作业疗法联合经耳迷走神经刺激脑卒中患者上肢运动功能及脑内多种神经递质功能的影响  

Effect of occupational therapy and transaural vagus nerve stimulation on the motor function of upper limbs and the function of various intracerebral neurotransmitters in stroke patients.

作　　者：朱琳[1] 任钰[1] 李冬[1] 阿依古再丽 ZHU Lin;REN Yu;LI Dong(Department of Rehabilitation Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China.)

机构地区：[1]新疆医科大学第一附属医院康复医学科,新疆乌鲁木齐830000

出　　处：《临床和实验医学杂志》2021年第10期1090-1094,共5页Journal of Clinical and Experimental Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(编号:2016D01C327)。

摘　　要：目的探究作业疗法联合经耳迷走神经刺激脑卒中患者上肢运动功能及脑内多种神经递质功能的影响。方法回顾性选取2018年4月至2020年3月新疆医科大学第一附属医院收治的脑卒中患者113例。根据治疗方法不同分为观察组(n=58)和对照组(n=55),对照组采用作业疗法,观察组在对照组基础上采用经耳迷走神经刺激,治疗1个月。观察2组患者治疗前、治疗后1个月上肢运动功能[上肢Fugl-Meyer评分(U-FM)、功能评估量表(MFAS)]、日常生活活动能力、脑内多种神经递质功能及不良反应。结果治疗前,2组患者U-FM、MFAS、改良Barthel指数评分比较,差异均无统计学意义(P>0.05);治疗后1个月,2组患者U-FM、MFAS、改良Barthel指数评分均高于治疗前,差异均有统计学意义(P<0.05),且观察组患者高于对照组,差异均有统计学意义(P<0.05)。2组患者治疗前与治疗后1个月以及组间脑内五羟色胺功率比较,差异均无统计学意义(P>0.05);观察组治疗后1个月大脑去甲肾上腺素功率高于治疗前和对照组,差异均有统计学意义(P<0.05),对照组治疗前与治疗后1个月比较,差异无统计学意义(P>0.05);观察组治疗后大脑乙酰胆碱功率、大脑多巴胺功率高于治疗前,差异均有统计学意义(P<0.05),对照组治疗前与治疗后1个月及组间比较,差异均无统计学意义(P>0.05)。观察组患者不良反应发生率5.17%与对照组的3.64%比较,差异无统计学意义(P>0.05)。结论作业疗法联合经耳迷走神经刺激脑卒中患者可有效调节脑内去甲肾上腺素、乙酰胆碱及多巴胺水平,改善上肢运动功能与日常生活活动能力,具有较好应用前景。Objective To explore the effect of occupational therapy combined with transaural vagus nerve stimulation on upper limb motor function and intracerebral neurotransmitter functions in stroke patients.Methods A total of 113 stroke patients admitted to the First Affiliated Hospital of Xinjiang Medical University from April 2018 to March 2020 were retrospectively selected and divided into observation group(n=58)and control group(n=55).According to different treatment methods,the control group was treated with occupational therapy,and the observation group was treated with transaural vagus nerve stimulation on the basis of the control group for 1 months.The upper limb motor function[upper limbfugl-meyer(U-FM),motor function assessment scale(MFAS)],activities of daily living,intracerebral neurotransmitter functions and adverse reactions before and after treatment were observed.Results Before treatment,there was no significant difference in U-FM,MFAS,and modified Barthel index scores between the two groups of patients(P>0.05);1 month after treatment,both groups had U-FM,MFAS,and modified Barthel index scores were higher than those before treatment,the differences were statistically significant(P<0.05),and the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in brain serotonin power between the two groups before treatment and 1 month after treatment,and between the two groups(P>0.05);the brain acetylcholine power and brain dopamine power of the observation group 1 month after treatment were higher than those before treatment,and the differences were statistically significant(P<0.05).The comparison between the control group before treatment and 1 month after treatment,the difference was not statistically significant(P>0.05);the observation group had high brain acetylcholine power and brain dopamine power after treatment before treatment,the difference was statistically significant(P<0.05),and the comparison between t

关 键 词：作业疗法 经耳迷走神经刺激 脑卒中 上肢运动功能 神经递质功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]