智能手康复训练联合经颅直流电刺激治疗轻度脑梗死伴手功能障碍的临床研究  

Clinical study of intelligent hand rehabilitation training combined transcranial direct current stimulation in the treatment of mild cerebral infarction with hand dysfunction

作　　者：戴训刚 吴琼瑛 张博洋 王金桂 DAI Xungang;WU Qiongying;ZHANG Boyang;WANG Jingui(Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine/Wuxi Hospital of Traditional Chinese Medicine,Wuxi 214000,China)

机构地区：[1]南京中医药大学无锡附属医院无锡市中医医院,江苏无锡214000

出　　处：《中国实用神经疾病杂志》2024年第12期1538-1542,共5页Chinese Journal of Practical Nervous Diseases

基　　金：无锡市卫生健康委重大科研项目(编号:Z202121);江苏省中医药科技发展计划项目(编号:YB201942)。

摘　　要：目的观察智能手康复训练联合经颅直流电刺激治疗轻度脑梗死伴手功能障碍的临床效果。方法将96例2022-01—2023-01南京中医药大学无锡附属医院诊治的轻度脑梗死伴手功能障碍患者随机分为研究组(48例,智能手康复训练结合经颅直流电刺激)和对照组(48例,常规康复结合经颅直流电刺激),评价组间上肢Fugl-Meyer运动功能评定量表(FMA)评分、上肢功能测试评分(UEFT)、偏瘫手功能测试分级、手握力测试、Lindmark上肢感觉功能评分、改良Barthel指数。结果治疗前2组患者的FMA评分、UEFT评分、偏瘫手功能测试分级、手握力测试、Lindmark各单项评分、改良Barthel指数均无统计学差异(P>0.05),治疗后2组患者的FMA评分、UEFT评分、偏瘫手功能测试分级、手握力测试、Lindmark各单项评分、改良Barthel指数均较治疗前明显升高(P<0.05)。治疗后研究组患者的FMA评分[(29.57±5.69)分比(22.59±5.02)分]、UEFT评分[(54.66±11.78)分比(41.49±10.59)分]、偏瘫手功能测试分级[(5.51±1.75)级比(3.75±0.73)级]、手握力测试[(18.54±4.52)kg比(14.02±3.56)kg]、Lindmark各单项评分[手指:(20.77±4.25)分比(16.89±2.56)分;腕关节:(8.44±1.98)分比(5.29±1.03)分;上肢:(20.73±3.96)分比(16.74±4.87)分]、改良Barthel指数[(56.78±8.72)分比(43.26±8.97)分]显著均高于对照组(P<0.05)。结论智能手康复训练联合经颅直流电刺激可显著改善轻度脑梗死伴手功能障碍患者的手及上肢功能,还可显著提升患者的日常生活能力,较常规康复训练联合经颅直流电刺激的效果更为显著。Objective To investigate the clinical effect of intelligent hand rehabilitation training combined transcranial direct current stimulation in the treatment of mild cerebral infarction with hand dysfunction.Methods A total of 96 patients with mild cerebral infarction and hand dysfunction treated in the Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine from January 2022 to January 2023 were selected as the study objects,and the enrolled subjects were randomly divided into the study group(48 cases,intelligent hand rehabilitation training combined transcranial direct current stimulation)and the control group(48 cases,conventional rehabilitation training combined with transcranial direct current stimulation).The treatment period for all patients was 4 weeks.The upper limb Fugl-Meyer assessment scale(FMA)score,upper limb function test(UEFT),hemiplegic mobile phone ability test score,hand grip strength test score,Lindmark upper limb sensory function score and modified Barthel index before and after rehabilitation were evaluated in the two groups.Results Before treatment,there were no significant differences in FMA score,UEFT score,hemiplegia mobile phone performance score,hand grip strength test score,Lindmark score and modified Barthel index between the two groups(P>0.05).After treatment,the FMA score,UEFT score,hemiplegia mobile phone performance test score,hand grip strength test score,Lindmark score and modified Barthel index of the two groups were significantly higher than those before treatment,and the differences were statistically significant(P<0.05).After treatment,in the study group,FMA score(29.57±5.69 vs 22.59±5.02),UEFT score(54.66±11.78 vs 41.49±10.59),hemiplegia cell phone performance test score(5.51±1.75 vs 3.75±0.73),hand grip strength test(18.54±4.52 vs 14.02±3.56),Lindmark score(finger:20.77±4.25 vs 16.89±2.56;wrist:8.44±1.98 vs 5.29±1.03;upper limb:20.73±3.96 vs 16.74±4.87)and modified Barthel index(56.78±8.72 vs 43.26±8.97)were significantly higher than those of contr

关 键 词：脑梗死 智能手康复训练 经颅直流电刺激 手功能障碍 生活质量 

分 类 号：R743.33[医药卫生—神经病学与精神病学]