脑卒中偏瘫患者药熨配合中医推拿的康复护理

2005年5月-2006年5月收治的66例脑卒中偏瘫患者在神经内科常规治疗的基础上，以药熨配合中医推拿进行康复治疗及护理。药熨法：取吴茱萸50g、莱菔子50g、白芥子50苦、菟丝子50g、苏子50g干燥成熟种子放入小布袋内充分摇匀，放入微波炉内（旁边放1小杯水）用高火加热2-3min，达70～80℃，将药袋放到患肢用力来回推熨；中医推拿：由专业治疗师为患者进行穴位推拿，护士协助其进行坐站走康复练习等。连续施护8周后瘫侧上肢运动功能2级以下7例，2～4级24例，～6级35例；瘫侧下肢运动功能2级以下8例，2～4级12例，～6级46例；治疗后步行能力1级6例，2级15例，3级21例，4级24例。认为在整个康复过程中，康复护理要做好：（1）非活动时瘫痪肢体需功能位摆放；（2）预防和治疗瘫痪肢体痉挛；（3）掌握患者残存机能的范围和程度，以便指导和训练患者进行日常生活活动。药熨时掌握药袋的适宜温度，不可在皮肤病变及破损处行药熨。

Rehabilitation Nursing of Medicated Ironing Combining with TCM Massage on Hemiplegic Patients after Stroke

From May 2005 to May 2006, 66 Hemiplegic patients after stroke were given treatment and nursing by medicated ironing method combining with TCM massage on the basis of conventional treatment of neurology. After 8 weeks of nursing and treament, motor function of limbs of hemiplegic patients after strok were improved greatly. The authors argued that during the process of rehabilitation, the nursing key points included： （1）the position of paralyzed limbs; （2）prevention and treatment of spasm of paralyzed limbs; （3）understanding the remained function of paralyzed limbs so as to direct and train them about daily life acitvity. In addition, the authors pointed out that the temperature of medicated ironing should be moderate and it could not be applied on the injuried and ill skin.