帕罗西汀联合改良强制运动疗法治疗脑梗死上肢瘫痪临床观察  

Clinical observation of paroxetine combined with modified constraint induced movement therapy in the treatment of cerebral infarction patient with upper limb paralysis

作　　者：刘海朋[1] 朱洪山[1] 李树强[1] 夏彬[1] 朱宁[1] 吴睿[1] 薛孟周 LIU Haipeng;ZHU Hongshan;Li Shuqiang;XIA Bin;ZHU Ning;WU Rui;XUE Mengzhou(The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学第二附属医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2021年第20期1817-1824,共8页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然科学基金面上项目(编号:81870942,81471174);重点国际(地区)合作研究项目(编号:81520108011);2018年度河南省科技攻关计划项目(编号:182102310298)。

摘　　要：目的观察帕罗西汀联合改良强制运动疗法(modified constraint induced movement therapy,mCIMT)治疗脑梗死上肢瘫痪的临床效果。方法选择脑梗死偏瘫患者60例,分为对照组和试验组。对照组采用mCIMT治疗,试验组采用帕罗西汀联合mCIMT治疗。在6周的治疗过程中统计2组放弃治疗并退出的患者数,用于评判患者对mCIMT治疗的依从性。治疗结束时对坚持完成治疗的患者分别采用简式Fugl-Meyer运动评价量表和日常Barthel指数量表评定,观察治疗效果。结果治疗依从性方面,对照组先后有33%(10/30)的患者退出试验,试验组有10%(3/30)的患者退出试验,2组比较差异有统计学意义(χ^(2)=4.812,P=0.028)。治疗后试验组Fugl-Meyer评分[(53.59±8.40)分]高于对照组[(44.90±7.40)分],差异有统计学意义(t=3.688,P=0.001)。治疗后试验组Barthel指数(63.44±5.35)高于对照组(52.75±4.84),差异有统计学意义(t=7.048,P=0.000)。结论帕罗西汀能显著提高脑梗死患者对mCIMT的治疗依从性,且可提高mCIMT的临床疗效。Objective To observe the clinical effect of paroxetine combined with modified constraint induced movement therapy(mCIMT)in the treatment of cerebral infarction with upper limb paralysis.Methods A total of 60 stroke patients were divided into control group and experimental group.mCIMT was used in the control group and paroxetine combined with mCIMT was used in the experimental group.During the 6-week course of treatment,the number of patients who abandoned treatment and withdrew from the two groups was counted in order to observe the therapy acceptability of patients to mCIMT treatment.At the end of the treatment,the treatment effect of the two groups of patients who insisted on completing the treatment was evaluated by the simple Fugl-Meyer evaluation Scale and the daily Barthel index scale,respectively.Results In terms of compliance,33%(10/30)of patients in the control group dropped out of the study.10%(3/30)of the patients in the experimental group dropped out of the study.The difference between the two groups was statistically significant(χ^(2)=4.812,P=0.028).In terms of efficacy,there was no difference in scores between the two groups before treatment.After treatment,the Fugl-Meyer score of the experimental group(53.59±8.40)was higher than this of the control group(44.90±7.40),and the difference was statistically significant(t=3.688,P=0.001).At the same time,the Barthel index score of the experimental group(63.44±5.35)was higher than this of the control group(52.75±4.84),and the difference was also statistically significant(t=7.048,P=0.000).Conclusion Paroxetine can significantly improve the therapy acceptability of cerebral infarction patients to mCIMT,and can help improve the clinical efficacy of mCIMT.

关 键 词：脑梗死 上肢瘫痪 帕罗西汀 改良强制运动疗法 治疗依从性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]