基于脑损伤患者遗忘特征的个性化记忆康复疗效

doi:10.3969/j.issn.1006-9771.2021.04.009

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (4): 445-449.doi: 10.3969/j.issn.1006-9771.2021.04.009

基于脑损伤患者遗忘特征的个性化记忆康复疗效

郭华珍^1,²(),恽晓平^1,²,张璞^1,²,张慧丽^1,²,高明明^1,²,宋桂芸^1,²

^1.首都医科大学康复医学院，北京市 100068
^2.中国康复研究中心北京博爱医院，北京市 100068

收稿日期:2020-08-17 修回日期:2021-02-25 出版日期:2021-04-25 发布日期:2021-04-20
通讯作者: 郭华珍 E-mail:ghzhellen@sohu.com
作者简介:郭华珍(1964-)，女，汉族，湖南冷水江市人，硕士，副主任医师，主要研究方向：认知功能障碍的评定与康复。
基金资助:
国家自然科学基金项目(81272165);中央级公益性科研院所基本科研业务费专项资金项目(2015CZ-41)

Effect of Individualized Memory Rehabilitation Based on Forgetting Characteristics of Patients with Brain Injury

Hua-zhen GUO^1,²(),Xiao-ping YUN^1,²,Pu ZHANG^1,²,Hui-li ZHANG^1,²,Ming-ming GAO^1,²,Gui-yun SONG^1,²

^1.Capital Medical University School of Rehabilitation, Beijing 100068, China
^2.Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2020-08-17 Revised:2021-02-25 Published:2021-04-25 Online:2021-04-20
Contact: Hua-zhen GUO E-mail:ghzhellen@sohu.com
Supported by:
National Natural Science Foundation of China(81272165);Fundamental Research Funds for Central Public Welfare Research Institutes(2015CZ-41)

摘要/Abstract

摘要： 目的

探讨基于脑损伤患者遗忘特征的个性化记忆康复疗效。

方法

2018年9月至2019年10月，本院60例脑损伤患者随机分为常规记忆训练组(对照组，n = 30)和个性化记忆训练组(观察组，n = 30)，观察组训练前进行遗忘特征测验，训练4周。训练前后分别进行Rivermead行为记忆测验第二版(RBMT-II)、蒙特利尔认知评估量表(MoCA)评定。

结果

组内比较，两组训练后RBMT-II和MoCA总分均明显高于训练前(|t| > 3.885, P < 0.01)。组间比较，两组训练前后RBMT-II和MoCA总分比较均无显著性差异(P > 0.05)；观察组训练前后RBMT-II和MoCA总分之差均显著大于对照组(|Z| > 3.757, P < 0.001)。

结论

记忆康复训练能改善脑损伤患者的记忆能力和总体认知功能，根据遗忘特征进行个性化记忆训练更为有效。

关键词: 脑损伤, 遗忘特征, 个性化记忆训练

Abstract: Objective

To investigate the effect of individualized memory rehabilitation based on the forgetting characteristics in patients with brain injury (BI).

Methods

From September, 2018 to October, 2019, 60 BI patients were randomly divided into routine memory training group (control group, n = 30) and individualized memory training group (observation group, n = 30). The observation group group was tested with forgetting characteristics pre-training. Both groups received memory training for four weeks, respectively. All patients were evaluated with Rivermead Behavioural Memory Test-2nd Edition (RBMT-II) and Montreal Cognitive Assessment (MoCA) pre- and post-training.

Results

The total post-training scores of RBMT-II and MoCA were higher than the pre-training scores in both groups (|t| > 3.885, P < 0.01). There was no significant difference in the total scores between two groups pre- and post-training (P > 0.05). The differences between post- and pre-training total scores of RBMT-II and MoCA were significantly higher in the observation group group than in the control group (|Z| > 3.757, P < 0.001).

Conclusion

Memory rehabilitation training could improve memory abilities and general cognitive function of BI patients, and it is more effective to carry out individualized memory rehabilitation training based on the forgetting characteristics.

