Abstract:

Objective　To observe the effects of traditional Chinese medicine (TCM) acupuncture combined with Otago exercise on psychological disorders and quality of life in stroke patients. Methods　This study was a randomized controlled trial. A total of 130 stroke patients with severe psychological disorders admitted to the Department of Neurology of Baoji Central Hospital from January 2020 to May 2023 were selected as the study objects. The patients were divided into a combined treatment group (65 cases) and a control group (65 cases) using the random number table method. In the control group, there were 33 males and 32 females, aged (65.47±8.61) years, and the course of disease was (16.89±3.62) months. In the combined treatment group, there were 34 males and 31 females, aged (66.52±7.99) years, and the course of disease was (15.91±4.23) months. The control group received conventional basic neuropharmacological treatment, and the combined treatment group received TCM acupuncture combined with Otago exercise on the basis of the control group. Both groups were treated for 4 weeks. The stroke recovery [National Institutes of Health Stroke Scale (NIHSS) and Mini-Mental State Examination (MMSE)], cognitive function and language function [Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE)], psychological recovery [Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD)], and daily living ability and quality of life [Barthel Index of daily living ability (BI) and World Health Organization Quality of Life Assessment (WHOQOL-BREF)] were compared between the two groups before and after treatment. Independent sample t test and χ² test were used for statistical analysis. Results　After treatment, the NIHSS score of the combined treatment group was lower than that of the control group [(8.85±2.89) points vs. (10.22±3.14) points], and the MMSE score was higher than that of the control group [(17.73±3.07) points vs. (15.82±3.62) points] (both P<0.05); the CRRCAE scores in the combined treatment group were higher than those in the control group (all P<0.05); the HAMD and HAMA scores in the combined treatment group were lower than those in the control group [(10.89±2.93) points vs. (12.81±3.62) points, (11.62±2.45) points vs. (13.09±3.52) points] (both P<0.05); the BI and WHOQOL-BREF scores in the combined treatment group were higher than those in the control group [(88.54±11.34) points vs. (83.26±15.13) points, (85.43±11.39) points vs. (79.74±10.62) points] (both P<0.05). Conclusion　TCM acupuncture combined with Otago exercise can improve the psychological disorders and quality of life in stroke patients.

Key words:

Stroke, Acupuncture, Otago exercise, Psychological disorders

摘要：

目的　探究中医针灸联合Otago运动对脑卒中康复患者心理障碍及生活质量的影响。方法　本研究为随机对照试验，选取2020年1月至2023年5月宝鸡市中心医院神经内科收治的130例心理障碍脑卒中患者作为研究对象。采用随机数字表法，将患者分为联合治疗组（65例）和对照组（65例）。对照组男33例，女32例；年龄（65.47±8.61）岁；病程（16.89±3.62）个月。联合治疗组男34例，女31例；年龄（66.52±7.99）岁；病程（15.91±4.23）个月。对照组采用神经内科常规药物治疗，联合治疗组在对照组基础上采用中医针灸联合Otago运动治疗。两组均治疗4周。比较两组治疗前后脑卒中恢复情况［美国国立卫生研究院卒中量表（NIHSS）、简易智力状态检查量表（MMSE）］、认知功能及语言功能［中国康复研究中心汉语标准失语症检查量表（CRRCAE）］、心理恢复情况［汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）］、日常生活自理能力和生活质量［日常生活能力Barthel指数（BI）、世界卫生组织生存质量测定量表（WHOQOL-BREF）］。采用独立样本t检验和χ²检验进行统计学分析。结果　治疗后，联合治疗组NIHSS评分低于对照组［（8.85±2.89）分比（10.22±3.14）分］，MMSE评分高于对照组［（17.73±3.07）分比（15.82±3.62）分］（均P<0.05）；联合治疗组CRRCAE各项目评分均高于对照组（均P<0.05）；联合治疗组HAMD和HAMA评分均低于对照组［（10.89±2.93）分比（12.81±3.62）分、（11.62±2.45）分比（13.09±3.52）分］（均P<0.05）；联合治疗组BI和WHOQOL-BREF评分均高于对照组［（88.54±11.34）分比（83.26±15.13）分、（85.43±11.39）分比（79.74±10.62）分］（均P<0.05）。结论　中医针灸联合Otago运动可改善脑卒中患者心理障碍和生活质量。

关键词:

脑卒中, 针灸, Otago运动, 心理障碍