《中国康复理论与实践》

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (9): 1057-1065.doi: 10.3969/j.issn.1006-9771.2025.09.009

• 应用研究 • 上一篇    下一篇

远隔缺血适应联合双耳节拍音乐训练对脑梗死认知障碍的效果

薛星1, 赵海燕1, 岳淑玲2, 成杰2, 唐启群1, 成晓华2, 郭宗海2, 刘萍萍2()   

  1. 1 华北理工大学， 河北唐山市 063210
    2 华北理工大学附属医院， 河北唐山市 063000
  • 收稿日期:2025-03-04 修回日期:2025-08-30 出版日期:2025-09-25 发布日期:2025-10-10
  • 通讯作者: 刘萍萍(1985-)，女，汉族，河北唐山市人，硕士，副主任护师，硕士研究生导师，主要研究方向：神经康复、老年康复， E-mail： tian454798634@163.com。
  • 作者简介:薛星(1986-)，女，汉族，河北邯郸市人，硕士研究生，主管护师，主要研究方向：神经康复、老年康复。
  • 基金资助:
    河北省医学科学研究课题计划项目(20242303)

Effect of remote ischemic conditioning combined with binaural beat music training in patients with cognitive dysfunction after cerebral infarction

XUE Xing1, ZHAO Haiyan1, YUE Shuling2, CHENG Jie2, TANG Qiqun1, CHENG Xiaohua2, GUO Zonghai2, LIU Pingping2()   

  1. 1 North China University of Science and Technology, Tangshan, Hebei 063210, China
    2 Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei 063000, China
  • Received:2025-03-04 Revised:2025-08-30 Published:2025-09-25 Online:2025-10-10
  • Contact: LIU Pingping, E-mail: tian454798634@163.com
  • Supported by:
    Hebei Province Medical Science Research Planning(20242303)

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摘要：

目的 探讨远隔缺血适应联合双耳节拍音乐训练对脑梗死认知障碍患者的效果。

方法 2024年6月至2025年1月，华北理工大学附属医院脑梗死后认知障碍患者200例，随机分为对照组(n = 50)、远隔缺血适应组(n = 50)、双耳节拍音乐组(n = 50)和联合组(n = 50)。各组均予常规训练，远隔缺血适应组增加远隔缺血适应训练，双耳节拍音乐组增加双耳节拍音乐训练，联合组增加双耳节拍音乐和远隔缺血适应训练，共14 d。干预前、干预后第14天和第90天分别采用蒙特利尔认知评估量表(MoCA)和脑卒中专用生活质量量表(SS-QOL)进行评估。

结果 对照组2例、双耳节拍音乐组3例、远隔缺血适应组4例和联合组3例脱落。MoCA评分的组间效应、时间效应和交互效应均显著(F > 13.463, P < 0.001)。干预后，第14天和第90天，各干预组MoCA评分均高于对照组(P < 0.05)，联合组均高于双耳节拍音乐组和远隔缺血适应组(P < 0.05)；第90天远隔缺血适应组高于双耳节拍音乐组(P < 0.05)。各组不同时间点SS-QOL评分均有显著性差异(χ2 > 75.182, P < 0.001)。干预后，第14天和第90天，各组间SS-QOL评分比较有显著性差异(H > 18.260, P < 0.001)；联合组均高于对照组和双耳节拍音乐组(|Z| > 3.149, P < 0.05)；第90天，远隔缺血适应组高于对照组(|Z| = 3.590, P < 0.05)，联合组高于远隔缺血适应组(|Z| = 3.186, P < 0.05)。

结论 远隔缺血适应、双耳节拍音乐及其联合训练均可改善脑梗死患者认知障碍，且远隔缺血适应优于双耳节拍音乐，联合训练效果最好。远隔缺血适应和联合训练均可提高脑梗死患者的生活质量，且联合训练效果更佳。

关键词: 脑梗死, 远隔缺血适应, 双耳节拍音乐, 认知障碍, 生活质量

Abstract:

Objective To explore the effect of remote ischemic conditioning (RIC) combined with binaural beat music (BBM) training in patients with cognitive dysfunction after cerebral infarction.

Methods From June, 2024 to January, 2025, 200 patients with cognitive dysfunction after cerebral infarction in the Affiliated Hospital of North China University of Science and Technology were randomly divided into control group (n = 50), RIC group (n = 50), BBM group (n = 50) and combined group (n = 50). All the groups received standardized routine training, RIC group received RIC, BBM group received BBM, and the combined group received RIC+BBM, for 14 days. They were assessed with Montreal Cognitive Assessment (MoCA) and Stroke-Specific Quality of Life Scale (SS-QOL) at baseline, day 14, and day 90.

Results Two cases in the control group, four in RIC group, three in BBM group and three in the combined group dropped out. For MoCA scores, the inter-group effect, intra-group effect and interaction effect were all significant (F > 13.463, P < 0.001). After intervention, on both day 14 and day 90, the score of MoCA was higher in each intervention group than in the control group (P < 0.05), and was higher in the combined group than in both BBM and RIC groups (P < 0.05); and on day 90, it was higher in RIC group than in BBM group (P < 0.05). For SS-QOL, the score increased with time in all the groups (χ2 > 75.182, P< 0.001). After intervention, there was significant difference at each time point among four groups (H > 18.260, P < 0.001). On day 14 and day 90, the score of SS-QOL was higher in the combined group than in the control and BBM groups (|Z| > 3.149, P < 0.05); on day 90, the score was higher in RIC group than in the control group (|Z| = 3.590, P < 0.05), and it was higher in the combined group than in RIC group (|Z| = 3.186, P < 0.05).

Conclusion RIC, BBM and their combination all improved cognitive function after cerebral infarction. RIC was superior to BBM, and the combined intervention yielded the greatest benefit. Both RIC and the combined intervention improved quality of life, with the combined approach being the most effective.

Key words: cerebral infarction, remote ischemic conditioning, binaural beat music, cognitive dysfunction, quality of life

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