本文選題：腦梗塞　切入點：樞經推拿　出處：《廣西醫(yī)科大學》2016年碩士論文

【摘要】：目的：通過觀察樞經推拿療法對腦梗塞患者的運動功能及腦血流動力學的影響,為腦梗塞患者的臨床康復治療探索一種更有效的治療方法,以改善腦梗塞患者遺留的肢體功能障礙的情況,降低其致殘率,提高其生活質量。方法：選擇符合納入標準的腦梗塞的患者60例,隨機分為治療組和對照組,每組各30例,對照組給予腦梗塞的常規(guī)基礎治療及常規(guī)推拿治療,治療組給予腦梗塞的常規(guī)基礎治療及樞經推拿療法。治療前24小時內給予患者第一次評定,治療2周后給予患者第二次評定,采用臨床神經功能缺損評分、改良Fugl-Meyer運動功能評分、Barthel旨數進行評價,并采用經顱多普勒(TCD)探測患者患側大腦中動脈(MCA),觀察其平均血流速度(Vm)值和脈動指數(PI)值。采用spss16.0軟件對觀察數據進行統(tǒng)計學分析,比較兩組間觀察指標的改善情況。結果：1.治療組與對照組組內比較,治療后患者的臨床神經功能缺損評分、改良Fugl-Meyer運動功能評分、Barthel指數與治療前比較,差異均具有統(tǒng)計學意義(P0.05)。2.經治療后,治療組的Barthel指數得分與對照組比較,差異無統(tǒng)計學意義(P0.05),但是治療組的臨床神經功能缺損評分、改良Fugl-Meyer運動功能評分與對照組比較,差異具有統(tǒng)計學意義(P0.05)。3.治療組和對照組經治療后,患者患側MCA的Vm、PI值與治療前比較,差異均具有統(tǒng)計學意義(P0.05)。4.經治療后,治療組患側MCA的Vm與對照組比較,差異具有統(tǒng)計學意義(P0.05)；治療組患側MCA的PI值與對照組比較,差異無統(tǒng)計學意義(P0.05)。結論：臨床上治療腦梗塞患者時,在西醫(yī)常規(guī)治療、中藥以及針灸的治療基礎上,加用樞經推拿法,能夠更好的改善患者神經功能缺損程度、運動功能及患側大腦中動脈的血流速度,值得臨床推廣。
[Abstract]:Objective: to investigate the effect of armature meridian massage therapy on motor function and cerebral hemodynamics in patients with cerebral infarction. In order to improve the left limb dysfunction, reduce the disability rate and improve the quality of life of patients with cerebral infarction, 60 patients with cerebral infarction who met the inclusion criteria were selected and randomly divided into treatment group and control group with 30 cases in each group. The control group was given routine basic treatment and conventional massage therapy for cerebral infarction, while the treatment group was given routine basic treatment and armature massage therapy for cerebral infarction. The patients were evaluated for the first time within 24 hours before treatment. After 2 weeks of treatment, the patients were assessed for the second time. The clinical neurological impairment score and the modified Fugl-Meyer motor function score were used to evaluate the number of Barthel scores. The mean blood flow velocity (Vm) and pulsation index (Pi) were measured by transcranial Doppler imaging (TCD) in the middle cerebral artery (MCA) of the affected side. The observed data were statistically analyzed by spss16.0 software. Results: 1.Compared with the control group, the clinical neurological deficit score, modified Fugl-Meyer motor function score and Barthel index were compared between the treatment group and the control group. After treatment, the scores of Barthel index in the treatment group were not significantly different from those in the control group (P 0.05), but the clinical neurological deficit score and the modified Fugl-Meyer motor function score in the treatment group were compared with those in the control group. The difference was statistically significant (P < 0.05). After treatment, the MCA of the patients in the treatment group and the control group were compared with those before treatment, and the differences were statistically significant. 4. After treatment, the VM of MCA in the treatment group was higher than that in the control group. There was no significant difference in Pi value of MCA between the treatment group and the control group. Conclusion: in clinical treatment of cerebral infarction patients, on the basis of routine western medicine treatment, traditional Chinese medicine and acupuncture treatment, there is no significant difference in Pi value between the treatment group and the control group. The application of armature massage can improve the degree of nerve function defect, motor function and blood flow velocity of the affected middle cerebral artery, which is worth popularizing in clinic.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R743.3

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