目的 观察肩三针联合体外冲击波治疗脑卒中后肩痛的临床疗效.方法 选取2019年1月—2019年8月广东医科大学附属医院康复医学科收治的60例脑卒中后偏瘫肩痛病人,按照随机数字表法分为A组、B组、C组,每组20例.A组采用肩三针治疗;B组采用肩三针联合体外冲击波治疗;C组采用体外冲击波治疗.比较3组疼痛程度疗效,观察3组治疗前后视觉模拟评分(VAS)、Fugl-Meyer上肢运动功能测量表(FMA)评分、生存质量测定简表(QOL-BREF)评分变化.结果 A组、C组肩痛程度缓解显效率分别为60.0％和70.0％,均明显低于B组的90.0％(P<0.01).治疗后,B组FMA评分明显高于A组与C组(P<0.05),QOL-BREF评分明显高于A组(P<0.05),VAS评分低于A组(P<0.05).结论 肩三针联合体外冲击波治疗脑卒中后肩痛病人,能够明显改善病人的上肢运动功能、疼痛及关节活动度,提高临床疗效.

目的:探讨脑卒中后吞咽功能障碍的四诊证候要素,为该病的中医病因病机的明确及其辨证临床诊治提供数据支持.方法:设计前瞻性观察方案,采用专门设计制定的脑卒中后吞咽障碍中医证候观察的量表,对224例纳入研究调查的吞咽障碍患者实施数据采集,通过频数分析及因子分析的统计方法进行证侯要素的提取,最后归纳出脑卒中后吞咽障碍疾病的中医证候要素分布规律.结果:因子分析提取6个证候要素作为公因子,综合分析观察对象的证候要素,其中包括虚证,气虚,痰浊,阴虚,血瘀,阳虚.中医认为脑卒中后吞咽障碍属"喉痹""舌喑""中风舌本病""喑痱""喉喑"等病名,病位在脑,病症在咽喉,涉及脏腑主要脾、肝、肾三脏,次为心,病机为本虚标实,本虚主要为(脾)气虚,标实主要为血瘀、痰浊,故多以补虚、化痰等立法诊治.结论:运用因子分析法对吞咽功能障碍进行中医证候要素进行数据的分析研究是可行而有价值的,可深入的剖析证候的的分布特点及规律,揭示疾病的病因病机及证候学特点,为疾病的的辨证施治提供证据支持.

Objective To investigate the therapeutic efficacy of aphasia strengthening training software system on aphasia patients after stroke .Methods Forty aphasia patients after stroke in our hospital were selected in recent years and randomly divided into observation group (n=20) and control group (n=20).In control group, speech therapists with routine and artificial method was provided , and family self training by the help of the family members to complete the speech therapist project arrangement were given to the subjects;while in observation group , speech therapists using self -developed aphasia training software system were provided , and the generated system training packages for training in the home environment were given .Before and after the treatment , the Chinese standard aphasia examination ( CRRCAE ) of language function evaluation were recorded for analysis .Results The repetition, oral expression, oral reading, reading, copying, description and dictation ability were significantly improved in both groups , while they were significantly in ob-servation group (P<0.05).Conclusion The aphasia training software system is well developed with satisfied efficacy on aphasia after stroke .

目的：探讨超激光疼痛治疗对膝关节骨性关节炎患者疼痛及生活质量的影响。方法将膝关节骨性关节炎（ KOA）患者90例分为观察1组、观察2组和对照组，每组30例。观察1组只采用超激光疼痛治疗，观察2组采用超激光疼痛治疗及康复训练，对照组只进行康复训练。3组患者分别在入组时及治疗第15次结束时，采用视觉模拟疼痛评定法（visual analogue scale，VAS）和生活质量简表（QOL-BREF）进行疼痛和生活质量的评估。结果治疗15次后，3组患者的疼痛均有所缓解，观察1组和观察2组与对照组患者的疼痛评分相比差异均有统计学意义（P＜0.05），观察1组与观察2组患者的疼痛评分相比差异无统计学意义（P＞0.05），对照组患者治疗前后疼痛评分差异无统计学意义（ P＞0.05）。在提高生活质量方面，观察1组及观察2组患者的生活质量评分较治疗前均有明显提高（P＜0.05），两组患者的生活质量评分比较差异无统计学意义（P＞0.05）；观察1组和观察2组与对照组患者的生活质量评分比较差异均有统计学意义（P＜0.05），对照组患者的生活质量评分较治疗前有所提高，但差异无统计学意义（ P＞0.05）。结论超激光疼痛治疗能有效缓解膝关节骨性关节炎患者疼痛症状，抑制炎症进展，并提高患者的生活质量。

