手部CPM结合中西医康复治疗对偏瘫患者手部痉挛及手功能疗效的观察

孙远标　荆丽艳　程子翠　向宪文　闫虎

【摘要】 目的：观察手部连续被动训练系统（Continuous passive motion，CPM）结合中西医康复治疗对降低偏瘫患者手部痉挛以及改善手功能的作用。方法：选取2016年1月-2017年5月在本科接受康复治疗的脑中风、脑外伤后伴有手部痉挛的偏瘫患者100例，将其随机分为观察组和对照组，各50例。对照组接受常规的中西医康复治疗，观察组在对照组基础上辅以手部CPM训练，观察比较两组手部痉挛及功能的变化。结果：治疗后，两组的肌张力和FMA评分均明显优于治疗前，差异均有统计学意义（P<0.001）；且观察组的肌张力和FMA评分均明显优于对照组，差异均有统计学意义（P<0.05）。结论：中西医结合康复治疗是降低偏瘫患者手部痉挛和改善手功能的有效方法，而手部CPM训练作为一种重要的辅助治疗方法，结合常规中西医康复治疗，可明显提高治疗效果。

【关键词】 手部CPM； 中西医结合； 康复； 手部痉挛； 手功能

Observation the Efficacy of Hand Spasm and Hand Function in Hemiplegic Patients Treated by Hand CPM Combined with Rehabilitation of Traditional Chinese and Western Medicine/SUN Yuan-biao，JING Li-yan，CHENG Zi-cui，et al.//Medical Innovation of China，2017，14（27）：107-110

【Abstract】 Objective：To observe the effect of hand continuous passive motion（CPM） combined with rehabilitation therapy of traditional Chinese and Western medicine on reducing hand spasm and improving hand function in patients with hemiplegia.Method：100 stroke and traumatic brain injury with hand spasticity of patients with hemiplegia from January 2016 to May 2017 were selected，they were randomly divided into the observation group and the control group，50 cases in each group.The control group only received traditional Chinese and Western medicine rehabilitation therapy，the observation group was trained with hand CPM training on the basis of the control group，the changes of hand spasm and function in two groups were observed.Result：After treatment，the muscle tone and FMA scores of two groups were significant better than those before treatment，the differences were statistically significant（P<0.001）；the muscle tone and FMA score of the observation group were significantly better than those of the control group，the differences were statistically significant（P<0.05）.Conclusion：The combination of Chinese and Western medicine rehabilitation therapy is an effective method to reduce hand spasm and improve hand function of hemiplegic patients，and hand CPM training as an important auxiliary treatment method，combining traditional Chinese and Western medicine treatment can improve the effect of treatment obviously.

【Key words】 Hand CPM； Integrated traditional Chinese and Western medicine； Rehabilitation； Hand spasm； Hand function

First-authors address：Taian City Traditional Chinese Medicine Hospital Affiliated to Shandong Traditional Chinese Medicine University，Taian 271000，China

doi：10.3969/j.issn.1674-4985.2017.27.030

2016年1月開始本科室应用美国QAL Medical OrthoAgility 6000手部连续被动训练系统（Continuous passive motion，CPM）结合中西医康复疗法治疗偏瘫患者，与常规中西医康复治疗的患者进行对照观察，发现在降低手部痉挛以及改善手功能方面有较好的临床效果，现报道如下。endprint

1 资料与方法

1.1 一般资料 选取2016年1月-2017年5月在本科接受康复治疗的偏瘫患者100例。纳入标准：有脑血管病、脑外伤、脑肿瘤、脑血管畸形、脑炎或脑膜炎等脑部病变病史，并经头颅CT或MRI检查证实有脑部病变；伴有偏瘫和手部痉挛；除外既往有运动功能障碍；肌萎缩不明显；从未接受手部CPM训练。随机将患者分为观察组和对照组，各50例。观察组男28例，女22例，年龄35～75岁，平均（52.56±17.86）岁；脑梗死32例，脑出血13例，脑外伤5例；左侧偏瘫26例，右侧24例。对照组男26例，女24例，年龄36～75岁，平均（53.78±19.22）岁；脑梗死30例，脑出血14例，脑外伤6例；左侧偏瘫28例，右侧22例。两组患者的一般资料比较，差异无统计学意义（P>0.05），具有可比性。