针刺结合作业治疗对脑卒中单侧忽略后综合功能的影响

目的:探讨针刺结合个体化作业治疗对脑卒中单侧忽略患者综合功能的疗效。方法:对入住本院的脑卒中后偏瘫患者进行神经心理学评测,确定65例右大脑半球卒中后单侧空间忽略患者,随机分为3组:其中20例接受常规康复治疗为对照组,22例在常规康复基础上予个体化作业治疗为观察组,23例常规康复治疗同时予针刺结合作业治疗为实验组。3组患者治疗前后分别予功能独立性评定(FIM)、Fugl-Meyer运动功能评定(FMA)、简易精神状态检查(MMSE)。结果:①观察组和实验组治疗后FIM、FMA、MMSE评分组明显高于治疗前,对照组治疗前后无明显差异。②3组治疗前后FIM、FMA、MMSE评分差值的平均效应不全相同,经过两两比较,实验组FIM、FMA、MMSE评分差值均高于观察组和对照组,观察组3项评分差值均高于对照组。结论:在常规康复治疗基础上采取针刺治疗和个体化作业治疗能显著提高脑卒中后单侧空间忽略患者的康复疗效。

Effects of acupuncture and occupational therapy on the comprehensive function of patients with unilateral spatial neglect after stroke

Abstract Objective: To explore the effects of acupuncture and occupational therapy on the comprehensive function of patients with unilateral spatial neglect(USN) after stroke. Method: Stroke patients with hemiplegia were evaluated by neuropsychological tests and 65 right hemispheric stroke patients out of them were identified with USN. These patients with USN were randomly assigned to 3 groups: 20 patients as a control group received conventional rehabilitation therapy, 22 patients as an observation group received type-specific occupational therapy while received conventional rehabilitation therapy, the remain patients as an experiment group received acupuncture combined with both of conventional and occupational therapies. These three groups were evaluated by Fugl-Meyer motor assessment scale(FMA), functional independence measure(FIM), and mini mental status examination(MMSE) before and after rehabilitation. Result: The patients both in observation group and experiment group had significantly higher scores of FIM,FMA,MMSE after treatment, but no statistically significant difference were observed in control group. The effects of mean increased scores of FIM,FMA,MMSE were not equal in the three groups before and after treatment. The increased scores in experiment group were significantly higher than the scores in the other groups.Conclusion: Acupuncture and occupational therapy can greatly improve the effects on the comprehensive function of patients with USN after stroke.