本文選題：康復(fù) + 肉毒毒素　； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：研究背景:腦卒中是世界范圍內(nèi)第2大致死原因,也是成人殘疾的主要原因之一,顯著降低了此類人群的生活質(zhì)量。為了尋找改善其生活質(zhì)量的康復(fù)治療方法,多種多樣的研究得以開展。已有研究證實(shí)結(jié)合技術(shù)較單一康復(fù)治療技術(shù)顯示更好的康復(fù)效果。A型肉毒毒素注射認(rèn)為是控制腦卒中后痙攣的有效方法,進(jìn)而促進(jìn)肢體運(yùn)動(dòng)功能的恢復(fù)。一些研究者認(rèn)為肉毒毒素注射技術(shù)聯(lián)合改良強(qiáng)制性運(yùn)動(dòng)療法或高強(qiáng)度的傳統(tǒng)康復(fù)療法對腦卒中后運(yùn)動(dòng)功能恢復(fù)是較具前景的有效治療方式。但是,目前尚未有文獻(xiàn)報(bào)道肉毒毒素注射技術(shù)聯(lián)合改良強(qiáng)制性運(yùn)動(dòng)療法與聯(lián)合高強(qiáng)度的傳統(tǒng)康復(fù)療法的臨床康復(fù)療效對比。目的:對比肉毒毒素注射技術(shù)聯(lián)合改良強(qiáng)制性運(yùn)動(dòng)療法與聯(lián)合高強(qiáng)度的傳統(tǒng)康復(fù)療法對腦卒中后上肢運(yùn)動(dòng)功能的康復(fù)療效,以探討促進(jìn)運(yùn)動(dòng)功能恢復(fù)的最佳康復(fù)療法。方法:選擇2014年2月-2016年11月于吉林大學(xué)第一醫(yī)院康復(fù)中心住院腦卒中患者58例,年齡10-70周歲,發(fā)病時(shí)間2周-12個(gè)月。其中共32例患者符合入組標(biāo)準(zhǔn),給予患側(cè)上肢行A型肉毒毒素注射治療。后應(yīng)用隨機(jī)數(shù)字表法分為肉毒毒素注射技術(shù)聯(lián)合改良強(qiáng)制性運(yùn)動(dòng)療法組和聯(lián)合高強(qiáng)度的傳統(tǒng)康復(fù)療法組,各16例。2組患者上肢治療時(shí)間均為1小時(shí)/天,5天/周,共4周。治療前及治療4周后采用改良Ashworth分級量表,Fugl-Meyer評估量表的上肢功能評估部分及Barthel指數(shù)進(jìn)行療效評估。結(jié)果:治療4周后2組患者的改良Ashworth分級量表、Fugl-Meyer評估量表及Barthel指數(shù)評估結(jié)果較治療前均明顯提高,差異具有統(tǒng)計(jì)學(xué)意義(p0.05)。肉毒毒素注射技術(shù)聯(lián)合改良強(qiáng)制性運(yùn)動(dòng)療法組與聯(lián)合高強(qiáng)度的傳統(tǒng)康復(fù)療法組治療后療效對比,改良強(qiáng)制性運(yùn)動(dòng)療法組的Fugl-Meyer評估量表及Barthel指數(shù)平均得分均高于聯(lián)合高強(qiáng)度的傳統(tǒng)康復(fù)療法組,差異具有統(tǒng)計(jì)學(xué)意義(p0.05);而改良Ashworth分級量表評估結(jié)果組間差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:肉毒毒素注射技術(shù)聯(lián)合改良強(qiáng)制性運(yùn)動(dòng)療法與聯(lián)合高強(qiáng)度的傳統(tǒng)康復(fù)療法均科促進(jìn)腦卒中后上肢運(yùn)動(dòng)功能的康復(fù)。其中,肉毒毒素注射技術(shù)聯(lián)合改良強(qiáng)制性運(yùn)動(dòng)療法在運(yùn)動(dòng)功能的恢復(fù)及日常生活能力的改善療效較為顯著。
[Abstract]:Background: stroke is the second leading cause of death in the world and one of the major causes of adult disability. In order to find rehabilitation methods to improve their quality of life, a variety of studies have been carried out. It has been proved that combined therapy is more effective than single rehabilitation therapy. Botulinum toxin injection is considered to be an effective method to control spasm after stroke and promote the recovery of limb motor function. Some researchers believe that botulinum toxin injection combined with improved compulsory exercise therapy or high-intensity traditional rehabilitation therapy is a promising and effective treatment for the recovery of motor function after stroke. However, there is no literature about the clinical rehabilitation effects of botulinum toxin injection combined with modified compulsory exercise therapy and high intensity traditional rehabilitation therapy. Objective: to compare the effects of botulinum toxin injection combined with modified compulsory exercise therapy and high intensity traditional rehabilitation therapy on motor function of upper limb after stroke, and to explore the best rehabilitation therapy to promote the recovery of motor function. Methods: from February 2014 to November 2016, 58 stroke patients, aged 10-70 years, were selected from the rehabilitation center of the first Hospital of Jilin University. The onset time was 2 weeks to 12 months. A total of 32 patients were treated with botulinum toxin type A (Botulinum toxin A) injection. Then the patients were randomly divided into Botox injection technique combined with modified compulsory exercise therapy group and high intensity traditional rehabilitation therapy group. The upper limb treatment time of each group was 1 hour / day and 5 days / week for 4 weeks. The curative effect was evaluated with the modified Ashworth rating scale Fugl-Meyer evaluation scale and Barthel index before treatment and 4 weeks after treatment. Results: the results of Fugl-Meyer scale and Barthel index were significantly higher in the two groups after 4 weeks of treatment than before treatment, and the difference was statistically significant (P 0.05). The therapeutic effects of botulinum toxin injection combined with modified compulsory exercise therapy group and high intensity traditional rehabilitation therapy group were compared. The average scores of Fugl-Meyer evaluation scale and Barthel index in the modified compulsory exercise therapy group were higher than those in the traditional rehabilitation therapy group with high intensity, and the difference was statistically significant (p 0.05), but there was no significant difference between the two groups in the evaluation results of the modified Ashworth rating scale. Conclusion: botulinum toxin injection combined with modified compulsory exercise therapy and high intensity traditional rehabilitation therapy can promote the recovery of upper limb motor function after stroke. Among them, Botulinum toxin injection combined with improved compulsory exercise therapy has a significant effect on the recovery of motor function and the improvement of daily living ability.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 Zhifeng Kou;Armin Iraji;;Imaging brain plasticity after trauma[J];Neural Regeneration Research;2014年07期

2 ;Functional magnetic resonance imaging evaluation of brain function reorganization in cerebral stroke patients after constraint-induced movement therapy[J];Neural Regeneration Research;2012年15期

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本文編號(hào)：1971962