目的:探讨热敏灸联合康复护理对中风患者神经功能、运动功能及生活能力的影响。方法:选取2018年1月—2020年9月本院收治的中风患者148例作为研究对象,采用随机数字表法分为研究组与对照组,每组各74例。对照组采用常规性护理干预,研究组采用热敏灸联合康复护理,所有患者均护理6个月;观察两组患者护理效果及护理前、护理6个月后神经功能、运动能力、生活能力及并发症(压疮、感染、深静脉血栓、关节痉挛)。结果:研究组护理总有效率高于对照组,差异有统计学意义(P＜0.05);护理6个月后,两组NIHSS评分低于护理前、Fuel Meyer评分、Barthel指数高于护理前,且研究组NIHSS评分低于对照组,而Fuel Meyer评分、Barthel指数高于对照组,差异有统计学意义(P＜0.05);研究组并发症发生率低于对照组,差异有统计学意义(P＜0.05)。结论:热敏灸配合康复护理可改善患者神经功能、运动功能及生活能力,降低压疮、感染、下肢深静脉血栓等并发症发生。
Objective: To explore the effect of heat-sensitive moxibustion combined with rehabilitation nursing on the neurological function, motor function and living ability of stroke patients. Methods: 148 stroke patients treated in our hospital from January 2018 to September 2020 were selected as the research object. They were randomly divided into the research group and the control group, with 74 cases in each group. The control group was treated with routine nursing intervention, and the research group was treated with thermal moxibustion combined with rehabilitation nursing. All patients were treated for 6 months;The nursing effect, neurological function, motor ability, living ability and complications (pressure ulcer, infection, deep venous thrombosis and joint spasm) were observed before and 6 months after nursing. Results: the total effective rate of nursing in the study group was higher than that in the control group (P＜0.05); After 6 months of nursing, the NIHSS score of the two groups was lower than that before nursing, the fuel Meyer score and Barthel index were higher than that before nursing, and the NIHSS score of the study group was lower than that of the control group, but the fuel Meyer score and Barthel index were higher than that of the control group (P＜0.05); The incidence of complications in the study group was significantly lower than that in the control group (P＜0.05). Conclusion: Heat-sensitive moxibustion combined with rehabilitation nursing can improve patients' neurological function, motor function and living ability, and reduce complications such as pressure ulcers, infections, and deep vein thrombosis.
[1] 陈美芬, 王苏英, 冯小红,等. 不同年龄和性别脑卒中高危人群的危险因素调查分析[J]. 实用预防医学, 2020, 27(4):73-76.
[2] Moore JL, Nordvik JE, Erichsen A,et al. Implementation of high-Intensity stepping training during inpatient stroke rehabilitation improves functional outcomes[J]. Stroke, 2020 ,51(2):563-570.
[3] 王明振, 孙忠人, 邹儒文,等. 热敏灸治疗神经系统疾病的研究进展[J]. 中华中医药杂志, 2019, 034(4):1599-1601.
[4] 郭晋斌. 卒中:中西医临床实践[M]. 北京:科学技术文献出版社, 2015:104-105.
[5] 承澹盦. 中国针灸学[M]. 北京:人民卫生出版社, 2008:367-368.
[6] Kwah LK, Diong J.National Institutes of Health Stroke Scale (NIHSS) [J].J Physiother, 2014, 60(1):61.
[7] 韩振廷, 韩庆国, 韩庆华,等. 中风病辩证论治[M]. 北京:中医古籍出版社, 2006:281-283.
[8] Hernández ED, Galeano CP, Barbosa NE,et al. Intra- and inter-rater reliability of Fugl-Meyer Assessment of Upper Extremity in stroke[J]. J Rehabil Med,2019, 51(9):652-659.
[9] Williams G . Barthel Index[M]. America:Encyclopedia of Clinical Neuropsychology,2017:143-144.
[10] 庞博, 杨丰文, 欧益,等. 中药干预中风临床证据年度分析[J]. 世界中医药, 2019, 14(12):48-52.
[11] 窦材集. 扁鹊心书[M]. 北京:中国医药科技出版社, 2011:118-120.
[12] 谢丁一, 陈彦奇, 李巧林,等. 陈日新热敏灸临床安全操作经验[J]. 中华中医药杂志, 2020, 35(4):255-257.
[13] 倪小佳,陈耀龙,蔡业峰. 中西医结合脑卒中循证实践指南(2019)[J]. 中国循证医学杂志, 2020, 20(8):39-50.
[14] 吴杰, 李佩芳, 王涛,等. 通督调神针法配合热敏灸治疗脑卒中后痉挛性瘫痪40例[J]. 安徽中医药大学学报, 2020,2(4): 52-56.
[15] 朱学亮, 檀占娜, 李伯英,等. 近年热敏灸疗法的研究概况[J]. 国际中医中药杂志, 2016, 38(2):190-192.
[16] 王玲, 叶陪青, 刘连春,等. 中医康复护理对脑卒中患者生活能力及神经功能的影响[J]. 新中医, 2020, 554(7):153-155.
[17] Gueye T, Dedkova M, Rogalewicz V,et al. Early post-stroke rehabilitation for upper limb motor function using virtual reality and exoskeleton: equally efficient in older patients[J]. Neurol Neurochir Pol, 2021,55(1):91-96.
