开窍定志方与头针联合视觉观察训练对脑卒中后单侧空间忽略的康复效果研究  

Study on the rehabilitation effect of Kaiqiao Dingzhi Prescription and head acupuncture combined with visual observation training on unilateral spatial neglect after stroke

作　　者：赵文化 卢俊英 赵怀消 刘银芳 张晓曼[2] ZHAO Wen-hua;LU Jun-ying;ZHAO Huai-xiao;LIU Yin-fang;ZHANG Xiao-man(Internal Medicine Department,Staff Hospital of Henan Wujian Construction Group,Zhengzhou,Henan 450000,China;不详)

机构地区：[1]河南五建建设集团职工医院内科,河南郑州450000 [2]郑州市第一人民医院神经内科,河南郑州450000

出　　处：《中华全科医学》2022年第10期1763-1768,共6页Chinese Journal of General Practice

基　　金：河南省医学科技攻关项目(2018020725)。

摘　　要：目的观察开窍定志方、头针联合视觉观察训练对脑卒中后单侧空间忽略患者的康复干预效果。方法将河南五建建设集团职工医院2019年1月—2020年6月收治的94例脑卒中单侧空间忽略患者按照随机数字表法分为治疗组(47例)和对照组(47例)。对照组在常规康复训练的基础上给予视觉观察训练,观察组在对照组基础上给予开窍定志方、头针。对比2组各项指标。结果与对照组相比,观察组患者治疗后的直线二等分试验、画钟试验、临摹画图试验、数字删除试验评分均有所降低(均P<0.05);运动功能评分量表(FMA)、日常生活能力(ADL)量表、脑卒中专用生活质量量表(SS-QOL)评分均显著升高(均P<0.05);治疗2周、4周后,观察组的凯瑟琳-伯哥量表(CBS)评分均显著低于对照组[(16.17±2.32)分vs.(18.24±3.27)分、(12.58±1.83)分vs.(16.06±2.10)分,均P<0.05],简易智能状态量表(MMSE)评分均显著高于对照组[(24.16±3.25)分vs.(22.30±3.20)分、(26.51±2.78)分vs.(25.10±1.69)分,均P<0.05];观察组治疗后血清中颅脑损伤相关因子S100β蛋白(S100β)、巨噬细胞炎性蛋白1α(MIP-1α)、神经元特异性烯醇化酶(NSE)水平及血小板聚集率、纤维蛋白原、全血高切黏度、全血低切黏度均低于对照组(均P<0.05)。结论开窍定志方、头针联合视觉观察训练利于控制脑卒中后单侧空间忽略患者的病情,可能与抑制S100β、MIP-1α、NSE等表达、改善血液流变以促进脑功能恢复、提高脑局部血液灌注有关。Objective To observe the effect of rehabilitation intervention using Kaiqiao Dingzhi Prescription and head acupuncture combined with visual observation training on patients with unilateral spatial neglect after stroke.Methods A total of 94 patients suffering from stroke and unilateral spatial neglect and admitted to the Staff Hospital of Henan Wujian Construction Group from January 2019 to June 2020 were divided into treatment group(47 cases)and control group(47 cases)by the random-number table method.The patients in the control group underwent visual observation training on the basis of routine rehabilitation training,whereas the patients in the observation group received a combination of Kaiqiao Dingzhi Prescription and head acupuncture.The indicators of the two groups were compared.Results Compared with the control group,the scores of linear bisection test,bell drawing test,copy drawing test and number deletion test in the observation group all decreased after treatment(all P<0.05).The Fugl-Meyer motor function assessment(FMA),activities of daily living(ADL)and stroke specific quality of life scale(SS-QOL)scores of the observation group significantly increased(all P<0.05).After 2 and 4 weeks of treatment,the Catherine Bergego scale(CBS)score of the observation group was significantly lower than that of the control group[(16.17±2.32)points vs.(18.24±3.27)points,(12.58±1.83)points vs.(16.06±2.10)points,all P<0.05].The mini-mental state examination(MMSE)score of cognitive function was significantly higher than that of the control group[(24.16±3.25)points vs.(22.30±3.20)points,(26.51±2.78)points vs.(25.10±1.69)points,all P<0.05].After treatment,the serum S100β,macrophage inflammatory protein-1α(MIP-1α),neuron-specific enolase(NSE)levels,platelet aggregation rate,fibrinogen,whole blood high shear viscosity and whole blood low shear viscosity of the observation group were significantly lower than that of the control group(all P<0.05).Conclusion Kaiqiao Dingzhi Prescription and head acupuncture combined wi

关 键 词：开窍定志方 头针 视觉观察训练 脑卒中后单侧空间忽略 临床研究 

分 类 号：R743.3[医药卫生—神经病学与精神病学]