神经肌肉关节促进法联合Brunntrom技术对脑卒中患者肢体功能康复的效果  

Outcomes of Brunntrom approach plus neuromuscular joint facilitation in the limb function rehabilitation in stroke patients

作　　者：罗强强 洪小娟[2] 王清华 鲍晓[2] 王松 洪乐 LUO Qiangqiang;HONG Xiaojuan;WANG Qinghua;BAO Xiao;WANG Song;HONG Le(Department of Rehabilitation,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院康复科,安徽芜湖241001 [2]粤北人民医院康复科,广东韶关512026

出　　处：《皖南医学院学报》2024年第3期229-233,共5页Journal of Wannan Medical College

基　　金：韶关市卫生健康科研项目(Y23014)。

摘　　要：目的:探析神经肌肉关节促进法联合Brunnstrom技术对脑卒中患者肢体功能康复及长链非编码RNA核仁小RNA宿主基因14(lncRNA SNHG14)、微小RNA-145-5p(miR-145-5p)表达的影响。方法:选择弋矶山医院2020年10月~2023年10月就诊的110例脑卒中患者进行回顾性研究,分为两组各55例。对照组给予Brunnstrom技术运动疗法,观察组给予神经肌肉关节促进法联合Brunnstrom技术。对比两组治疗前后肢体Fugl-Meyer运动功能评定量表[上肢部分(FMA-UE)、下肢部分(FMA-LE)及总分]、下肢肌张力[改良Ashworth痉挛量表(MAS)]、神经损伤康复情况[美国国立卫生研究院卒中量表(NIHSS)]、血清神经因子[血清髓鞘碱性蛋白(MBP)]、神经生长因子(NGF)及miRNA相关指标(lncRNA SNHG14、miR-145-5p)。结果:两组患者治疗后FMA-UE、FMA-LE及总分均较治疗前上升(P<0.05),且观察组治疗后FMA-UE、FMA-LE及总分上升幅度均高于对照组(P<0.05);而两组患者治疗后MAS、NIHSS评分均较治疗前下降(P<0.05),观察组治疗后MAS、NIHSS评分下降幅度均高于对照组(P<0.05)。两组患者治疗后MBP、lncRNA SNHG14均较治疗前下降(P<0.05),观察组治疗后MBP、lncRNA SNHG14下降幅度均高于对照组(P<0.05);两组患者治疗后NGF、miR-145-5p均较治疗前上升(P<0.05),观察组治疗后NGF、miR-145-5p上升幅度均高于对照组(P<0.05)。结论:神经肌肉关节促进法联合Brunnstrom技术应用于脑卒中患者临床效果显著,可加速肢体功能及神经功能康复,降低下肢肌张力,改善血清神经因子、lncRNA SNHG14、miR-145-5p水平。Objective:To investigate the effects of neuromuscular joint facilitation(NJF)combined with Brunnstrom movement therapy approach on the limb functional recovery and the expression of long non-coding RNA small nucleolar RNA host gene 14(lncRNA SNHG14)and microRNA-145-5p(miR-145-5p)in stroke patients.Methods:A retrospective study was conducted in 110 stroke cases treated in our hospital from October 2020 to October 2023.The cases were divided into two groups(n=55 in each group).Patients in the control group received Brunnstrom movement therapy,and those in the observational group underwent NJF plus Brunnstrom′s exercise.The two groups were compared concerning the limb motor function using Fugl-Meyer Assessment of the Upper Extremity(FMA-UE),Fugl-Meyer Assessment of Lower Extremity(FMA-LE)and total score,lower limb muscle tension using Modified Ashworth Spasm Scale(MAS)before and after treatment as well as rehabilitation status of nerve injury assessed by National Institute of Health Stroke Scale(NIHSS),serum nerve factors(serum myelin basic protein,MBP),nerve growth factor(NGF),and miRNA related indicators(lncRNA SNHG14,miR-145-5p).Results:After treatment,FMA-UE,FMA-LE and total score in two groups were increased compared to pre-treatment(P<0.05),and the increase of FMA-UE,FMA-LE and total score was greater in observational group than in control group(P<0.05),whereas MAS and NIHSS scores were decreased in both groups after therapy(P<0.05).After treatment,MAS and NIHSS scores in observational group were significantly lower than those in control group(P<0.05).MBP and lncRNA SNHG14 were decreased in the two groups following treatment(P<0.05),and the decrease rate of MBP and lncRNA SNHG14 in observational group was higher than that in control group(P<0.05),whereas NGF and miR-145-5p in both groups were increased after treatment(P<0.05),and the increase of NGF and miR-145-5p was greater in observational group than in control group(P<0.05).Conclusion:Combined NJF with Brunnstrom movement therapy approach can significant

关 键 词：脑卒中 神经肌肉关节促进法 Brunnstrom技术 长链非编码RNA核仁小RNA宿主基因14 微小RNA-145-5p 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]