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论著

综合康复训练对脑卒中后轻度认知障碍患者的应用效果及认知功能影响

The application effect and cognitive function impact of comprehensive rehabilitation training on patients with mild cognitive impairment after stroke

:1080-1086
 
     目的   探讨综合康复训练对脑卒中后轻度认知障碍患者的应用效果及认知功能影响。方法   选取2022年2月—2023年2月暨南大学附属广州红十字会医院收治的80例脑卒中后轻度认知障碍患者展开前瞻性研究,应用抽签法将其分为综合康复组与常规组,各40例。常规组实施常规干预,综合康复组在常规组基础上增加综合康复训练,对比其认知功能,简易智能精神状态检查量表(MMSE)、美国国立卫生院卒中量表(NIHSS)评分变化,运动功能与平衡功能,日常生活能力与生活质量。结果   干预后综合康复组患者洛文斯顿作业疗法认知量表评分注意力为(3.36±0.42)分、思维运动为(17.34±2.31)分、定向力为(13.19±1.24)分,均高于常规组,且两组干预后高于干预前(P<0.05);干预后综合康复组患者MMSE评分为(25.58±4.12)分高于常规组,且两组干预后高于干预前,NIHSS评分为(14.53±2.62)分,低于常规组,且两组干预后低于干预前(P<0.05);干预后综合康复组患者Fugl-Meyer运动功能评定量表评分为(14.51±3.23)分、手臂动作调查测试表评分为(26.86±5.25)分、平衡量表评分为(43.06±5.13)分,高于常规组,且两组干预后高于干预前(P<0.05);干预后综合康复组患者日常生活活动能力量表评分为(53.02±4.43)分、脑卒中专用生活质量量表评分为(97.11±12.23)分,高于常规组,且两组干预后高于干预前(P<0.05)。结论   针对脑卒中后轻度认知障碍患者采取综合康复训练可促进患者认知功能恢复,提升患者运动功能及机体平衡功能,改善患者智力水平与神经功能,进一步提升患者日常生活能力与生活质量。
        Objective  To explore the effect of comprehensive  rehabilitation training on cognitive function in patients with mild cognitive impairment after stroke.Methods  A  prospective  study was conducted on  80  patients with mild cognitive impairment after stroke,who admitted to the hospital from February 2022 to February 2023.They were divided into a comprehensive rehabilitation group and a control group using a lottery method,with 40 patients in each group.The control group  received  routine intervention,while the comprehensive  rehabilitation group  received additional comprehensive  rehabilitation training on the basis of the control group.Their cognitive function,Mini Mental State Examination Scale(MMSE),National  Institutes of Health Stroke Scale in the United States(NIHSS)score changes,motor function and balance function,daily living ability and quality of life were compared.Results  After intervention,the Lowenstein Occupational Therapy Cognitive Scale scores of attention(3.36±0.42),thinking and motor(17.34±2.31),and orientation(13.19±1.24)in the comprehensive  rehabilitation group were higher than those in the control group,and both groups had higher scores after intervention than before(P<0.05).After intervention,the MMSE score(25.58±4.12)of patients in the comprehensive rehabilitation group was higher than that of the control group,and both groups had higher scores after intervention compared to those before intervention.The NIHSS score(14.53±2.62)was lower than that of the control group,and both groups had lower scores after intervention compared to those before interventionP<0.05).After intervention,the Fugl Meyer Assessment score(14.51±3.23),Arm Movement Survey Test Form score(26.86±5.25),and Balance Scale score(43.06±5.13)in the comprehensive rehabilitation group were higher than those in the control group,and both groups had higher scores after intervention than before(P<0.05).After intervention,the Basic Activity of Daily Living score(53.02±4.43)and stroke specific quality of life score(97.11±12.23)in the comprehensive  rehabilitation group were higher than those in the control group,and both groups had higher scores after intervention than before(P<0.05).Conclusions  Comprehensive  rehabilitation training for patients with mild cognitive impairment after stroke can promote cognitive function recovery,improve motor function and balance function,enhance intelligence and neurological function,and further improve daily living ability and quality of life.
论著

功能性经口摄食分级的吞咽管理对高龄吞咽障碍患者的应用效果

Application effect of Functional Oral Intake Scale swallowing management on elderly patients with swallowing disorders

