本文選題：缺血性腦卒中 + 肢體功能障礙�。� 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：[目的]通過比較溫水足浴和中藥足浴對缺血性腦卒中患者患側(cè)上、下肢運(yùn)動(dòng)功能及其肌力,中醫(yī)癥狀及血壓改善的效果,探索中藥足浴對缺血性腦卒中患者肢體功能障礙康復(fù)的影響,旨在為缺血性腦卒中肢體功能障礙患者尋找安全有效、耐受性好的輔助康復(fù)方法,為臨床護(hù)理提供參考,進(jìn)一步拓寬中藥足浴的應(yīng)用領(lǐng)域。[方法]將符合本研究納入、排除標(biāo)準(zhǔn)的170例急性缺血性腦卒中患者隨機(jī)分為中藥足浴組、溫水足浴組各85例。兩組患者均接受缺血性腦卒中常規(guī)藥物治療和常規(guī)護(hù)理。中藥足浴組(試驗(yàn)組)予以中藥足浴,每晚1次,每次20min,7天一個(gè)療程,共兩個(gè)療程;溫水足浴組(對照組)予以溫水足浴,方法和療程同中藥足浴組。采用簡化Fugl-Meyer運(yùn)動(dòng)功能評定量表(FMA)、肌力等級(jí)評估、"風(fēng)痰瘀阻"型缺血性腦卒中患者中醫(yī)證候量化分級(jí)表比較兩組患者患側(cè)上、下肢運(yùn)動(dòng)功能,患側(cè)上、下肢肌力,中醫(yī)癥狀及血壓改善的情況。[結(jié)果](1)一般資料比較:兩組性別、年齡、經(jīng)濟(jì)、卒中量表(NIHSS)評分、基礎(chǔ)疾病、病程、偏癱肢體方面比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。(2)組內(nèi)自身前后比較:①對照組干預(yù)1周后上肢FMA評分、下肢FMA評分與干預(yù)前比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)2周后與干預(yù)前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05):試驗(yàn)組:干預(yù)1周及2周后上、下肢FMA評分與干預(yù)前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)2周后與干預(yù)1周后比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。②對照組干預(yù)2周后的上肢肌力、下肢肌力均明顯高于干預(yù)前(P0.05),但是干預(yù)2周后與干預(yù)1周后、干預(yù)1周后與干預(yù)前比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組干預(yù)2周后的上肢肌力、下肢肌力均明顯高于干預(yù)前,差異有統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)1周后的上、下肢肌力高于干預(yù)前,但差異無統(tǒng)計(jì)學(xué)意義(P0.05)。③對照組干預(yù)1周后及干預(yù)2周后中醫(yī)證候積分與干預(yù)前比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)2周后與干預(yù)1周后比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組干預(yù)1周后及2周后與干預(yù)前比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)2周后與干預(yù)1周后比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。④對照組干預(yù)2周后的平均收縮壓、平均舒張壓及平均血壓均低于干預(yù)1周后、干預(yù)前(P0.05),但是干預(yù)1周后和干預(yù)前比較(P0.05);試驗(yàn)組干預(yù)2周后的血壓明顯低于干預(yù)1周后(P0.05),干預(yù)1周后的血壓明顯低于干預(yù)前(P0.05)。(3)兩組干預(yù)后組間比較:①干預(yù)1周后及干預(yù)2周后試驗(yàn)組下肢FMA評分均顯著高于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。②干預(yù)1周后和干預(yù)2周后試驗(yàn)組下肢肌力均顯著高于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。③干預(yù)2周后試驗(yàn)組上肢FMA評分顯著高于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);但干預(yù)1周后比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。④干預(yù)1周后上肢肌力比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);但干預(yù)2周后比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。⑤干預(yù)1周后和干預(yù)2周后試驗(yàn)組中醫(yī)證候積分較對照組低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。⑥干預(yù)1周后和干預(yù)2周后試驗(yàn)組平均血壓與對照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。[結(jié)論]中藥足浴法可促進(jìn)缺血性腦卒中患者患側(cè)肢體功能障礙康復(fù),有益于增加患側(cè)肢體肌力,改善其中醫(yī)癥狀,穩(wěn)定血壓。該方法療效確切、簡單易行、綠色安全,可運(yùn)用于缺血性腦卒中患者肢體功能障礙的康復(fù)。
[Abstract]:[Objective] to explore the effect of Chinese medicine foot bath on the rehabilitation of limb dysfunction in patients with ischemic stroke by comparing the effects of warm water foot bath and Chinese traditional medicine foot bath on the affected side of the patients with ischemic stroke, the function of lower extremity movement and muscle strength, the symptoms of traditional Chinese medicine and the improvement of blood pressure. Effective and well tolerated rehabilitation methods provide reference for clinical nursing and further widen the application field of Chinese medicine foot bath. [method] 170 patients with acute ischemic stroke were randomly divided into Chinese medicine foot bath group and 85 cases in warm water foot bath group. The two groups were treated with conventional medicine treatment for ischemic stroke. Treatment and routine nursing. Chinese medicine foot bath group (test group) was given Chinese medicine foot bath, 1 times a night, each time 20min, 7 days a course of treatment, a total of two courses, warm water foot bath group (control group) to give warm water foot bath, methods and course of treatment with the Chinese medicine foot bath group. The use of simplified Fugl-Meyer exercise function assessment scale (FMA), strength grade assessment, "wind phlegm stasis obstruction" ischemic brain brain The scale of TCM Syndromes of stroke patients was compared with the two groups of patients on the side of the affected side, lower limb motor function, upper limb, lower limb muscle strength, TCM symptoms and blood pressure improvement. [results] general data were compared: two groups of sex, age, economy, stroke scale (NIHSS) score, basic disease, course of disease, hemiplegia limbs, the difference was not statistically significant difference ( P0.05) (2) the comparison in the group itself: (1) the FMA score of the upper limb in the control group after 1 weeks, and the difference between the lower extremity FMA score and the prior intervention was not statistically significant (P0.05). The difference was statistically significant (P0.05) after the intervention for 2 weeks and before the intervention: the experimental group was compared with the intervention of the lower extremities after 1 and 2 weeks, and the difference was statistically significant. P0.05, after intervention for 2 weeks and 1 weeks after intervention, the difference was statistically significant (P0.05). (2) the upper limb muscle strength of the control group after 2 weeks of intervention was significantly higher than that before intervention (P0.05), but after 2 weeks of intervention and intervention for 1 weeks, the difference was not statistically significant after intervention for 1 weeks and before intervention (P0.05); the experimental group intervened for 2 weeks after the upper limb muscle. Strength and lower limbs muscle strength were significantly higher than before intervention, the difference was statistically significant (P0.05), 1 weeks after intervention, lower limb muscle strength was higher than before the intervention, but there was no significant difference (P0.05). 3. After intervention for 1 weeks and 2 weeks after intervention, the difference was statistically significant (P0.05), after intervention for 2 weeks and after intervention 1 weeks after intervention. The difference was statistically significant (P0.05). The difference was statistically significant (P0.05) after intervention for 1 weeks and 2 weeks after intervention. After intervention for 2 weeks, the difference was statistically significant (P0.05). (4) the mean systolic pressure, mean diastolic pressure and mean blood pressure in the control group after 2 weeks were lower than that of the intervention for 1 weeks, before intervention, before intervention. (P0.05), but after intervention for 1 weeks and before intervention (P0.05), the blood pressure of the experimental group was significantly lower than that of 1 weeks after intervention (P0.05), the blood pressure of the intervention group was significantly lower than that before intervention (P0.05) after 1 weeks (P0.05). (3) the two groups were compared with the intervention group: (1) after 1 weeks and after 2 weeks, the lower extremities FMA scores were significantly higher than the control group, the difference was statistically significant Significance (P0.05). After intervention for 1 weeks and after 2 weeks of intervention, the lower limb muscle strength of the experimental group was significantly higher than that of the control group (P0.05). (3) after 2 weeks of intervention, the FMA score of the upper limb of the experimental group was significantly higher than that of the control group (P0.05), but the difference was not statistically significant (P0.05) after 1 weeks of intervention (P0.05). 4. After intervention, the upper limb muscles were treated with the intervention of 1 weeks. The difference was not statistically significant (P0.05), but after 2 weeks of intervention, the difference was statistically significant (P0.05). After intervention for 1 weeks and after 2 weeks of intervention, the TCM syndrome score was lower than the control group, the difference was statistically significant (P0.05). 6. After intervention for 1 weeks and after 2 weeks, the average blood pressure in the experimental group was compared with the control group, the difference was statistically significant. [Conclusion] [Conclusion] [Conclusion] foot bath method can promote the rehabilitation of limb dysfunction in patients with ischemic stroke. It is beneficial to increase the muscle strength of the affected limbs, improve the symptoms of the Chinese medicine and stabilize the blood pressure. This method is effective, simple and safe, and can be used for the rehabilitation of limb dysfunction in patients with ischemic stroke.

【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R248.9

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