基于个性优势的结构化治疗与教育对缺血性脑卒中康复效果的随机对照试验

doi:10.3969/j.issn.1006-9771.2024.08.012

摘要/Abstract

摘要：

目的评估一种个性优势的结构化治疗与教育方案对缺血性脑卒中患者康复的效果。

方法 2021年3月至2023年9月，昆山市第一人民医院114例缺血性脑卒中患者随机分为对照组(n = 57)和试验组(n = 57)。对照组接受常规药物治疗、康复训练和健康教育，试验组接受常规药物治疗、康复训练，以及基于个性优势的结构化治疗与教育方案，共6周。比较两组改良Rankin量表(mRS)评分、运动诱发电位(MEP)潜伏期和振幅、改良Barthel指数、康复自我效能感量表评分和3个月的复发情况，以及Morisky服药依从性量表(MMAS)和五因素正念量表(FFMQ)评分。

结果治疗后，试验组mRS评分(t = 5.002)、MEP潜伏期(t = 9.739)和振幅(t = 4.394)、改良Barthel指数(t = 11.261)、康复自我效能感量表评分(Z = -2.638)、MMAS评分(t = 19.521)和FFMQ评分(t = 15.381)均优于对照组(P < 0.05)。

结论基于个性优势的结构化治疗与教育方案有助于促进缺血性脑卒中患者的康复和自我管理。

关键词: 缺血性脑卒中, 结构化治疗与教育, 康复, 自我管理, 随机对照试验

Abstract:

Objective To evaluate the effect of structured therapy and education based on personal strength on ischemic stroke.

Methods From March, 2021 to September, 2023, a total of 114 patients with ischemic stroke from the First People's Hospital of Kunshan were randomly divided into control group (n = 57) and experimental group (n = 57). The control group received routine medicine, rehabilitation training and standard health education, while the experimental group received routine medicine, rehabilitation training and structured therapy and education based on personal strength, for six weeks. They were compared with the scores of modified Rankin Scale (mRS), motor-evoked potential (MEP) latency and amplitude, modified Barthel Index and Self-Recovery Efficacy Scale score and recurrence within three months after the start of the study. The scores of Morisky Medication Adherence Scale (MMAS) and Five Facet Mindfulness Questionaire (FFMQ) were also compared.

Results After treatment, the score of mRS (t = 5.002), MEP latency period (t = 9.739) and amplitude (t = 4.394), modified Barthel Index (t = 11.261), the score of Self-Recovery Efficacy Scale (Z = -2.638), and the scores of MMAS (t= 19.521) and FFMQ (t= 15.381) were better in the experimental group than in the control group (P< 0.05).

Conclusions Structured therapy and education based on personal strength could faciliate to improve the recovery and self-management of ischemic stroke patients.

Key words: ischemic stroke, structured therapy and education, rehabilitation, self-management, randomized controlled trial

中图分类号:

R804.23

于婷婷, 蔡福良, 缪桂华, 顾晨, 彭媛. 基于个性优势的结构化治疗与教育对缺血性脑卒中康复效果的随机对照试验[J]. 《中国康复理论与实践》, 2024, 30(8): 965-971.

YU Tingting, CAI Fuliang, MIAO Guihua, GU Chen, PENG Yuan. Effect of structured therapy and education based on personal strength on ischemic stroke: a randomized controlled trial[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(8): 965-971.

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组别	n	性别(男/女)/n	年龄/岁	身高/cm	体质量/kg	偏瘫侧(左/右)/n
对照组	57	41/16	58.3±8.21	168.1±7.73	71.93±8.55	25/32
试验组	57	39/18	57.9±7.97	167.3±6.30	69.46±7.52	22/35
χ²/t值		0.168	0.255	0.605	1.641	0.326
P值		0.682	0.799	0.547	0.104	0.568

组别	n	测试	$\bar{x}\pm s$	t值	P值
对照组	57	前测	3.66±0.57	2.272	0.021
		后测	3.46±0.33
试验组	57	前测	3.69±0.52	6.653	< 0.001
		后测	3.09±0.46
治疗前两组均值差			0.04±0.10	0.360	0.721
治疗后两组均值差			-0.37±0.07	5.002	< 0.001

指标	组别	n	测试	$\bar{x}\pm s$	t值	P值
潜伏期/ms	对照组	57	前测	24.97±0.78	2.616	0.010
			后测	24.49±1.22
	试验组	57	前测	25.02±0.83	9.121	< 0.001
			后测	23.32±1.14
	治疗前两组均值差			0.05±0.15	0.338	0.736
	治疗后两组均值差			1.67±0.17	9.739	< 0.001
振幅/mV	对照组	57	前测	0.57±0.10	2.772	0.007
			后测	0.64±0.13
	试验组	57	前测	0.58±0.12	7.089	< 0.001
			后测	0.75±0.14
	治疗前两组均值差			0.00±0.02	0.170	0.866
	治疗后两组均值差			0.11±0.03	4.394	< 0.001

组别	n	测试	$\bar{x}\pm s$	t值	P值
对照组	57	前测	36.11±4.16	10.162	< 0.001
		后测	43.09±3.36
试验组	57	前测	35.56±4.42	23.351	< 0.001
		后测	50.58±4.04
治疗前两组均值差			-0.51±0.65	0.783	0.435
治疗后两组均值差			7.23±0.64	11.261	< 0.001

组别	n	测试	M(Q_L, Q_U)	Z值	P值
对照组	57	前测	117(83,128)	-1.831	0.067
		后测	119(99,132)
试验组	57	前测	125(100,131)	-3.146	0.002
		后测	130(122,132)
治疗前两组均值差				-0.916	0.361
治疗后两组均值差				-2.638	0.008