Key words: brain injury, forgetting characteristic, individualized memory training

中图分类号:

R749.1

郭华珍,恽晓平,张璞,张慧丽,高明明,宋桂芸. 基于脑损伤患者遗忘特征的个性化记忆康复疗效[J]. 《中国康复理论与实践》, 2021, 27(4): 445-449.

Hua-zhen GUO,Xiao-ping YUN,Pu ZHANG,Hui-li ZHANG,Ming-ming GAO,Gui-yun SONG. Effect of Individualized Memory Rehabilitation Based on Forgetting Characteristics of Patients with Brain Injury[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(4): 445-449.

图/表 7

表1

图1

图2

图3

图4

表2

表3

参考文献 23

1	李轶圆. 从艾宾浩斯记忆曲线谈如何提升英语词汇量[J]. 教育教学论坛, 2019(14): 203-204.
	Li T Y. A Tentative analysis on vocabulary accumulation from the perspective of forgetting curve [J]. Jiaoyu Jiaoxue Luntan, 2019(14): 203-204.
2	祁鸣. 艾宾浩斯记忆曲线理论在康复护理学翻转课堂中的应用效果[J]. 卫生职业教育, 2019, 37(4): 112-114.
	Qi M. Health Vocational Educ, 2019, 37(4): 112-114.
3	朱亮,郑彩慧,赵舒,等. 基于艾宾浩斯记忆曲线的方剂学教学改革[J]. 中国中医药现代远程教育, 2018, 16(13): 16-19.
	Zhu L, Zheng C H, Zhao S. Teaching reform of traditional Chinese medicine formulae based on Ebbinghaus's memory curve [J]. Chin Med Modern Distance Educ Chin, 2018, 16(13): 16-19.
4	黄彬洋,刘晓瑞,韩雨欣,等. 基于艾宾浩斯记忆曲线理论对康复学科理实一体模拟教学的构架探索[J]. 医学理论与实践, 2017, 30(17): 2655-2656.
	Huang B Y, Liu X R, Han Y X, et al. J Med Theory Pract, 2017, 30(17): 2655-2656.
5	赵丹,赵秀敏,陈瑛,等. 艾宾浩斯记忆曲线PDCA带教对妇产科的中专护生手卫生状况影响[J]. 中医药管理杂志, 2016, 24(5): 141-143.
	Zhao D, Zhao X M, Chen Y, et al. J Trad Chin Med Manag, 2016, 24(5): 141-143.
6	刘思远. 从艾宾浩斯记忆曲线谈反刍式实践教学[J]. 文学教育(上), 2020(9): 165-167.
	Liu S Y. Literat Educ (A), 2020(9): 165-167.
7	王新霞,刘秀静,张芳,等. 艾宾浩斯记忆曲线在慢性心力衰竭病人健康教育中的效果研究[J]. 全科护理, 2020, 18(8): 1020-1022.
	Wang X X, Liu X J, Zhang F, et al. Chin General Prac Nurs, 2020, 18(8): 1020-1022.
8	胡娟,熊沫. 艾宾浩斯记忆曲线指导的健康教育对放射性皮炎病人健康知识水平、遵医行为及自我照护能力的影响[J]. 全科护理, 2020, 18(24): 3181-3183.
	Hu J, Xiong M. Chin General Prac Nurs, 2020, 18(24): 3181-3183.
9	郭华珍,恽晓平,张璞,等. 闭合性脑外伤患者恢复期的图画遗忘特征[J]. 中国康复理论与实践, 2016, 22(5): 508-510.
	Guo H Z, Yun X P, Zhang P, et al. Characteristics of picture forgetting in closed traumatic brain injury patients during recovery [J]. Chin Rehabil Theory Pract, 2016, 22(5): 508-510.
10	Huppert F A, Piercy M. Dissociation between learning and remembering in organic amnesia [J]. Nature, 1978, 275(5678): 317-318.
11	Hara H. Memory rehabilitation for amnesic with acquired brain injury [J]. Brain Nerve, 2018, 70(7): 829-840.
