高压氧联合镜像神经元康复训练对脑卒中后偏瘫患者运动功能及血清BDNF、NGF水平的影响  

Effects of hyperbaric oxygen combined with mirror neuron rehabilitation training on motor function and serum brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)levels in patients with hemiplegia after stroke

作　　者：李慧 曹运雄 宁小娟[3] LI Hui;CAO Yunxiong;NING Xiaojuan(Department of Rehabilitation,The Fourth People's Hospital of Chenzhou;Clinical Laboratory,The Fourth People's Hospital of Chenzhou;Department of Pain,The First People's Hospital of Chenzhou,Chenzhou 423000,China)

机构地区：[1]郴州市第四人民医院康复科,湖南郴州423000 [2]郴州市第四人民医院检验科,湖南郴州423000 [3]郴州市第四人民医院郴州市第一人民医院疼痛科,湖南郴州423000

出　　处：《新疆医科大学学报》2025年第3期299-304,共6页Journal of Xinjiang Medical University

基　　金：湖南省郴州市技术创新引导项目(lcyl2021040);湖南省卫生健康委科研计划项目(202103101200)。

摘　　要：目的探讨高压氧联合镜像神经元康复训练对脑卒中后偏瘫患者运动功能及血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)水平的影响。方法选取本院2020年1月至2024年1月收治的脑卒中后偏瘫患者118例,采用随机数字表法将其分为研究组与对照组,每组各59例。两组均给予常规治疗,对照组给予镜像神经元康复训练,研究组在对照组的基础上给予高压氧治疗。治疗后1个月,比较两组临床疗效、血清BDNF、NGF水平、血液流变学指标,评估患者肢体运动功能及步态情况。结果研究组总有效率为94.92%,高于对照组83.05%(P<0.05);治疗1个月后,两组血清BDNF、NGF水平均升高,且研究组更高(P<0.05);与治疗前相比,治疗1个月后两组纤维蛋白原、全血高切黏度、血浆黏度均降低,且研究组上述指标更低(P<0.05);研究组治疗1、3个月及对照组治疗3个月的Fugl-Meyer上肢运动功能(FMA-UE)评分、Fugl-Meyer下肢运动功能(FMA-L)评分均高于治疗前(P<0.05);两组治疗3个月后的FMA-UE评分、FMA-L评分高于治疗1个月(P<0.05);与对照组比较,研究组治疗1、3个月的FMA-UE评分、FMA-L评分更高(P<0.05);与治疗前比较,两组治疗1个月后步频、步速、跨步长比率均更高,且研究组高于对照组(P<0.05)。结论高压氧联合镜像神经元康复训练治疗可有效调节BDNF、NGF水平与血液流变学,降低神经功能损伤程度,改善患者上下肢体运动功能及步行能力,具有较好的临床效果。Objective To investigate the effects of hyperbaric oxygen combined with mirror neuron rehabilitation training on motor function and serum levels of brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)in patients with hemiplegia after stroke.Methods A total of 118 patients with hemiplegia after stroke treated in the hospital from January 2020 to January 2024 were selected and divided into study group and control group by random number table method,with 59 cases in each group.Both groups were given conventional treatment,the control group was given mirror neuron rehabilitation training,and the study group was given hyperbaric oxygen therapy on the basis of the control group.1 month after the treatment.The clinical efficacy,serum BDNF,NGF levels and hemorheology indexes of the 2 groups were compared,and the limb motor function and gait of the patients were evaluated.Results The total effective rate of the research group was 94.92%,which was higher than that of the control group 83.05%(P<0.05).After 1 month of the treatment,serum BDNF and NGF levels were increased in both groups,and higher in research group(P<0.05).Compared with before the treatment,fibrinogen,whole blood high tangential viscosity and plasma viscosity were all decreased in the 2 groups after 1 month of the treatment,and the above indexes were lower in the study group(P<0.05).The Fugl-Meyer upper limb motor function(FMA-UE)score and Fugl-Meyer lower extremity motor function(FMA-L)score of the research group after 1 and 3 months of the treatment were higher than those before the treatment(P<0.05).The FMA-UE score and FMA-L score of the control group after 3 months of postoperative treatment were higher than those before the treatment(P<0.05).The FMA-UE score and FMA-L score of the 2 groups after 3 months of the treatment were higher than those after 1 month of the treatment(P<0.05).Compared with the control group,the FMA-UE score and FMA-L score of the research group were higher after 1 and 3 months of the treatment(P<0.05).Compared with

关 键 词：脑卒中 偏瘫 镜像神经元康复训练 高压氧 运动功能 脑源性神经营养因子 神经生长因子 

分 类 号：R493[医药卫生—康复医学] R459.6[医药卫生—临床医学] R743.3