针灸按摩配合综合康复护理对高血压脑出血后肢体偏瘫的影响

摘要

Objective: To analyze the influence of the therapy combining acupuncture and massage with com-prehensive rehabilitation nursing over the patients suffering from limb hemiplegia because of hypertensive cerebral hemorrhage. Methods: Overall 82 patients of limb hemiplegia due to hypertensive cerebral hemorrhage varying de-grees were randomized into two groups by concealing their admission numbers, 41 cases in each group. The control group were used the traditional method combing acupuncture, massage and rehabilitation nursing, while besides re-ceiving the treatment like the control group, the observation group were given comprehensive rehabilitation nursing according the TCM syndrome differentiation. The patient's activities of daily living and motion function were evalu-ated by modified MBI and FMA before nursing and after nursing for 3 months, 6 months and 12 months in the two groups; meanwhile the comparisons of secondary disturbance rate occurring in the patients were made in the re-search. Results: The scores of MBI and FMA in the patients of the observation group after treatment and nursing for 3 months, 6 months and 12 months were higher than that in the control group; the occurrence rates of shoulder-hand syndrome, shoulder pain, arthrogryposis of shoulder and shoulder joint subluxation in the observation group were 26.83%, 19.51%, 53.66% and 9.76% respectively, the secondary disturbance rates occurring in the patients of the observation group were markedly lower than the control group and the differences had statistical meaning in the two groups (P<0.05). Conclusion: The process of treating and nursing the patients suffering from limb hemiplegia be-cause of hypertensive cerebral hemorrhage is long and slow. The comprehensive rehabilitation nursing aiming to pa-tients' conditions and psychological state can decrease the secondary disturbance, shorten rehabilitating time and im-prove their daily-life capacity.%目的：探讨针灸、按摩配合综合康复护理对高血压脑出血后肢体偏瘫的影响。方法：将高血压脑出血伴不同程度偏瘫患者82例采用随机数字表法分为2组各41例，对照组采用常规针灸、按摩配合康复护理，观察组在此基础上结合中医辨证施护给予综合康复护理，采用改良Barthel指数(MBI)和简化Fugl-Mey-er运动功能量表(FMA)分别对护理前及护理后3个月、6个月、12个月日常生活能力和运动功能进行评价，同时比较2组继发障碍发生率。结果：观察组患者治疗与护理后3个月、6个月、12个月MBI指数、FMA评分均高于对照组；观察组肩-手综合征、肩痛、肩关节挛缩、肩关节半脱位的发生率分别为26.83%、53.66%、19.51%、9.76%，继发障碍发生率明显低于对照组，2组比较差异具有统计学意义(P＜0.05)。结论：高血压脑出血后肢体偏瘫患者的治疗与护理是长期漫长的过程，针对患者病情及心理状态进行辨证综合护理，可减少继发障碍，缩短康复时间，增强患者的日常生活能力。