目的观察智能运动系统训练对脑卒中后下肢功能的影响。方法将脑卒中患者48例随机分成观察组和对照组,每组24例。观察组予智能运动系统结合综合康复训练,对照组予综合康复训练。6周后以改良Ashworth痉挛评定量表、Fugl-Meyer运动功能评分(下肢)、10 m最快步行速度法(MWS)进行评价。结果两组患者治疗后下肢的肌张力、下肢功能、步行功能均较治疗前有改善(P<0.05),而观察组治疗后评分与对照组的差异有统计学意义(P<0.05)。结论智能运动系统可促进脑卒中患者下肢功能的恢复。

Objective To explore the effect of the family rehabilitation nursing of senile prolapse of lumbar intervertebral disc.Methods 48 cases of senile prolapse of lumbar intervertebral disc were randomly divided into control and observation groups,each group 24 cases.Observation group patients were given the family rehabilitation nursing for 6 months.Results The therapeutic effects were assessed by the treatment of lumbar spine disorders performance criteria'(Japanese Association of Plastic Surgery).The score in control and observation group were improved(P＜0.05,P＜0.01),and the score and the improving index of observation group were increased than that of control group(P＜0.01).Conclusions The family rehabilitation nursing has an obvious effect on senile prolapse of lumbar intervertebral disc.

Objective To evaluate the effects of rehabilitation training according to Brtmnstrom stage on ability of daily life (ADL) and motor function of stroke patients. Methods 120 bemiplegia patients who suf-fered from stroke were randomly divided into the observation group and the control group with 60 cases in each group. Both groups received routine cerebrovascular medicine treatment and routine nursing, the observation group received rehabilitation training according to Brannstrom stage(including body position,simple kinesithera-py,daily life exercise), psychological nursing and health guidance. The motor function and ADL were as-sessed respectively by Brurmstrom assessment and Barthel index before and 4 weeks after training using rank test. Results Brurmstrom stage and ADL of the observation group were better than those of the control group after rehabilitation training. Conclusions Early rehabilitation training according to Bnmnstrom stage can obviously improve the recovery of motor function and ADL as well as life quality of stroke patients.

Objective To explore the methods and results of early comprehensive rehabilitation care of post-stroke aphasia. Methods 75 patients with post-stroke aphasia were randomly divided into the early rehabilitation care group, the delayed rehabilitation care group and the control group with 25 patients in each group. The control group received routine neurological treatment and nursing, while the early and delayed rehabilitation care groups were given psychological nursing and health education based upon rou-tine nursing. Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE) was used for assessment before and after the rehabilitation care among the three groups and then the results under-went comparison. Results After rehabilitation intervention, the early and delayed rehabilitation care groups were significantly different from the control group in listening, understanding, repeating, oral expres-sion, recitation and reading. The ability of listening, understanding, repeating, oral expression, recitation and reading in early rehabilitation care group improvod more greatly than those of the delayed rehabilitation care group. Conclusions Comprehensive rehabilitation nursing intervention can promote verbal function of patients with stroke aphasia. Earlier intervention care has more obvious effect.

目的观察循证护理对脑卒中患者并发肩手综合征(SHS)的预防作用。方法136例急性脑卒中患者随机分为常规护理组和循证护理组各68例,循证护理组经循证后实施针对性护理干预,分别在干预前及干预后1、2、4周统计SHS发生率,并进行日常生活能力评分(BI)。结果循证护理组患者在接受护理干预后SHS发生率明显低于常规护理组(5.9%vs22.1%,P<0.05)。两组患者各观察时间点的BI评分均较干预前提高(P<0.01),且在干预后1、2、4周循证护理组的评分均较常规护理组高(P<0.01)。结论循证护理的应用可有效地降低脑卒中患者的SHS发生率,可显著改善其日常生活能力。

Objective To design the Leizhou Peninsula's Dialect Aphasia Software L1 and study its evaluation and language training in patients with Leizhou Peninsula's dialect aphasia(LPDA).Methods Thirty patients with LPDA were evaluated by self-made L1 software and Chinese Rehabilitation Research Center Standard Aphasia Examination(CRRCAE) at the interval of 7～10 days,respectively.Meanwhile,all patients received language training with L1 software for 6 weeks.Results The aphasia types and correct answer rates were similar by the evaluation of two methods(P>0.05).Speech abilities such as repeating,spoken language, reading,transcription,description,dictation and the like were obviously improved after 6 week training(P<0.01 or 0.05).Conclusion L1 software is helpful in the evaluation and language training of LPDA.