:775-781
 
       目的  探讨功能性经口摄食分级的吞咽管理对高龄吞咽障碍患者的应用效果。方法  选取2022年5月—2024年5月暨南大学附属广州市红十字会医院收治的80例高龄吞咽障碍患者作为研究对象,应用随机数字表法将其分为观察组与对照组,各40例。对照组患者实施常规干预,观察组实施功能性经口摄食分级的吞咽管理干预,对比两组患者干预效果、干预前后的吞咽功能与营养状况、吞咽障碍相关并发症发生率,以及干预前后两组生活质量变化。结果  观察组总有效率为92.50%,高于对照组的72.50%(χ 2 =5.541,P=0.019);两组干预后综合性营养评估法(SGA)、进食评估问卷调查工具-10(EAT-10)评分均降低,且观察组[(6.62±1.24)(15.26±3.42)分]低于对照组[(10.85±2.32)(23.51±4.37)分],对比差异有统计学意义(t分别为10.170、9.403,P<0.05);观察组吞咽障碍相关并发症发生率17.50%低于对照组42.50%(χ 2 =5.952,P=0.015);两组干预后生活质量综合评定量表(GQOLI-74)相关维度物质评分均升高,且观察组患者GQOLI-74相关维度物质生活(16.62±2.24)、心理功能(18.26±4.42)分、社会功能(21.62±3.66)分、躯体功能(23.26±4.37)分均高于对照组[(13.25±3.32)(13.51±2.37)(15.26±2.35)(16.62±3.73)]分,对比差异有统计学意义(t分别为5.322、5.990、9.248、7.309,P<0.05)。结论  功能性经口摄食分级的吞咽管理对高龄吞咽障碍患者干预效果显著,且可提升其吞咽功能,改善营养状况,同时可辅助降低吞咽障碍相关并发症发生率,提高患者生活质量。
       Objective  To explore the application effect of Functional Oral Intake Scale(FOIS)swallowing management on elderly patients with swallowing disorders.Methods  A total of 80 elderly patients with dysphagia admitted to the Guangzhou Red Cross Hospital Affiliated to Jinan University from May 2022 to May 2024 were selected as research subjects.They were divided into an observation group and a control group,with 40 cases in each group,using a random number table method.The control group received routine intervention,while the observation group received FOIS swallowing management intervention.The intervention effects were compared between the two groups,including pre and post intervention,swallowing function and nutritional status,incidence of swallowing related complications,and changes in quality of life before and after the intervention.Results  The total effective rate of the observation group was 92.50%,which was higher than the 72.50% of control group(χ 2 =5.541,P=0.019).After the intervention,the comprehensive nutrition assessment(SGA)and the feeding assessment instrument-10(EAT-10)were decreased,and the observation group ([6.62±1.24]and[15.26±3.42]) were lower than the control group ([10.85±2.32]and[23.51±4.37]),and the comparative difference was statistically significant(t=10.170,9.403,P<0.05).The incidence of complications related to swallowing disorders in the observation group was 17.50%,lower than that in the control group was 42.50%(χ 2 =5.952,P=0.015).After intervention,the scores of GQOLI-74 related dimensions were increased in both groups.In addition,GQOLI-74 related dimensions of material life(16.62±2.24)scores,psychological function(18.26±4.42)scores,social function(21.62±3.66)scores,physical function(23.26±4.37)scores in observation group were higher than those in control group ([13.25±3.32],[13.51±2.37],[15.26±2.35],[16.62±3.73]),and the difference was statistically significant(t=5.322,5.990,9.248,7.309,P<0.05).Conclusions  The swallowing management of FOIS has a significant intervention effect on elderly patients with swallowing disorders,and can improve their swallowing function,nutritional status,and assist in reducing the incidence of swallowing disorder related complications,thereby improving the quality of life of patients.
论著

淋巴细胞亚群在鉴别低增生性骨髓增生异常综合征和再生障碍性贫血中的价值

The value of lymphocyte subpopulations in differentiation between hypoplastic myelodysplastic syndrome and aplastic anemia

