紧张性颈反射刺激配合促进疗法治疗脑卒中患者痉挛性偏瘫  

Tonic neck reflexes stimulation plus facilitation therapy for spastic hemiplegia in stroke patients

作　　者：杨光伟[1] 刘宏斌[1] 张雄伟[2] 

机构地区：[1]齐齐哈尔医学院第三附属医院神经内科,黑龙江省齐齐哈尔市161000 [2]解放军第二炮兵总医院神经内科,北京市100088

出　　处：《中国临床康复》2005年第21期10-11,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨紧张性颈反射刺激结合其他康复治疗对脑卒中痉挛性偏瘫患者肢体痉挛状态的治疗效果。方法:脑卒中痉挛性偏瘫患者100例为1999-10/2001-10齐齐哈尔医学院第三附属医院神经内科收治,所有患者均为首次发病,病程1～6个月。将100例患者随机分为治疗组和对照组各50例,两组均应用Brunnstrun康复治疗,治疗组在此基础上,采用紧张性颈反射刺激训练。在治疗前和治疗后30d分别进行Brunnstrun分级评定以观察疗效(Brannstrun为六级评分法,评级越高,患者异常运动模式和肌痉挛状况越缓解)。结果:按意向处理分析,100例患者均完成治疗,无脱落者。治疗前患者Brunnstrun分级:治疗组Ⅰ或Ⅱ级8例(16%,8/50),Ⅲ级42例(84%,42/50);对照组Ⅰ或Ⅱ级6例(12%),Ⅲ级44例(88%)。治疗后患者Brunnstrun分级:治疗组7例(88%,7/8)Ⅰ或Ⅱ级的患者恢复到Ⅳ级,36例(86%,36/42)Ⅲ级患者恢复到Ⅳ级。对照组2例(33%,2/6)Ⅰ或Ⅱ级的患者恢复到Ⅳ级,15例(34%,15/44)Ⅲ级患者恢复到Ⅳ级。结论:在脑卒中患者痉挛性偏瘫的1～6个月内,采用紧张性颈反射刺激结合其他康复治疗能明显改善偏瘫肢体的痉挛状态,并可促进患者运动功能的恢复。AIM:To investigate the curative effect of tonic neck reflexes stimulation combined with other rehabilitation therapy on the spasticity of limbs in stroke patients with spastic hemiplegia.METHODS:Totally 100 stroke patients with spastic hemiplegia for the first time(the disease course was 1 to 6 months),who were treated in the Department of Neurology,the Third Affiliated Hospital of Qiqihar Medical College from October 1999 to October 2001,were randomly divided into treatment group(n=50) and control group(n=50).All the patients received Brunnstrun rehabilitative treatment, besides tonic neck reflexes stimulation training was given to those in the treatment group.Before treatment and 30 days after treatment,the curative effects were observed with the evaluation of Brunnstrun classification(the 6degree scoring was used,the higher the degree,the better the amelioration of their abnormal exercise mode and muscular spasm status).RESULTS:According to intentiontotreat analysis,all the 100 patients finished the treatment,no one lost.The scores of Brunnstrun before treatment: In the treatment group,grade Ⅰor Ⅱwas in 8 cases(16%,8/50) and grade Ⅲin 42 cases(84%,42/50);In the control group,grade Ⅰor Ⅱwas in 6 cases(12%) and grade Ⅲin 44 cases(88%).After treatment, 7 cases (88%,7/8) with grade Ⅰor Ⅱand 36 patients (86%,36/42) with grade Ⅲrecovered to grade Ⅳin treatment group; In the control group, 2 patients(33%,2/6) with grade Ⅰor Ⅱand 15 patients(44%,15/44) with grade Ⅲrecovered to grade Ⅳ.CONCLUSION:The tonic neck reflexes stimulation combined with other rehabilitation therapy can effectively relieve the spasticity of hemiplegic limb and accelerate the recovery of motor function in stroke patients with spastic hemiplegia within 1 to 6 months of onset.

关 键 词：脑血管意外 偏瘫/康复 痉挛 功能恢复 

分 类 号：R743[医药卫生—神经病学与精神病学]