-08 00:02

本文选题：头枕部推拿　切入点：认知障碍　出处：《湖北中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究头枕部推拿治疗脑梗死后轻度认知障碍可能机制。探讨脑梗死后轻度认知障碍与睡眠障碍是否存在相关性;以及睡眠障碍是否会加重脑梗死后轻度认知障碍的进展;是否能从改善睡眠角度治疗脑梗死后轻度认知障碍,延缓认知障碍的进展。为推拿手法作为治疗认知障碍的新方法寻60例符合以上条件的脑梗死后轻度认知障碍合并睡眠障碍的患者,以随机分组的方法,将60例入组患者,分为对照组30例,治疗组30例,治疗组采用头枕部推拿手法结合认知训练治疗,对照组单纯使用认知训练治疗,并且对治疗组和对照组患者在治疗前后分别行简易智能精神状态检查量表(Minimum Mental State Examination,MMSE)、蒙特利尔认知量表(Montreal Cognitive Assessment,MOCA)、匹茨堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)评分,治疗结束后,进行资料整理与统计,将全部资料输入EXCEL表,建立数据库,用SPASS17.0统计软件进行统计处理。计量资料根据数据性质懫用t检验或非参数Wilcoxon秩和检验,计数资料采用卡方检验。结果:治疗组与对照组治疗后的MMSE、MOCA、PSQI评分进行对比,经统计学分析,P0.05,表明治疗组疗效优于对照组,利用头枕部推拿手法结合认知训练可以延缓或改善脑梗死后轻度的认知障碍。对照组合并睡眠障碍经治疗前后PSQI评分经统计学分析,P0.05,无明显差异,治疗组合并睡眠障碍的PSQI评分经统计学分析,P0.05,具有统计学意义,治疗组中合并睡眠障碍的患者与对照组中合并睡眠障碍患者的MMSE、MOCA、PSQI评分对比,P0.01,具有显著性差异,表明头枕部手法对脑梗死后的睡眠障碍具有一定的疗效,并且在治疗睡眠障碍的同时,可能会促进轻度认知障碍的改善或延缓认知障碍的进展。结论:推拿手法中的头枕部手法可以作为非药物手段治疗脑梗死后轻度认知障碍的治疗方法,并且在合并有睡眠障碍的轻度认知障碍疗效更佳,可能说明睡眠障碍的治疗可能会延缓轻度认知障碍,甚至改善轻度认知障碍,睡眠可能与认知功能的关系是正相关的。今后推拿手法可以作为临床上治疗脑梗死后轻度认知障碍的新的治疗方法,它操作简便,安全性高,绿色健康,值得临床上运用推广。观察指标:MMSE,MOCA,PSQI
[Abstract]:Objective: to study the possible mechanism of head and occipital massage in the treatment of mild cognitive impairment after cerebral infarction, to explore whether there is a correlation between mild cognitive impairment after cerebral infarction and sleep disorder, and whether sleep disorder will aggravate the progression of mild cognitive impairment after cerebral infarction. Is it possible to treat mild cognitive impairment after cerebral infarction from an improved sleep perspective, In order to find 60 patients with mild cognitive impairment after cerebral infarction and sleep disorder, 60 patients with mild cognitive impairment after cerebral infarction were selected as a new method for the treatment of cognitive impairment, and 60 patients were randomly divided into groups. The patients were divided into control group (30 cases) and treatment group (30 cases). The treatment group was treated with head and occipital massage manipulation combined with cognitive training, while the control group was treated with cognitive training alone. Before and after treatment, the patients in the treatment group and the control group were assessed with Minimum Mental State examination scale, Montreal Cognitive Assessment scale, Pittsburgh Sleep Quality Index and PSQI, respectively. After the treatment, the patients in the treatment group were evaluated with the MMSE scale, the Montreal Cognitive Assessment scale and the Pittsburgh Sleep quality Index scale (PSQI). The data are arranged and counted, all the data are input into the EXCEL table, the database is established, and the statistical processing is carried out by the SPASS17.0 statistical software. According to the nature of the data, the data are measured by t test or non-parametric Wilcoxon rank sum test. Results: the MMSE MOCA PSQI score of the treatment group was compared with that of the control group, and the statistical analysis showed that the therapeutic effect of the treatment group was better than that of the control group. The use of head and occipital massage combined with cognitive training could delay or improve mild cognitive impairment after cerebral infarction. The PSQI score of the control group with sleep disorder before and after treatment had no significant difference (P 0.05). The PSQI scores of patients with sleep disorders in the treatment group were significantly different from those in the control group (P 0.01). The results indicate that head and occipital manipulation has certain curative effect on sleep disorder after cerebral infarction, and at the same time, Conclusion: the head and occipital manipulation of massage manipulation can be used as a non-drug treatment for mild cognitive impairment after cerebral infarction. And in patients with mild cognitive impairment with sleep disorder, the effect is better, which may indicate that the treatment of sleep disorder may delay mild cognitive impairment or even improve mild cognitive impairment. Sleep may be positively related to cognitive function. Massage manipulation can be used as a new clinical treatment for mild cognitive impairment after cerebral infarction. It is simple, safe, green and healthy. It is worth popularizing in clinic. Observation Index: MMSE MOCAA PSQI
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R244.1

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