:689-693
 
       目的   探讨淋巴细胞亚群在鉴别低增生性骨髓增生异常综合征(hypo-MDS)和再生障碍性贫血(AA)中的价值。方法   选取2020年7月—2023年6月在平顶山市第一人民医院治疗的80例hypo-MDS或和AA患者进行回顾性分析,其中hypo-MDS 48例、AA 32例,分析两组患者各类淋巴细胞(CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ 、CD3+ CD57+ T-大颗粒淋巴细胞、CD3- CD16/CD56+ 自然杀伤细胞、CD19+ B淋巴细胞)的差异。结果   hypo-MDS组的CD3+ (78.42±8.02)%与AA组的(75.65±8.44)%对比差异无统计学意义(P>0.05);hypo-MDS组的CD4+ (47.54±6.88)%、CD4+ /CD8+(2.16±0.61)%高于AA组的CD4+ (40.11±5.71)%、CD4+ /CD8+ (1.49±0.48)%,CD8+ (23.12±6.42)%低于AA组CD8+ (31.77±6.79)%(P<0.05);hypo-MDS患者CD3+ CD57+ T-大颗粒淋巴细胞(13.45±3.77)%、CD3- CD16/CD56+自然杀伤细胞(12.32±3.97)%高于AA组CD3+ CD57+ T-大颗粒淋巴细胞(9.77±2.15)%、CD3- CD16/CD56+ 自然杀伤细胞(8.84±2.11)%,CD19+ B淋巴细胞(9.75±2.08)%低于AA组(12.65±3.35)%(P<0.05)。结论   淋巴亚群变化情况可用于AA和hypo-MDS的鉴别诊断。
       Objective  To explore the value of lymphocyte subsets in differentiation between hypoplastic myelodysplastic syndrome(hypo MDS)and aplastic anemia(AA).Methods  A  retrospective analysis was conducted on 80 patients with hypo MDS and AA who underwent treatment in the First People’s Hospital of Pingdingshan City from July 2020 to June 2023.Among them,there were 48 cases of hypo MDS and 32 cases of AA.The differences in lymphocytes(CD3+ ,CD4+ ,CD8+ ,CD4+ /CD8+CD3+ CD57+  T-large granular lymphocytes,CD3- CD16/CD56+  natural killer cells,and CD19+  B lymphocytes)between the two groups of patients were analyzed.Results  There was no statistically significant difference in CD3+ (78.42±8.02)% between the hypo MDS group and the AA group(75.65±8.44)%(P>0.05).The CD4+ (47.54±6.88)% and CD4+ /CD8+ (2.16±0.61)% in the hypo MDS group were higher than those in the AA group(40.11±5.71)% and (1.49±0.48)%,respectively.The CD8+(23.12±6.42)% was lower than that in the AA group(31.77±6.79)%(P<0.05).The levels of CD3+ CD57+  T-large granular lymphocytes(13.45±3.77)% and CD3- CD16/CD56+  natural killer cells(12.32±3.97)% in hypo MDS patients were higher than those in the AA group([9.77±2.15]%,[8.84±2.11]%),and CD19+  B lymphoid cells(9.75±2.08)% were lower than that in the AA group([12.65±3.35]%,P<0.05).Conclusions  The changes in lymphatic subpopulations can be used for the differential diagnosis of AA or hypo MDS
论著

运动干预联合治疗性聆听对孤独症谱系障碍儿童社会交往功能的影响

The effect of exercise intervention combined with therapeutic listening on social communication function inchildren with autism spectrum disorder