Objective To investigate the effects of early partial body weight supported stand training on depression and balance function after massive cerebral infarction.Methods 40 patients with depression after massive cerebral infarction were divided into 2 groups,training group(n=20) and control group(n=20).All patients were treated with routine medication and rehabilitation.The patients of the training group also received partial body weight supported stand training in addition.They were assessed with the Hamilton depression scale(HAMD) and the Berg balance scale(BBS) before and after the treatment.Results After 8 weeks of treatment,the scores of HAMD and BBS of the training group had improved significantly more than those in the control group(P<0.05).Conclusion Early partial body weight supported stand training on the patients with depression after massive cerebral infarction may obviously improve balance function and reduce the degree of depression.

目的:观察物理因子治疗、功能训练等综合治疗合并糖尿病的老年性腰椎间盘突出症患者的疗效,了解糖尿病对老年性腰惟间盘突出症患者疗效的影响.方法:24例单纯老年性腰椎间盘突出症患者为对照组,21例合并糖尿病的老年性腰椎间盘突出症患者为观察组,两组均予综合治疗5周,观察两组疗效.结果:两组患者经5周综合治疗后,采用日本整形外科协会"腰椎疾患治疗成绩评分标准"及改善指数分别对其疗效进行评估,对照组治疗后评分为22.36±2.61改善指数为0.36±0.10;观察组治疗后评分为18.54±6.55,改善指数为0.23±0.18,两组比较差异有显著性(P<0.05).结论:合并糖尿病的老年性腰椎间盘突出症患者的综合治疗效果较单纯老年性腰椎间盘突出症患者差.

目的:探讨脊旁排针治疗对慢性下腰痛的临床作用。方法:将87例慢性下腰痛患者随机分脊旁排针组44例,对照组43例,对照组给与常规体针治疗。脊旁排针组给于脊旁排针治疗,治疗30天2,组治疗前后都进行腰椎功能评价。结果:2组评价指标都有改善,脊旁排针组优于对照组,2组比较差异显著(P<0.01)。结论:脊旁排针治疗慢性下腰痛疗效显著,有着简便易行特点,易于临床推广。

目的探讨等张运动和等长运动对健康人血小板膜糖蛋白Ⅱb/Ⅲa受体活性及血黏度的影响。方法以健康人为研究对象,分为中年组30例(男女各15例)和青年组30例(男女各15例),进行等张运动及等长运动各3个月,按50%运动强度的靶心率为目标值,运动时间为30min/次,每周3次,连续3个月,测定运动训练前及运动训练后两组血小板膜糖蛋白Ⅱb/Ⅲa受体活性及血黏度。结果等张运动3个月和等长运动3个月后,中年组的血小板膜糖蛋白Ⅱb/Ⅲa受体活性及全血黏度均较运动训练前显著降低(P<0.05),血浆黏度变化不大(P>0.05),而青年组在等张运动3个月及等长运动3个月后,血小板膜糖蛋白Ⅱb/Ⅲa受体活性及血黏度变化不大(P>0.05)。结论长期规律的等张运动及等长运动可导致中年健康人血小板膜糖蛋的Ⅱb/Ⅲa受体活性及全血黏度降低,从而降低血小板的聚集性,改善血液循环,降低心血管疾病的发生,而青年健康人则影响不大。

Aim: To investigate the changes of pulmonary function and quality of life (QOL) of patients after pneumonectomy, and to discuss the effect of rehabiliation training on pulmonary function and QOL of patients after pneumonectomy. Methods: Sixty patients with pneumonectomy were randomly divided into rehabilitation group and control group, with 30 in each group. Rehabilitation group was treated with routine treatments plus systematic rehabilitation training, while control group only used routine treatments. After 1-year follow-up, the changes in pulmonary function and QOL of the two groups were compared at 3 months before operation, and 3, 6, 12 months after operation. Results: Pulmonary function was declined 3 months after operation. QOL had no changed. There was no significant difference between the two groups (F = 1.395 - 1.705, P > 0.05). Pulmonary function of rehabilitation group was recovered to the normal level 6 months after operation, while only recovered to 80% of the normal level in the control group. Pulmonary function and QOL had significant difference between the two groups(F = 3.901 - 4.415, P < 0.05). Twelve months after operation, pulmonary function of the two groups was recovered to the preoperative level, and 20% of the patients in the rehabilitation group recovered normal level. There were significant difference between the two groups(F = 3.958 - 4.171, P < 0.05). QOL of the two groups was markedly enhanced, which was better in the rehabilitation group (F = 11.354, P < 0.01). Conclusion: Improvement in pulmonary function and QOL of patients after pneumonectomy is directly related with stabilization of illness, which was beth better rehabilitation training can improve the reconstruction of pulmonary function and enhance the QOL of patients.

