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摇扳法改善缺血性脑卒中后上肢运动功能的临床疗效观察

发布时间:2018-03-18 08:13

  本文选题:摇扳法 切入点:缺血性脑卒中 出处:《黑龙江中医药大学》2016年硕士论文 论文类型:学位论文


【摘要】:目的:观察摇扳法改善缺血性脑卒中后上肢运动功能的临床疗效。方法:将60例缺血性脑卒中后有上肢运动功能障碍的患者,随机分为观察组和对照组,每组30例,其中观察组的治疗方法是常规系统药物、针灸、物理因子治疗、运动疗法、作业疗法、摇扳法治疗:对照组的治疗方法是临床常用推拿手法治疗,其他同观察组。应用改良Barthel指数评分、神经功能缺损程度评分中的上肢评分、Fugl-Meyer运动功能评分(上肢)及改良Ashworth分级法评分对患者治疗前后进行系统评价,来比较两种治疗方法的临床效果。结果:(1)观察组与对照组治疗前组间比较改良Barthel指数,P0.05,无显著差异,提示二组治疗前无差别,具有可比性;二组治疗前后组内比较, P0.05,有统计学意义,提示二组治疗前后组内评分有显著差异;二组治疗后组间比较,P0.05,无显著差异,二组治疗后差别不明显。(2)观察组与对照组治疗前组间比较神经功能缺损程度评分中的上肢评分,P0.05,无显著差异,提示二组治疗前无差别,具有可比性;二组治疗前后组内比较, P0.05,提示二组治疗前后组内评分有显著差异;观察组与对照组治疗后组间比较,P0.05,无统计学意义,提示二组治疗后无显著差异。(3)观察组与对照组治疗前组间比较Fugl-Meyer运动功能评分(上肢),P0.05,无显著差异,提示二组治疗前无差别,具有可比性;二组治疗前后组内比较, P0.05,有统计学意义,提示二组治疗前后组内评分有显著差异;观察组与对照组治疗后组间比较,P0.05,无显著差异,二组治疗后差别不明显。(4)观察组与对照组治疗前组间比较改良Ashworth分级法评分,P0.05,无显著差异,提示二组治疗前无差别,具有可比性;二组治疗前后组内比较, P0.05,有统计学意义,提示二组治疗前后组内评分有显著差异;观察组与对照组治疗后组间比较,P0.05,有显著差异,提示改良Ashworth分级法评分观察组优于对照组。结论:1.两种治疗方法均可有效改善缺血性脑卒中后上肢运动功能障碍,改善其日常生活能力,降低神经功能缺损程度。2.摇扳法可明显提高缺血性脑卒中患者上肢肌张力,治疗效果优于对照组,适合临床推广应用。
[Abstract]:Objective: to observe the clinical effect of wrench on the motor function of upper limb after ischemic stroke. Methods: sixty patients with upper limb motor dysfunction after ischemic stroke were randomly divided into observation group and control group with 30 cases in each group. The treatment methods in the observation group are routine systemic drugs, acupuncture, physical factor therapy, exercise therapy, occupational therapy, and wriggle therapy. In the control group, the treatment methods are massage manipulation commonly used in clinic. In the other observation groups, the patients were systematically evaluated before and after treatment with the modified Barthel index, the upper limb score and the Fugl-Meyer motor function score (upper limb) and the modified Ashworth scoring method before and after treatment. Results there was no significant difference in the modified Barthel index (P0.05) between the observation group and the control group before treatment, suggesting that there was no difference and comparability between the two groups before treatment. There was significant difference in the scores between the two groups before and after treatment, indicating that there was no significant difference in the scores between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment. There was no significant difference between the two groups after treatment. (2) there was no significant difference in the upper limb score between the observation group and the control group before treatment, indicating that there was no difference and comparability between the two groups before treatment. The comparison between the two groups before and after treatment indicated that there was a significant difference in the scores between the two groups before and after treatment, and there was no significant difference between the observation group and the control group after treatment. It was suggested that there was no significant difference between the two groups after treatment. (3) the Fugl-Meyer motor function score (P0.05, P 0.05) between the observation group and the control group before treatment was not significantly different, suggesting that there was no difference between the two groups before treatment and was comparable. There was significant difference in the scores between the two groups before and after treatment, which indicated that there was no significant difference between the observation group and the control group after treatment. There was no significant difference between the observation group and the control group before treatment, indicating that there was no significant difference between the two groups before treatment, suggesting that there was no difference between the two groups before and after treatment, and the comparison between the two groups before and after treatment had statistical significance. The results indicated that there were significant differences in the scores between the two groups before and after treatment, and there were significant differences between the observation group and the control group after treatment. The results suggest that the modified Ashworth grading method is superior to the control group. Conclusion the two treatment methods can effectively improve the motor dysfunction of upper limbs and improve the ability of daily living after ischemic stroke. The method of shaking and pulling can obviously increase the muscle tension of the upper limb of the patients with ischemic stroke, and the therapeutic effect is better than that of the control group, which is suitable for clinical application.
【学位授予单位】:黑龙江中医药大学
【学位级别】:硕士
【学位授予年份】:2016
【分类号】:R246.6

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