:403-409
 
       目的   探讨运动干预联合治疗性聆听对孤独症谱系障碍儿童社会交往功能的影响。方法   选取黄河三门峡医院2020年1月—2023年10月收治的100例孤独症患儿,应用随机数字表法分为两组,各50例。对照组患儿实施常规护理,观察组在对照组基础上增加运动干预联合治疗性聆听。分别在干预前及干预6个月后采用孤独症治疗评价量表(ATEC)、儿童感觉统合发展评定量表、格塞尔发育量表(GDS)及中国韦氏儿童智力量表(WISC-R)评价两组患儿社会交往能力、感觉统合发展水平、神经发育水平及智力水平变化。结果   干预后两组患儿的ATEC各部分评分,包括健康/生理/行为、感知/认知能力、社交能力、语言表达/沟通能力及ATEC总分均降低,观察组低于对照组(P<0.05);干预后两组患儿学习能力发展、本体感觉、触觉防御、前庭功能及儿童感觉统合发展评定量表总分均升高,观察组高于对照组P<0.05);干预后两组患儿动作能、应物能、言语能、应人能相关神经发育情况评分均升高,观察组高于对照组(P<0.05);干预后两组患儿言语智商、操作智商、总智商相关WISC-R评分均升高,观察组高于对照组(P<0.05)。  运动干预联合治疗性聆听对孤独症谱系障碍儿童应用效果显著,可提升其社会交往能力,促进感觉统合发展,进而促进其神经发育及智力水平提升。
       Objective  To  explore the  effect  of  exercise intervention  combined with therapeutic listening  on  social communication function in children with autism spectrum disorder.Methods  A total of 100 autistic children who were admitted to our hospital from January 2020 to October 2023 were selected and divided into two groups by random number table method,with 50 children each.The control group received routine care,while the observation group  received exercise intervention combined with therapeutic listening in addition to routine care.The Autism Treatment Evaluation Scale (ATEC),Children’s Sensory Integration Development Scale,Gesell Development Scale,and Wechsler Intelligence Scale for Children-Revised by China (WISC-R)were used before and 6 months after the intervention to evaluate the social communication ability,sensory integration development level,neural development level,and intellectual level changes of the two groups of children.Results  After intervention,the score of every dimension in ATEC including the health/physiology/behavior,perception/cognitive ability,social ability,language expression/communication ability,and total ATEC score of the two groups of children decreased,and the observation group was lower than the control group (P<0.05).After intervention,the total scores of the learning ability development insufficient,proprioceptive dysfunction,excessive tactile defense,vestibular dysfunction,and children’s sensory integration development assessment scale in both groups of children increased,with the observation group being higher than the control group (P<0.05).After intervention,the neurological development scores related to motor,adapt,language,and social ability in both groups of children increased,and the observation group was higher than the control group (P<0.05).After intervention,the WISC-R scores related to verbal intelligence,operational intelligence,and total intelligence in both groups of children increased,and the observation group was higher than the control group (P<0.05).Conclusions  The combination of exercise intervention and therapeutic listening has asignificant effect on children with autism spectrum disorder,which can enhance their social communication ability,promote sensory integration development,and ultimately promote their neural development and intellectual level improvement.
论著

ApoE 基因多态性与大动脉粥样硬化型脑梗死及卒中后认知障碍的相关性研究

Correlation of ApoE gene polymorphisms with large artery atherosclerotic cerebral infarction and post-stroke cognitive impairment

:338-345
 
      目的   探讨载脂蛋白E(ApoE)基因多态性与卒中后认知障碍的相关性,即大动脉粥样硬化型脑梗塞的严重程度。方法   采用病例——对照研究的方法,收集九江学院附属医院神经内科的100例急性缺血性脑卒中且病因分型为大动脉粥样硬化型患者(脑梗死组)和50例性别、年龄匹配的非缺血性脑卒中患者(对照组)。检测患者的 ApoE 基因型、血脂、美国国立卫生院卒中量表(NIHSS)、卒中后6个月简易智力状态检查量表(MMSE)等,采用多因素方差分析等统计学方法分析他们之间的关联性。结果  ApoE 3/4基因型频率与Ɛ3、Ɛ4等位基因频率,在脑梗死组别中高于对照组(P<0.05)。同时,携带Ɛ3等位基因患者的低密度脂蛋白水平高于携带Ɛ2、Ɛ4等位基因的患者;进一步分析发现含Ɛ3等位基因的脑梗死患者NIHSS评分更高、卒中后认知障碍更严重(P<0.05)。结论  ApoE基因型为Ɛ3/4、等位基因Ɛ3、Ɛ4更易罹患大动脉粥样硬化型脑梗死,提示该基因型是脑梗死的易感基因,脑梗死后认知障碍患者Ɛ3等位基因的频率较高,可能是卒中后认知障碍的易感因素。
       Objective  To  explore the  relationship  between ApoE  gene  polymorphisms  and  post-stroke  cognitive  impairment,the severity of large artery atherosclerotic cerebral infarction.Methods  A  case-control research  study was conducted,gathering  data from  100 individuals  diagnosed with large artery atherosclerotic cerebral infarction according to the TOAST classification,who admitted to the Neurology Department of the Affiliated Hospital of Jiujiang University.Additionally,50 non-ischemic stroke patients,matched for gender and age,were included as the control group.The patients were assessed for ApoE genotype,blood lipid,NIHSS,and MMSE scale at 6 months post-stroke,and statistical methods were used to analyze their associations.  Results  Significant differences were observed in the ApoE 3/4 genotype frequency and Ɛ3、Ɛ4 allele frequency between patients with cerebral infarction and the control group,with a notably higher incidence of cerebral infarction in the former.Furthermore,patients carrying the Ɛ3 allele exhibited significantly higher LDL levels than those carrying Ɛ2 or Ɛ4.The analysis also revealed that patients with the Ɛ4 allele experienced higher NIHSS and severer post-stroke cognitive impairment.Conclusions  The findings suggest that the ApoE genotype Ɛ3/4 and allele Ɛ3、Ɛ4 may predispose individuals to develop large atherosclerotic cerebral infarction,indicating a susceptibility gene for cerebral infarction.Additionally,the Ɛ3 allele was associated with a higher frequency of cognitive deficits after cerebral infarction,implying that it may be a predisposing factor for post-stroke cognitive impairment.
论著

