本文選題：搖扳法　切入點(diǎn)：缺血性腦卒中　出處：《黑龍江中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：觀察搖扳法改善缺血性腦卒中后上肢運(yùn)動(dòng)功能的臨床療效。方法：將60例缺血性腦卒中后有上肢運(yùn)動(dòng)功能障礙的患者,隨機(jī)分為觀察組和對(duì)照組,每組30例,其中觀察組的治療方法是常規(guī)系統(tǒng)藥物、針灸、物理因子治療、運(yùn)動(dòng)療法、作業(yè)療法、搖扳法治療：對(duì)照組的治療方法是臨床常用推拿手法治療,其他同觀察組。應(yīng)用改良Barthel指數(shù)評(píng)分、神經(jīng)功能缺損程度評(píng)分中的上肢評(píng)分、Fugl-Meyer運(yùn)動(dòng)功能評(píng)分(上肢)及改良Ashworth分級(jí)法評(píng)分對(duì)患者治療前后進(jìn)行系統(tǒng)評(píng)價(jià),來比較兩種治療方法的臨床效果。結(jié)果：(1)觀察組與對(duì)照組治療前組間比較改良Barthel指數(shù),P0.05,無顯著差異,提示二組治療前無差別,具有可比性；二組治療前后組內(nèi)比較, P0.05,有統(tǒng)計(jì)學(xué)意義,提示二組治療前后組內(nèi)評(píng)分有顯著差異；二組治療后組間比較,P0.05,無顯著差異,二組治療后差別不明顯。(2)觀察組與對(duì)照組治療前組間比較神經(jīng)功能缺損程度評(píng)分中的上肢評(píng)分,P0.05,無顯著差異,提示二組治療前無差別,具有可比性；二組治療前后組內(nèi)比較, P0.05,提示二組治療前后組內(nèi)評(píng)分有顯著差異；觀察組與對(duì)照組治療后組間比較,P0.05,無統(tǒng)計(jì)學(xué)意義,提示二組治療后無顯著差異。(3)觀察組與對(duì)照組治療前組間比較Fugl-Meyer運(yùn)動(dòng)功能評(píng)分(上肢),P0.05,無顯著差異,提示二組治療前無差別,具有可比性；二組治療前后組內(nèi)比較, P0.05,有統(tǒng)計(jì)學(xué)意義,提示二組治療前后組內(nèi)評(píng)分有顯著差異；觀察組與對(duì)照組治療后組間比較,P0.05,無顯著差異,二組治療后差別不明顯。(4)觀察組與對(duì)照組治療前組間比較改良Ashworth分級(jí)法評(píng)分,P0.05,無顯著差異,提示二組治療前無差別,具有可比性；二組治療前后組內(nèi)比較, P0.05,有統(tǒng)計(jì)學(xué)意義,提示二組治療前后組內(nèi)評(píng)分有顯著差異；觀察組與對(duì)照組治療后組間比較,P0.05,有顯著差異,提示改良Ashworth分級(jí)法評(píng)分觀察組優(yōu)于對(duì)照組。結(jié)論：1.兩種治療方法均可有效改善缺血性腦卒中后上肢運(yùn)動(dòng)功能障礙,改善其日常生活能力,降低神經(jīng)功能缺損程度。2.搖扳法可明顯提高缺血性腦卒中患者上肢肌張力,治療效果優(yōu)于對(duì)照組,適合臨床推廣應(yīng)用。
[Abstract]:Objective: to observe the clinical effect of wrench on the motor function of upper limb after ischemic stroke. Methods: sixty patients with upper limb motor dysfunction after ischemic stroke were randomly divided into observation group and control group with 30 cases in each group. The treatment methods in the observation group are routine systemic drugs, acupuncture, physical factor therapy, exercise therapy, occupational therapy, and wriggle therapy. In the control group, the treatment methods are massage manipulation commonly used in clinic. In the other observation groups, the patients were systematically evaluated before and after treatment with the modified Barthel index, the upper limb score and the Fugl-Meyer motor function score (upper limb) and the modified Ashworth scoring method before and after treatment. Results there was no significant difference in the modified Barthel index (P0.05) between the observation group and the control group before treatment, suggesting that there was no difference and comparability between the two groups before treatment. There was significant difference in the scores between the two groups before and after treatment, indicating that there was no significant difference in the scores between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment. There was no significant difference between the two groups after treatment. (2) there was no significant difference in the upper limb score between the observation group and the control group before treatment, indicating that there was no difference and comparability between the two groups before treatment. The comparison between the two groups before and after treatment indicated that there was a significant difference in the scores between the two groups before and after treatment, and there was no significant difference between the observation group and the control group after treatment. It was suggested that there was no significant difference between the two groups after treatment. (3) the Fugl-Meyer motor function score (P0.05, P 0.05) between the observation group and the control group before treatment was not significantly different, suggesting that there was no difference between the two groups before treatment and was comparable. There was significant difference in the scores between the two groups before and after treatment, which indicated that there was no significant difference between the observation group and the control group after treatment. There was no significant difference between the observation group and the control group before treatment, indicating that there was no significant difference between the two groups before treatment, suggesting that there was no difference between the two groups before and after treatment, and the comparison between the two groups before and after treatment had statistical significance. The results indicated that there were significant differences in the scores between the two groups before and after treatment, and there were significant differences between the observation group and the control group after treatment. The results suggest that the modified Ashworth grading method is superior to the control group. Conclusion the two treatment methods can effectively improve the motor dysfunction of upper limbs and improve the ability of daily living after ischemic stroke. The method of shaking and pulling can obviously increase the muscle tension of the upper limb of the patients with ischemic stroke, and the therapeutic effect is better than that of the control group, which is suitable for clinical application.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.6

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