上肢智能反馈训练联合揿针对脑卒中患者肩、肘、手功能的影响研究  

Effects of upper limb intelligent feedback training combined with pressing on shoulder,elbow,and hand func⁃tions in stroke patients

作　　者：刘泽晶 陈世宏 钱晓蕊 杨华 徐丰 LIU Zejing;CHEN Shihong;QIAN Xiaorui(Department of Rehabilitation Medicine,Taizhou Central Hospital(Taizhou University Affiliated Hospital),Taizhou 318001,China)

机构地区：[1]台州市中心医院(台州学院附属医院)康复医学科,浙江台州318001 [2]黑龙江中医药大学附属第四医院康复医学科

出　　处：《全科医学临床与教育》2024年第11期988-992,共5页Clinical Education of General Practice

基　　金：黑龙江省卫生健康委科研课题(20212020010119)。

摘　　要：目的探究上肢智能反馈训练联合揿针对脑卒中患者肩、肘、手功能的影响。方法选取脑卒中患者100例,按照随机数字表法分为观察组和对照组,各50例。对照组患者给予常规康复训练+常规针灸治疗,观察组患者给予上肢智能反馈训练+揿针治疗。采用Fugl-Meyer量表(FMA)、上肢功能评分(UEFI)、Berg平衡量表(BBS)分别评估上肢运动、手、平衡功能,采用蒙特利尔认知状态表(MoCA)、美国卫生研究院卒中量表(NIHSS)评估认知功能和神经功能。比较两组治疗前后FMA、UEFI、BBS评分、肩和肘活动程度、MoCA评分、NIHSS评分、血清同型半胱氨酸(Hcy)、血清基质金属蛋白酶-9(MMP-9)以及生活质量水平。结果治疗8周后,观察组FMA、UEFI、BBS、MoCA评分及心理功能、躯体功能、社会功能、物质生活评分均高于对照组(t分别=8.38、5.95、3.58、2.20、6.24、3.39、3.58、4.17,P均<0.05),肩外展、肩前屈、伸肘、屈肘评分,NIHSS评分及Hcy、MMP-9水平均低于对照组(t分别=-6.31、-7.96、-3.00、-2.74、-5.98、-3.05、-5.23,P均<0.05)。结论上肢智能反馈训练联合揿针疗法通过多种机制有效改善脑卒中患者手功能、肩和肘活动度以及认知和神经功能,有利于促进上肢运动功能康复,提高其生活质量。Objective To explore the effects of upper limb intelligent feedback training combined with pressing on shoulder,elbow,and hand functions in stroke patients.Methods Totally 100 stroke patients were selected and divide in⁃to observation group and control group using a random number table method,with 50 cases in each.The patients in the control group were given conventional rehabilitation training combined with conventional acupuncture and moxibustion treatment,and the patients in the observation group were given upper limb intelligent feedback training combined with press acupuncture treatment.The Fugl Meyer assessment(FMA),upper extremity functional index(UEFI),and Berg bal⁃ance scale(BBS)were used to evaluate upper limb movement,hand,and balance function,respectively.The Montreal cognitive assessment(MoCA)score and the national institutes of health stroke scale(NIHSS)score were used to evalu⁃ate cognitive and neurological function.The FMA,UEFI,BBS scores,shoulder and elbow mobility,MoCA scores,NIHSS scores,serum homocysteine(Hcy),serum matrix met alloproteinase-9(MMP-9),and quality of life between two groups before and after treatment were compared.Results After 8 weeks of treatment,the FMA,UEFI,BBS,MoCA scores,psy⁃chological function,physical function,social function,and material life scores of the observation group were higher than those of the control group(t=8.38,5.95,3.58,2.20,6.24,3.39,3.58,4.17,P<0.05),while the shoulder abduction,shoul⁃der flexion,elbow extension,and elbow flexion scores,NIHSS scores,Hcy,MMP-9 levels were low⁃er than those of the control group(t=-6.31,-7.96,-3.00,-2.74,-5.98,-3.05,-5.23,P<0.05).Con⁃clusion The combination of upper limb intelligent feedback training and acupressure therapy effective⁃ly improves hand function,shoulder and elbow range of motion,as well as cognitive and neurological function in patients through various mechanisms,which is beneficial for promoting the rehabilitation of upper limb motor function and improving their quality of life.

关 键 词：上肢智能反馈训练 揿针 脑卒中患者 手功能 肩功能 肘功能 

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]