Aim: To observe the effect of rehabilitative treatment of pulmonary surgery on pulmonary postoperative complication, pulmonary function and the courses in elder patients with pulmonary insufficiency. Methods: Seventy-eight patients were randomly divided into rehabilitation group(n = 40) and control group(n = 38). The patients in the control group received routine treatment, besides, patients in the rehabilitation group received pulmonary function exercise, including the treatment of breath, cough, posture therapy and joint movement exercises. The pulmonary postoperative complications, indices of pulmonary function and duration of hospitalization were recorded and compared. Results: There were significant differences in the incidence rate of pulmonary postoperative complication between the rehabilitation group (20%) and the control group(63%) (X2 = 15.00, P < 0.001). The pulmonary function indices(FEV, FVC, PEF) at the 6th day were significantly different between the two groups(t = 3.14, 3.23, 4.01, P < 0.01). The duration of hospitalization of the rehabilitation group[ (12.1 ± 4.3) d] was significantly different from that of the control group[ (20.4 ± 6.4) d], (t = 2.56, P < 0.05). Conclusion: Rehabilitative treatment can reduce the pulmonary postoperative complication, improve pulmonary function in elder patients with pulmonary insufficiency, and promote their recovery.

Aim: To explore the effect of rehabilitation therapy on patients with heart valve replacement. Methods: A total of 104 patients were randomly divided into rehabilitation group and control group. The patients in the control group received routine treatment, and rehabilitation group received rehabilitative therapy on the basis of routine treatment, including training of breathing, cough, motion of joint training, myodynamic training, and endurance training. postoperative incidence of pulmonary complication, duration of hospitalization and body activity energy level were compared between the two groups. Results: The postoperative incidence of pulmonary complication in rehabilitation group was 8% and 24% in control group (X2 = 4.60, P < 0.05); the duration of hospitalization in rehabilitation group was(17.8 ± 4.5) d, and that in control group was (26.2 ± 7.2) d, (t = 2.12, P < 0.05); The body activity energy level before discharge in rehabilitation group was(4.98 ± 0.41) METs, and that in control group was (4.21 ± 0.53) METs, (t = 2.25, P < 0.05); 3 months after discharge, that in rehabilitation group was (8.67 ± 0.74) METs, control group was (6.86 ± 0.63) METs, (t = 2.81, P < 0.01). The differences were significant. Conclusion: Rehabilitation treatment is important in decreasing incidence of postoperative pulmonary complication, shortening duration of hospitalization and improving quality of life.

目的:探讨运动治疗改善老年性腰椎间盘突出症患者腰痛症状及生活质量的效果。方法:对64例老年性腰椎间盘突出症的患者随机数字表法分为治疗组（n=36）和对照组（n=28）,对照组予休息及理疗,治疗组予理疗及运动治疗。结果:治疗组疗效满意率为72.22%,对照组疗效满意率为46.43%,两组比较差异有显著性意义（χ2=4.40,P＜0.05）。结论:老年性腰椎间盘突出症通过进行运动治疗可以改善患者的症状、体征及生活工作能力。

目的:探讨运动治疗对腰椎间盘突出症术后复发的影响。方法:对124例腰椎间盘突出症术后患者按随机数字表法分为治疗组68例和对照组56例。对照组予休息及护腰治疗,治疗组予适当的休息及护腰治疗外,术后予长期的运动治疗。结果:3年后对治疗组和对照组进行随访,治疗组复发率为1.79%,对照组复发率为13.24%,两组比较差异有显著性意义（χ2=5.43,P＜0.05）。结论:腰椎间盘突出症术后坚持运动治疗可降低术后的复发率。

目的:探讨介入心理治疗对脑外伤后综合征患者康复疗效的影响.方法:105例脑外伤后综合征患者分为2组.常规组51例给予常规治疗;心理组54例在常规治疗时介入心理治疗.2组均于初诊及治疗1个月后用症状自评量表(SCL-90)评定患者的躯体化症状和心理状况.3个月后用功能状态问卷(FSQ)评定患者的社会生活能力.结果:治疗后,2组患者的躯体症状和心理状况、社会生活能力均有改善,但心理组的改善程度较常规组显著(P<0.05,P<0.005).结论:心理治疗的介入有助于提高脑外伤后综合征患者的康复治疗效果.