12	McDonald B C, Flashman L A, Arciniegas D B, et al. Methylphenidate and memory and attention adaptation training for persistent cognitive symptoms after traumatic brain injury: A randomized, placebo-controlled trial. [J]. Neuropsychopharmacol, 2017, 42(9): 1766-1775.
13	Withiel T D, Wong D, Ponsford J L, et al. Comparing memory group training and computerized cognitive training for improving memory function following stroke: a phase II randomized controlled trial [J]. J Rehabil Med, 2019, 51(5): 343-351.
14	Withiel T D, Stolwyk R J, Ponsford J L, et al. Effectiveness of a manualised group training intervention for memory dysfunction following stroke:a series of single case studies [J]. Disabil Rehabil, 2020, 42(21): 3033-3042.
15	Lesniak M M, Iwanski S, Szutkowska-Hoser J, et al. Comprehensive cognitive training improves attention and memory in patients with severe or moderate traumatic brain injury [J]. Appl Neuropsychol Adult, 2020, 27(6): 570-579.
16	薛翠萍,恽晓平,张一,等. 工作记忆训练系统对脑损伤患者工作记忆障碍的疗效[J]. 中国康复理论与实践, 2016, 22(5): 523-527.
	Xue C P, Yun X P, Zhang Y, et al. Effect of working memory training system on working memory impairment after brain injury [J]. Chin Rehabil Theory Pract, 2016, 22(5): 523-527.
17	Lesniak M M, Mazurkiewicz P, Iwanski S, et al. Effects of group versus individual therapy for patients with memory disorder after an acquired brain injury: a randomized, controlled study [J]. J Clin Exp Neuropsychol, 2018, 40(9): 853-864.
18	Manoli R, Chartaux-Danjou L, Delecroix H, et al. Long-term forgetting in patients with traumatic brain injury [J]. Ann Phys Rehabil Med, 2017(60S): e45.
19	尹文刚. 神经心理学[M]. 北京:科学出版社, 2007: 158-159.
	Yin W G. Neuropsychology [M]. Beijing: China Science Publishing & Media Ltd., 2007: 158-159.
20	车丽萍. 记忆术:科学的记忆方法[M]. 上海:上海教育出版社, 2006: 44-46.
	Che L P. Mnemotechny: Scientific Memory Method [M]. Shanghai: Shanghai Educational Publishing House, 2006: 44-46.
21	Chiaravalloti N D, Demaree H, Gaudino E, et al. Can the repetition effect maximize learing in multiple sclerosis? [J]. Clin Rehabil, 2003, 17(1): 58-68.
22	Rapp B, Wiley R W. Re-learning and remembering in the lesioned brain [J]. Neuropsychologia, 2019, 132: 107126.
23	Middleton E L, Schwartz M F, Rawson K A, et al. Towards a theory of learning for naming rehabilitation: retrieval practice and spacing effects [J]. J Speech Lang Hear Res, 2016, 59(5): 1111-1122.

