易-和康复技术改善缺血性中风痉挛性偏瘫随机对照研究

金贺; 郑斌; 陈红; 王雅惠; 韩笑; 江澜; 张勇; 耿花蕾; 王月; 邹忆怀

doi:10.3969/j.issn.2095-6606.2021.02.006

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易-和康复技术改善缺血性中风痉挛性偏瘫随机对照研究

临床研究 | 更新时间：2021-05-20

- 易-和康复技术改善缺血性中风痉挛性偏瘫随机对照研究
- 暂无标题
- 现代中医临床 2021年28卷第2期页码：25-29
- 作者机构：
  
  1.北京中医药大学东直门医院　北京　 100700
  2.北京朝阳医院
  3.北京中医药大学
  4.北京协和医院
- 作者简介：
  
  金贺，男，在读博士生
  #邹忆怀，男，教授、主任医师，博士生导师，E-mail：zouyihuai2004@163.com
- 基金信息：
  
  北京市科技计划课题(No.Z141107002514145)()
- DOI：10.3969/j.issn.2095-6606.2021.02.006
  中图分类号： R247.9
- 纸质出版日期：2021-03-30，
  
  收稿日期：2020-09-21，
- 稿件说明：
移动端阅览
金贺, 郑斌, 陈红, 等. 易-和康复技术改善缺血性中风痉挛性偏瘫随机对照研究[J]. 现代中医临床, 2021,28(2):25-29.
金贺, 郑斌, 陈红, 等. 易-和康复技术改善缺血性中风痉挛性偏瘫随机对照研究[J]. 现代中医临床, 2021,28(2):25-29. DOI： 10.3969/j.issn.2095-6606.2021.02.006.

DOI：

摘要

目的

观察易－和康复技术改善缺血性中风后痉挛性偏瘫的临床疗效。

方法

将171例缺血性中风后痉挛性偏瘫的患者，通过中央随机系统按2∶1比例将患者随机分为治疗组114例、对照组57例。其中，治疗组脱落17例，完成病例观察97例，脱落率为14.9%；对照组脱落8例，完成病例观察49例，脱落率为14.0%。治疗组采用易－和康复技术。对照组采用Bobath康复技术。采用Brunnstrum评价量表评价患者肢体改善程度，观察患侧肢体运动功能评级。

结果

对2组左上肢4个时间点运动功能评级行广义估计方程检验，参数估计结果显示：①组间比较结果：Wald

=5.244，

0.05，组间差异有统计学意义，2种疗法疗效不同，治疗组疗效优于对照组；②重复测量时间比较结果示：Wald

=44.313，

0.05，时间差异有统计学意义，治疗在不同时间的效果不同。对2组右上肢4个时间点运动功能评级行广义估计方程检验，参数估计结果显示：①组间比较结果：Wald

=9.563，

0.05，组间差异有统计学意义，2种疗法疗效不同，治疗组疗效优于对照组；②重复测量时间比较结果：Wald

=44.313，

0.05，时间差异有统计学意义，治疗在不同时间点的效果不同。分别对2组左下肢、右下肢4个时间点运动功能评级行广义估计方程检验，参数估计结果显示组间差异均无统计学意义。在治疗期间未观察到与治疗相关的严重不良事件。

结论

2种康复技术均可有效提高患者的肢体功能，易－和康复技术更有助于促进缺血性中风患者上肢的分离运动。

Abstract

Objective

To observe the clinical efficacy of Facility-balance rehabilitation on spastic hemiplegia after ischemic stroke.

Methods

A total of 171 patients with spastic hemiplegia after ischemic stroke were randomly assigned to the intervention group (

=114) and control group (

=57) according to the proportion of 2∶1 in the central random system. Brunnstrum rating was used to evaluate and compare the efficacy.

Results

The efficacies of the two therapies were analyzed by generalized estimation equation. Main results of left upper limb were listed as follows: ① results of inter group comparison: Wald

=5.244

0.05; ② comparison results of repeated measurement time: Wald

=44.313

0.05. Main results of right upper limb: ① results of inter group comparison: Wald

=9.563

0.05; ② comparison results of repeated measurement time: Wald

=44.313

0.05. No serious adverse events were found.

Conclusions

The two rehabilitation techniques can effectively improve the limb function of patients

and Facility-balance rehabilitation technology is more helpful to promote the upper limb separation movement of patients with ischemic stroke

which is safe and has no side effects.

关键词

中医康复技术Bobath康复技术中风病康复缺血性中风痉挛性偏瘫

Keywords

traditional Chinese medicine rehabilitation technologyBobath rehabilitation technologystroke rehabilitationlimb spasm after ischemic stroke

references

WU S M, WU B, LIU M, et al. Stroke in China: advances and challenges in epidemiology, prevention and management[J].Lancet Neurol, 2019,18(4):394-405.

DIETZ V, SINKJAER T. Spastic movement disorder: impaired reflex function and altered muscle mechanics[J].Lancet Neurol, 2007,6(8):725-733.

LAZORTHES Y, SOL J C, SALLERIN B, et al.The surgical management of spasticity[J].Eur J Neurol, 2002,9(S1):35-41.

NIELSEN J B, CRONE C, HULTBORN H.The spinal pathophysiology of spasticity－from a basic science point of view[J].Acta Physiol, 2007,189:171-180.

