肢体低频脉冲电疗法联合康复机器人对脑卒中患者认知与运动功能的影响

doi:10.3760/cma.j.issn.1007-1245.2024.17.022

摘要/Abstract

摘要：

目的　探究肢体低频脉冲电疗结合康复机器人在脑卒中患者中的应用效果。方法　选取2021年1月至2023年8月在西安中医脑病医院诊治的80例脑卒中患者进行随机对照研究，根据来院顺序进行编号，前40例为对照组，后40例为观察组。对照组：男23例、女17例，年龄46～72（56.34±6.34）岁；接受基础治疗。观察组：男25例、女15例，年龄45～72（56.64±7.25）岁；在对照组的治疗基础上另接受肢体低频脉冲电疗+康复机器人治疗。两组患者均治疗8周。评估两组治疗后临床疗效、认知功能、运动功能，以及血清脑源性神经营养因子（BDNF）和神经生长因子（NGF）水平的变化。统计学方法采用t检验、χ²检验。结果　治疗后，观察组总有效率高于对照组［92.50%（37/40）比65.00%（26/40）］，差异有统计学意义（χ²=9.04，P<0.05）；观察组美国国立卫生研究院卒中量表（NIHSS）评分低于对照组［（6.34±2.18）分比（8.29±2.57）分］，差异有统计学意义（t=3.66，P<0.05）。治疗4周与治疗结束，观察组认知功能评分均高于对照组［（20.21±5.18）分比（17.84±4.66）分、（26.81±5.49）分比（21.96±4.65）分］，差异均有统计学意义（t=2.15、4.26，均P<0.05）；观察组Fugl-Meyer运动功能评分量表（FMA）和Barthel指数评分均高于对照组［（53.75±10.37）分比（48.88±8.65）分、（63.69±13.54）分比（55.00±12.25）分、（49.64±9.62）分比（33.36±8.39）分、（73.31±11.64）分比（54.68±10.33）分］，差异均有统计学意义（t=2.28、3.01、8.07、7.57，均P<0.05）；观察组NGF和BNDF均高于对照组［（6.65±1.03）μg/L比（5.89±0.97）μg/L、（8.51±1.26）μg/L比（7.61±1.14）μg/L、（3.64±0.54）μg/L比（3.21±0.65）μg/L、（4.69±0.79）μg/L比（3.25±0.72）μg/L］，差异均有统计学意义（t=3.40、3.35、3.22、8.52，均P<0.05）。结论　肢体低频脉冲电疗结合康复机器人治疗脑卒中患者，能提高血清BDNF和NGF水平，改善患者认知功能和运动功能。

关键词:

脑卒中, 认知功能, 运动功能, 低频脉冲电疗, 康复机器人

Abstract:

Objective　To investigate the effect of low-frequency pulsed electrostimulation combined with rehabilitation robots for stroke patients. Methods　Eighty stroke patients treated at Xi'an Encephalopathy Hospital of Traditional Chinese Medicine from January 2021 to August 2023 were selected for the randomized controlled trial. They were numbered upon admission; the first 40 patients were assigned to a control group, and the latter 40 to an observation group. The observation group included 25 males and 15 females who were (56.64±7.25) years old. The control group included 23 males and 17 females who were (56.34±6.34) years old. The control group took basic treatment; in addition, the observation group took low-frequency pulsed electrostimulation and rehabilitation robot treatment. Both groups were treated 8 weeks. The clinical efficacies, cognitive function, motor function, and serum levels of brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) were evaluated. t and χ² tests were applied. Results　The effective rate in the observation group was higher than that in the control group [92.5% (37/40) vs. 65.00% (26/40)], with a statistical difference (χ²=9.04; P<0.05). The score of National Institutes of Health Stroke Scale (NIHSS) in the observation group was lower than that in the control group [(6.34±2.18) vs. (8.29±2.57)], with a statistical difference (t=3.66; P<0.05). After 4 and 8 weeks' treatment, the scores of cognitive function in the observation group were higher than those in the control group [(20.21±5.18) vs. (17.84±4.66) and (26.81±5.49) vs. (21.96±4.65)], with statistical differences (t=2.15 and 4.26; both P<0.05); the scores of Fugl-Meyer Assessment and Barthel Index in the observation group were higher than those in the control group [(53.75±10.37) vs. (48.88±8.65), (63.69±13.54) vs. (55.00±12.25), (49.64±9.62) vs. (33.36±8.39), and (73.31±11.64) vs. (54.68±10.33)], with statistical differences (t=2.28, 3.01, 8.07, and 7.57; all P<0.05); the levels of BDNF and NGF in the observation group were higher than those in the control group [(6.65±1.03) μg/L vs. (5.89±0.97) μg/L, (8.51±1.26) μg/L vs. (7.61±1.14) μg/L, (3.64±0.54) μg/L vs. (3.21±0.65)μg/L, (4.69±0.79) μg/L vs. (3.25±0.72) μg/L], with statistical differences (t=3.40, 3.35, 3.22, and 8.52; all P<0.05). Conclusion　Low-frequency pulsed electrostimulation combined with rehabilitation robots for stroke patients can improve their serum levels of BDNF and NGF and cognitive and motor functions.

Key words:

Stroke, Cognitive function, Motor function, Low-frequency pulsed electrostimulation, Rehabilitation robots

平兴团赵富强屈博仵晓莉王南陈跃.

肢体低频脉冲电疗法联合康复机器人对脑卒中患者认知与运动功能的影响 [J]. 国际医药卫生导报, 2024, 30(17): 2931-2935.

Ping Xingtuan, Zhao Fuqiang, Qu Bo, Wu Xiaoli, Wang Nan, Chen Yue.

Effect of low-frequency pulse electrostimulation combined with rehabilitation robots on cognitive and motor functions in stroke patients [J]. International Medicine and Health Guidance News, 2024, 30(17): 2931-2935.

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