解痉方药浴结合推拿治疗卒中后肢体痉挛的观察研究

发布时间：2018-06-26 22:59

本文选题：脑卒中 + 痉挛　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：本研究通过观察解痉方药浴结合推拿与常规康复治疗两种方法对脑卒中后肢体痉挛患者的疗效,探索解痉方药浴结合推拿的临床疗效及安全性,为脑卒中后肢体痉挛的中医康复治疗及研究提供临床实践依据。方法：本研究采用中央随机对照试验方法,对符合纳入标准的脑卒中后肢体痉挛患者随机分为对照组和治疗组,对照组20例,治疗组23例。其中对照组给予基础治疗(二级预防、对症处理、中药、针刺)及康复训练,治疗组则在此基础上加解痉方药浴及推拿治疗,疗程为4周。以改良Ashworth量表、简化Fugl-Meyer量表及改良Barthel指数为疗效评估指标,分别在治疗前、治疗4周后进行评估,得出观察数据后,各组数据进行自身前后对照及治疗后组间对照,实验数据以SPSS 21.0软件进行统计学分析,最后得出结论。结果：一、基线对比：治疗组及对照组患者一般资料及治疗前改良Ashworth分级、简化Fugl-Meyer运动功能评分及改良Barthel指数评分无显著性差异(P＞0.05)：二、同组治疗前后疗效对比：治疗4周后,两组患者在痉挛缓解、运动功能及日常生活能力上均有改善,与治疗前相比差异均有统计学意义(P＜0.05)；三、治疗后组间疗效对比：治疗组在治疗4周后,改良Ashworth分级、简化Fugl-Meyer运动功能评分及改良Barthel指数评分均较前改善,改良Ashworth分级、简化Fugl-Meyer运动功能总分、简化Fugl-Meyer上肢运动功能评分、简化Fugl-Meyer下肢运动功能评分及改良Barthel指数评分的前后差值与对照组相比,差异均有统计学意义(P＜0.05)。说明解痉方药浴结合推拿组在缓解脑卒中后肢体痉挛及提高运动功能、日常生活能力方面优于常规康复治疗。四、在整个研究治疗过程中对照组与治疗组患者均没有出现不良反应。结论：解痉方药浴结合推拿与常规康复治疗两种方法对脑卒中后肢体痉挛患者的痉挛缓解程度、肢体运动功能及日常生活能力均有改善作用,且解痉方药浴结合推拿在缓解痉挛程度、提高肢体运动功能及日常生活能力方面均优于常规康复治疗,两种治疗方案有较可靠的安全性。
[Abstract]:Objective: to observe the curative effect of spasmolysis prescription combined with massage and routine rehabilitation therapy on patients with limb spasm after stroke, and to explore the clinical efficacy and safety of spasmodic prescription combined with massage. To provide clinical practice basis for rehabilitation therapy and research of limb spasm after stroke. Methods: the patients with limb spasm after stroke were randomly divided into two groups: control group (n = 20) and treatment group (n = 23). The control group was given basic treatment (secondary prevention, symptomatic treatment, traditional Chinese medicine, acupuncture) and rehabilitation training, while the treatment group was treated with antispasmodic medicine bath and massage for 4 weeks. The modified Ashworth scale, simplified Fugl-Meyer scale and modified Barthel index were used to evaluate the efficacy before and after 4 weeks of treatment respectively. After the observation data were obtained, the data of each group were compared before and after treatment. The experimental data were statistically analyzed by SPSS 21.0 software, and the conclusion was drawn. Results: first, baseline comparison: there was no significant difference in general data, modified Ashworth classification, simplified Fugl-Meyer motor function score and modified Barthel index score between the treatment group and the control group (P > 0. 05). Comparison of therapeutic effects before and after treatment in the same group: after 4 weeks of treatment, the spasm relief, motor function and activity of daily living were improved in both groups, and there were significant differences compared with those before treatment (P < 0.05). After 4 weeks of treatment, the modified Ashworth grade, simplified Fugl-Meyer motor function score and modified Barthel index score were improved. The modified Ashworth grade, the total Fugl-Meyer motor function score and the Fugl-Meyer upper limb motor function score were simplified. The difference between the simplified Fugl-Meyer lower limb motor function score and the modified Barthel index score was statistically significant compared with the control group (P < 0.05). The results showed that the combination of spasmodic and massage therapy was superior to routine rehabilitation therapy in relieving limb spasm and improving motor function and daily life ability after stroke. 4. There were no adverse reactions in both the control group and the treatment group. Conclusion: the treatment of spasmodic prescription combined with massage and routine rehabilitation therapy can improve the degree of spasticity, motor function and daily living ability of patients with spasm after stroke. The combination of spasmodic and massage was superior to conventional rehabilitation therapy in relieving spasticity, improving limb motor function and daily living ability.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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