多发性硬化缓解期患者康复治疗神经功能和疲劳度恢复的疗效观察  

Observation on the efficacy of rehabilitation on recovery of neurofunction and fatigue of patients with multiple sclerosis during remitting period

作　　者：朱琳[1] 宋为群[1,2] 岳月红[1] 刘霖[2] 张大华[2] 张金舟 

机构地区：[1]首都医科大学宣武医院康复科教育部神经变性病重点实验室,北京100053 [2]首都医科大学宣武医院康复科 [3]华北煤碳医学院康复系

出　　处：《中国康复医学杂志》2011年第9期807-810,817,共5页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金(30770714);首都医学发展科研基金(2007-2068);高等学校博士学科点专项科研基金(20091107110004);北京市卫生系统高层次卫生技术人才培养计划(2009-3-62)资助

摘　　要：目的:观察神经康复治疗对缓解期多发性硬化患者功能、疲劳度的恢复。方法:将29例多发性硬化后两个月以内的患者,按照入院病历号的奇偶性将患者分为神经康复观察组(19例)和对照组(10例)。所有患者均接受多发性硬化的常规药物治疗及常规护理,神经康复观察组同时给予接受30min/次,1次/d的神经康复的功能锻炼方法,训练时间均为4周。在治疗后进行疗效判定,且分别在治疗前及治疗4周时进行Kurtzke功能障碍状态评分、Lindmark运动功能评定中体位转移及行走评分、Barthel日常生活活动能力评定、疲劳严重程度评分(FSS)。结果:治疗4周后,疗效判定发现观察组总有效率为84.20%,对照组为40.00%,两组比较差异有显著性意义(χ2=5.983,P<0.05).在Kurtzke功能障碍状态评分、Lindmark运动功能评定中体位转移及行走评分、Barthel日常生活活动能力评定中,观察组治疗后评分分别为6.32±1.83、12.37±6.92、57.63±15.40,观察组表现为,治疗4周后临床症状较治疗前有明显改善(P<0.05)。而对照组仅在Kurtzke量表中治疗后评分为7.30±0.95,表现为治疗后优于治疗前(P<0.05)。在FSS量表中,治疗4周后观察组治疗后评分为29.84±7.01,疲劳度有明显改善(P<0.01),对照组无明显改善(P>0.05)。结论:神经康复治疗对缓解期多发性硬化患者的功能恢复和降低疲劳度有显著疗效。Objective：To observe the efficacy of rehabilitation on recovery of neurofunction and fatigue of patients with multiple sclerosis during remitting period.Method：Twenty-nine patients were divided into observation group（n=19）and control group（n=10） according to their odd and even numbers on admission.All patients received conventional neurological medication,traditional physiotherapy,etc.At the same time,observation group received physical therapy program 30min,one times a day,five days a week.The duration of treatment was four weeks for both group.Use Kurtzke scale,Lindmark scale,Barthel index（BI） and fatigue severity scale（FSS） before and 4 weeks after the treatment.Result：The scores of Kurtzke、Lindmark、BI were 6.32±1.83,12.37±6.92,57.63±15.40 respectively in observation group,four weeks after the treatment,patients＇ symptoms improved significantly than before（P0.05）.In control group Kurtzke score was 7.30±0.95,patients＇ performance were better than before（P0.05）,but no significant difference was found for Lindmark score and BI.In observation group,score of FSS was 29.84±7.01 which was significant different compared to before the treatment （P0.01） but no significant difference was found in control group（P0.05）.Conclusion：Rehabilitation has significant efficacy for improving neuro function and reducing fatigue.

关 键 词：多发性硬化 康复 疲劳度 

分 类 号：R744.51[医药卫生—神经病学与精神病学]