URBAN P P, WOLF T, EBELE M, et al.Occurence and clinical predictors of spasticity after ischemic stroke[J].Stroke, 2010,41(9):2016-2020.

RUSH R, KUMBHARE D.Spasticity[J].CMAJ, 2015,187(6):436.

SUNNERHAGEN K S, OLEVER J, FRANCISCE G E.Assessing and treating functional impairment in poststroke spasticity[J].Neurology, 2013,80(S2):S35-S44.

TEASELL R, SALBACH N M, FOLEY N, et al.Canadian stroke best practice recommendations: rehabilitation, recovery, and community participation following stroke.Part one: rehabilitation and recovery following stroke: 6th edition update 2019[J].Int J Stroke, 2020,15(7):763-788.

CHAVEZ L M, HUANG S S, MACDONALD I, et al.Mechanisms of acupuncture therapy in ischemic stroke rehabilitation: a literature review of basic studies[J/OL].Int J Mol Sci, 2017，18(11): 2270[2020-07-22].https://pubmed.ncbi.nlm.nih.gov/29143805/https://pubmed.ncbi.nlm.nih.gov/29143805/.

WANG M, LIU S, PENG Z, et al.Effect of Tui Na on upper limb spasticity after stroke: a randomized clinical trial[J].Ann Clin Transl Neurol, 2019,6(4):778-787.

ZHANG Y, JIN H, MA D Y, et al.Efficacy of integrated rehabilitation techniques of traditional chinese medicine for ischemic stroke: a randomized controlled trial[J].Am J Chin Med, 2013,41(5):971-981.

BISHOP L, KITAGO T.Getting involved in research with stroke rehabilitation technologies[J].Stroke, 2019,50(2):e28-e30.

UIVAROASN D, TIT D M, IOVAN C, et al.Effects of combining modern recovery techniques with neurotrophic medication and standard treatment in stroke patients[J].Sci Total Environ, 2019,679(8):80-87.

中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学，2011,14(35):4013-4017.

CAURAUAG J H, SUMMERS J J.Neural plasticity and bilateral movements: a rehabilitation approach for chronic stroke[J].Prog Neurobiol, 2005,75(5):309-320.

THOMSA L H, FRENCH B, COUPE J, et al.Repetitive task training for improving functional ability after stroke[J].Stroke，2017,48(4):e102-e103.

MICHIELSEN M, VAUGHAN G J, HOLLAND A, et al.The Bobath concept-a model to illustrate clinical practice[J].Disabil Rehabil, 2019,41(17):2080-2092.

HUANG C Y, LIN G H, HUANG Y J, et al.Improving the utility of the brunnstrom recovery stages in patients with stroke: validation and quantification[J/OL].Medicine (Baltimore), 2016，95(31): e4508[2020-08-01].https://pubmed.ncbi.nlm.nih.gov/27495103/https://pubmed.ncbi.nlm.nih.gov/27495103/.

HAN F, AMATYA B, BENSMAIL D, et al.Non-pharmacological interventions for spasticity in adults: an overview of systematic reviews[J].Ann Phys Rehabil Med, 2019,62(4):265-273.

ZHU Y, YANG Y, LI J.Does acupuncture help patients with spasticity? a narrative review[J].Ann Phys Rehabil Med, 2019,62(4):297-301.

LIM S M, YOO J, LEE E, et al.Acupuncture for spasticity after stroke: a systematic review and meta-analysis of randomized controlled trials[J/OL].Evidence-based complementary and alternative medicine, 2015, 2015: 870398[2020-08-01].https://pubmed.ncbi.nlm.nih.gov/25628750/https://pubmed.ncbi.nlm.nih.gov/25628750/.

邹忆怀，李宗衡，张华，等.王永炎教授“松”与“静”的观点在偏瘫康复中的应用[J].中国医药学报，2004,19(9):540-541.

刘宏伟.体用通和康复训练法治疗缺血性中风偏瘫痉挛状态的临床疗效观察[D].北京：北京中医药大学，2016.

BETHOUX F.Spasticity management after stroke[J].Phys Med Rehabil Clin N Am, 2015,26(4):625-639.

BROWN P.Pathophysiology of spasticity[J].J Neurol Neurosurg Psychiatry, 1994,57(5): 773-777.

LEVIN M F, SOIOMON J M, SHAH A, et al.Activation of elbow extensors during passive stretch of flexors in patients with post-stroke spasticity[J].Clin Neurophysiol, 2018,129(10):2065-2074.

BARNES M P.Medical management of spasticity in stroke[J].Age Ageing, 2001,30(Suppl 1): 13-16.

MORRIS S L, DODD K J, MORRIS M E.Outcomes of progressive resistance strength training following stroke: a systematic review[J].Clin Rehabil, 2004,18(1):27-39.

KHAN F, AMATYA B.Rehabilitation in multiple sclerosis: a systematic review of systematic reviews[J].Arch Phys Med Rehabil, 2017,98(2):353-367.

AMANO S, TAKEBAYASHI T, HANADA K, et al.Constraint-induced movement therapy after injection of botulinum toxin type A for a patient with chronic stroke: one-year follow-up case report[J].Phys Ther, 2015,95(7):1039-1045.

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