Effect of Tuina Manipulation at Different Intervening Time for Limb Disorder in Ischemic Stroke Patients
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摘要:
目的:通过多中心、随机、对照的临床研究观察不同介入时间推拿手法对脑卒中患者肢体障碍的影响。方法:选取在杭州市第一人民医院、浙江中医药大学附属第三医院及余姚市中医医院针灸推拿康复科就诊的脑卒中肢体障碍患者,共120 例。按随机数字表法分为2 组各60 例。观察组在发病后7~14 d 的时间段开始采用推拿手法,对照组为在发病后14~30 d 的时间段开始采用推拿手法。比较治疗前及治疗8 周后神经功能缺损程度评定标准(NFDS)、Berg 平衡量表(BBS)、10 m 最大步行速度(10 m MWS)、简式Fugl-Meyer(FMA) 及改良的Barthel(MBI) 指数量表的评分,评估不同介入时间的推拿手法对脑卒中肢体障碍的影响。结果:治疗后,2 组NFDS、BBS、10 m MWS、FMA、MBI 评分均较治疗前明显改善,差异均有统计学意义(P<0.05)。治疗后,观察组NFDS 评分与对照组比较,明显下降,差异有统计学意义(P<0.05);观察组BBS、10 m MWS、FMA 评分、MBI 分别与对照组比较,均明显升高,差异均有统计学意义(P<0.05)。结论:在早期7~14 d 时间段开始对脑卒中肢体障碍患者采用推拿干预后,不仅可提早促进神经恢复,还可提高步行能力、平衡功能和运动能力,有效提高日常生活能力。
Abstract:
Abstract:Objective:To observe the effect of tuina manipulation at different intervening time for limb disorder in stroke patients through a multicenter, randomized and controlled clinical study. Methods: A total of 120 cases of stroke patients with limb disorder, who were treated in Acupuncture- Moxibustion and Tuina Rehabilitation Department of Hangzhou First People's Hospital, the Third Affiliated Hospital of Zhejiang Traditional Chinese Medicine University and Yuyao Hospital of Traditional Chinese Medicine, were selected and divided into two groups according to the random number table method, with 60 cases in each group. The observation group was treated with tuina manipulation from the 7th to 14th days after diagnosis;the control group was treated with tuina manipulation from the 14th to 30th days after diagnosis. Before treatment and after eight-week treatment,the scores of Neurological Function Defect Scale(NFDS),Berg Balance Scale(BBS),10 m maximum walking speed(10 m MWS), Fugl- Meyer Assessment(FMA) and Modified Barthel Index(MBI) were compared, and the effect of tuina manipulation at different intervening time for limb disorder in stroke patients was evaluated. Results: After treatment, the scores of NFDS, BBS, 10 m MWS, FMA and MBI in the two groups were significantly improved when compared with those before treatment,differences being significant(P<0.05). After treatment,the NFDS score in the observation group was significantly decreased when compared with that in the control group, the difference being significant(P<0.05); the scores of BBS, 10 m MWS,FMA and MBI in the observation group were significantly increased when compared with those in the control group,differences being significant(P<0.05). Conclusion:In the early 7th to 14th days,tuina intervention for stroke patients with limb disorder can not only promote their nerve recovery,but also improve walking ability,balance function and motor ability,and effectively improve the ability of daily living.