文章摘要

强制性运动疗法联合丁苯酞对老年脑梗死恢复期患者上肢运动功能、认知功能和日常生活能力的影响

作者: 1邱锦芳, 1郭峰, 1林军
1 厦门大学附属中山医院干部保健科，福建 厦门 361000
通讯: 邱锦芳 Email: qiu18352975560@163.com
DOI: 10.3978/j.issn.2095-6959.2022.12.009
基金: 厦门市医疗卫生指导性项目(3502Z20209040)。

摘要

目的：探讨强制性运动疗法(constraint-induced movement therapy，CIMT)联合丁苯酞对老年脑梗死患者上肢运动功能、认知功能和日常生活能力的影响。方法：选取2018年6月至2021年6月于厦门大学附属中山医院就诊的老年脑梗死恢复期患者108例，随机分为对照组(n=36)、CIMT组(n=36)和联合组(n=36)；3组均接受常规康复治疗，CIMT组辅以CIMT训练，联合组辅以CIMT联合丁苯酞治疗。于治疗前及治疗4周后，采用Fugl-Meyer评定量表上肢部分(Fugl-Meyer Assessment Upper Extremity，FMA-UE)、Carroll上肢功能测试(Upper Extremity Function Test，UEFT)评估患者上肢运动功能，采用简易智力状态量表(Mini-Mental State Examination，MMSE)、蒙特利尔认知评估量表(Montreal Cognitive Assessment，MoCA)评价患者认知功能，采用改良Barthel指数量表(Modified Barthel Index，MBI)、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale，NIHSS)评价患者的日常生活能力和神经功能。结果：治疗后，3组FMA-UE、UEFT、MMSE、MoCA、MBI评分均显著提高(均P<0.05)，CIMT组显著高于对照组(P<0.05)，联合组显著高于CIMT组和对照组(P<0.05)；且治疗前后FMA-UE、UEFT、MMSE、MoCA、MBI评分差值比较，联合组>CIMT组>对照组(均P<0.05)。治疗后，3组NHISS评分均显著降低(均P<0.05)，CIMT组显著低于对照组(P<0.05)，联合组显著低于CIMT组和对照组(P<0.05)；且治疗前后NHISS评分差值比较，联合组>CIMT组>对照组(P<0.05)。结论：CIMT联合丁苯酞能够有效改善老年脑卒中患者上肢运动功能和认知功能，提高日常生活能力，促进神经功能恢复。
关键词： 脑卒中；老年人；强制性运动疗法；丁苯酞；上肢运动功能；认知功能

Effect of constraint-induced movement therapy combined with butylphthalide on limb motor function, cognitive function and daily living ability of elderly patients with cerebral infarction in recovery period

Authors: 1QIU Jinfang, 1GUO Feng, 1LIN Jun
1 Department of Health Care, Zhongshan Hospital Affiliated to Xiamen University, Xiamen Fujian 361000, China

CorrespondingAuthor: QIU Jinfang Email: qiu18352975560@163.com

DOI: 10.3978/j.issn.2095-6959.2022.12.009

Foundation: This work was supported by the Xiamen Medical and Health Guidance Project, China (3502z20209040).

Abstract

Objective: To investigate the effect of constraint-induced movement therapy (CIMT) combined with butylphthalide on upper limb motor function, cognitive function, and daily living ability of elderly patients with cerebral infarction. Methods: From June 2018 to June 2021, 108 elderly patients in the recovery period of cerebral infarction who were treated at Zhongshan Hospital Affiliated to Xiamen University were selected and randomly divided into a control group (n=36), a CIMT group (n=36), and a combined group (n=36). All 3 groups received routine rehabilitation treatment, CIMT group was supplemented with CIMT training, and the combined group was supplemented with CIMT combined with butylphthalide. Before the treatment and 4 weeks after the treatment, the Fugl-Meyer Assessment Upper Extremity (FMA-UE) and Carroll Upper Extremity Function Test (UEFT) were used to evaluate the upper limb motor function of patients. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate the cognitive function of patients, and Modified Barthel Index (MBI) and National Institutes of Health Stroke Scale (NIHSS) were used to evaluate the daily living ability and neurological function of patients. Results: After the treatment, the scores of FMA-UE, UEFT, MMSE, MoCA, and MBI in the 3 groups were significantly improved (all P<0.05). The scores in the CIMT group were significantly higher than those in the control group (P<0.05). The scores in the combined group were significantly higher than those in the CIMT group and the control group (P<0.05). Comparison of FMA-UE, UEFT, MMSE, MoCA, and MBI scores before and after the treatment showed the combined group > the CIMT group > the control group (all P<0.05). After the treatment, the NHISS scores of the 3 groups were significantly decreased (P<0.05), with the score of the CIMT group significantly lower than that of the control group (P<0.05), and the score of the combined group significantly lower than that of the CIMT group and the control group (P<0.05). Comparison of NHISS score before and after the treatment showed the combined group > the CIMT group > the control group (P<0.05). Conclusion: CIMT combined with butylphthalide can effectively improve the upper limb motor function, cognitive function, and daily living ability, and promote the recovery of neurological function of elderly patients with cerebral infarction.

Keywords： cerebral infarction; the elderly; constraint-induced movement therapy; butylphthalide; upper limb motor function; cognitive function

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