经颅微电流刺激联合自我穴位按摩在 2 型糖尿病患者睡眠障碍中的应用

Application of transcranial microcurrent stimulation combined with self-acupoint massage in patients with sleep disorders of type 2 diabetes mellitus

:187-191
 
      目的 探讨2型糖尿病(T2DM)睡眠障碍患者使用经颅微电流刺激(CES)联合自我穴位按摩干预的效果。方法 使用随机数表法将南昌大学第二附属医院2022年6月—2023年1月收治的T2DM合并睡眠障碍患者100例分为两组,每组各50例。对照组采用CES干预,基于此,观察组加用自我穴位按摩,比较两组临床疗效、睡眠质量及血糖水平。结果 与对照组干预总有效率80.00%(40/50)比较,观察组干预总有效率96.00%(48/50)更高(χ 2 =6.061,P=0.014);两组干预后匹兹堡睡眠质量指数(PSQI)中入睡时间、睡眠效率、催眠药物、睡眠障碍、睡眠时间、主观睡眠质量、日间功能障碍及总分均降低,且观察组[(0.95±0.28)分、(1.05±0.24)分、(0.55±0.14)分、(0.67±0.20)分、(0.92±0.21)分、(0.82±0.20)分、(0.65±0.18)分、(5.61±1.10)分]均低于对照组[(1.42±0.33)分、(1.30±0.33)分、(1.40±0.26)分、(1.14±0.27)分、(1.31±0.30)分、(1.32±0.37)分、(1.22±0.27)分、(9.11±1.26)分](t=7.679、4.332、20.354、9.891、7.531、8.406、12.421、14.797,均P<0.001);两组干预后餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)及空腹血糖(FBG)水平均降低,且观察组2 hPG[(6.14±0.68)mmol/L]、HbA1c[(3.45±0.37)%]、FBG[(5.52±0.48)mmol/L]低于对照组[(7.12±1.25)mmol/L、(4.30±0.34)%、(6.58±0.67)mmol/L](t=4.870、11.961、9.094,均P<0.001)。结论 对T2DM合并睡眠障碍患者使用CES联合自我穴位按摩干预效果满意,可有效提高患者的睡眠质量,调节血糖水平。
综述

浅析音乐疗法在儿童发育障碍疾病中的应用

Analysis of the application of music therapy in childhood developmental disorders

:62-70
 
       患有发育障碍类疾病的儿童数量庞大,给社会造成了严重的影响。这类疾病难以预防和治愈,同时缺乏特效药物,因此治疗主要依赖于行为和教育干预,药物治疗只是辅助手段。然而,目前临床相关治疗均有一定的不足,如存在不良反应、治疗周期相对较长、专业性要求相对较高等缺点。与之相比,音乐疗法具有操作简便、不良反应少等优势,因此可应用于儿科多种慢性疾病的治疗。文章旨在通过研究现代音乐治疗,探讨结合古代五音疗法、现代知识以及中医理论,为儿童临床治疗提供一定的方法指导。
      The number of children suffering from developmental disorders is substantial,causing significant impact on society.These diseases are difficult to prevent and cure,with a lack of specific medications,thus treatment primarily  relies on behavioral and educational interventions,with medication being only an auxiliary measure.However,current clinical treatments have certain drawbacks,such as potential toxic side effects,relatively long treatment periods,and high demands for specialization.In contrast,music therapy offers significant advantages such as easy operation and minimal side effects,making it suitable for the treatment of various chronic pediatric disease.This paper aims to explore the integration of ancient pentatonic therapy,modern knowledge,and traditional Chinese medicine theory through the study of modern music therapy,providing guidance for clinical treatment of children.
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