组别	n	性别(男/女，n)	年龄(岁)	受教育年限(年)
对照组	30	26/4	45.03±15.30	14.07±3.03
观察组	30	24/6	42.63±13.02	14.57±3.39
t/χ²值		-0.684	0.654	-0.602
P值		0.172	0.242	0.784

组别	n	训练前	训练后	差值	t值	P值
对照组	30	11.23±4.99	12.13±5.02	15.55	-3.885	0.001
观察组	30	11.83±4.23	18.70±4.10	45.45	-12.431	< 0.001
t/Z值		-0.503	-5.550	-6.761^a
P值		0.607	0.535	< 0.001

组别	n	训练前	训练后	差值	t值	P值
对照组	30	15.73±5.71	17.30±5.34	22.20	-4.032	< 0.001
观察组	30	19.07±5.66	22.10±5.40	38.80	-9.666	< 0.001
t/Z值		-2.273	-3.434	-3.757^a
P值		0.793	0.968	< 0.001

[1]	付文娟, 侯剑华, 于肖楠, 陈天勇. 脑损伤康复期患者及配偶的共同二元应对与婚姻满意度和生活质量的关系：基于共同命运模型的分析[J]. 《中国康复理论与实践》, 2023, 29(12): 1446-1453.
[2]	刘俊明, 黄富表, 刘静娅, 杨絮. 阴极经颅直流电刺激对右侧脑损伤患者上肢及手指运动功能的影响[J]. 《中国康复理论与实践》, 2023, 29(1): 82-87.
[3]	林爱金,王洁琼,敖丽娟,陈茉弦. 新生鼠缺氧缺血性脑损伤远期行为学研究[J]. 《中国康复理论与实践》, 2021, 27(8): 908-912.
[4]	张霜,吴野环,张一,张瑜,程云. 三种认知量表间记忆内容的相关性分析[J]. 《中国康复理论与实践》, 2020, 26(7): 807-812.
[5]	闫冬梅,施庆喜,仝娇,马珊,赵星星,车世红. 区域性高危儿网络化管理体系在预防残疾中的作用[J]. 《中国康复理论与实践》, 2020, 26(2): 242-248.
[6]	赵彬, 唐强, 朱路文, 王艳, 梁碧莹. 丰富环境对缺氧缺血性脑损伤新生大鼠海马神经元凋亡及脑源性神经营养因子/酪氨酸蛋白激酶受体信号通路的影响[J]. 《中国康复理论与实践》, 2019, 25(12): 1418-1424.
[7]	张小年, 张晓颖, 张悦, 翟晓雪, 尹群辉, 张皓. 脑损伤后意识障碍患者音乐治疗的研究进展[J]. 《中国康复理论与实践》, 2018, 24(7): 812-814.
[8]	吕富岩, 张雷红, 宫兆帅, 苑爱云. 丰富环境促进缺氧缺血性脑损伤神经可塑性的研究进展[J]. 《中国康复理论与实践》, 2018, 24(5): 509-512.
[9]	张继红, 马存根. 高脂饮食诱导肥胖对小鼠缺血性脑损伤的影响[J]. 《中国康复理论与实践》, 2018, 24(10): 1146-1150.
[10]	施红梅, 张静. 心理治疗结合康复治疗对脑损伤患者抑郁的效果[J]. 《中国康复理论与实践》, 2018, 24(10): 1206-1209.
[11]	罗泽汝心，谭波涛，伍亚民. 脊髓损伤导致认知障碍及其相关机制的研究进展[J]. 《中国康复理论与实践》, 2017, 23(4): 390-393.
[12]	杨飞祥, 张皑峰, 郝鹏, 尚俊奎, 段红梅, 杨朝阳, 李晓光. 神经营养因子3-壳聚糖载体对大鼠运动皮层损伤后内源性神经发生和运动功能的效果[J]. 《中国康复理论与实践》, 2017, 23(2): 155-161.
[13]	姜敏, 王继先, 余波, 杨国源, 陈文华. 丰富环境对小鼠缺血性脑损伤后运动、社交功能的作用[J]. 《中国康复理论与实践》, 2017, 23(1): 32-36.
[14]	恽晓平. 认知康复的发展方向与趋势①[J]. 《中国康复理论与实践》, 2016, 22(5): 497-498.
[15]	张慧丽，恽晓平，郭华珍，宋桂芸，高明明. 脑损伤患者的执行功能损害①[J]. 《中国康复理论与实践》, 2016, 22(5): 504-507.

基于脑损伤患者遗忘特征的个性化记忆康复疗效

Effect of Individualized Memory Rehabilitation Based on Forgetting Characteristics of Patients with Brain Injury

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 7

参考文献 23

相关文章 15

Metrics

本文评价

推荐阅读 0