摘要
背景:脑卒中后便秘是一种常见的并发症,会降低患者的生活质量,故探讨脑卒中后便秘的治疗方法显得尤为重要。目的:探讨胃肠康复治疗(内脏筋膜手法+中频电刺激)对脑卒中后便秘患者生活质量、血清P物质(SP)和5⁃羟色胺(5⁃HT)水平的影响。方法:选择2020年10月—2021年10月上海市同仁医院收治的70例脑卒中后便秘患者,随机分为对照组(乳果糖治疗)和治疗组(胃肠康复治疗)。评估治疗前后蒙特利尔认知评估量表(MoCA)、Barthel指数评定量表(BI)、焦虑/抑郁自评量表(SAS/SDS)、胃肠道症状评定量表(GSRS)、Wexner便秘评分量表和便秘患者生活质量量表(PAC⁃QOL),采用ELISA法检测血清SP、5⁃HT水平。结果:治疗后,两组MoCA评分无明显差异,SAS评分、SDS评分、GSRS评分、Wexner评分和PAC⁃QOL评分均显著下降(P<0.05)。重复测量方差分析结果显示两组SAS评分、SDS评分差异有统计学意义(P<0.05),且治疗组SAS评分、SDS评分下降更明显;两组MoCA评分、BI评分、GSRS评分、Wexner评分和PAC⁃QOL评分无明显差异(P>0.05)。治疗组血清SP和5⁃HT水平显著高于对照组(P<0.05)。结论:对于改善脑卒中患者的便秘症状,“内脏筋膜手法+中频电刺激”的胃肠康复治疗方法具有与药物治疗相当的治疗效果,值得在临床上进行推广。
Background:Post⁃stroke constipation is a commonly seen complication,which can reduce the quality of life of patients.Therefore,it is particularly important to explore the treatment of post⁃stroke constipation.Aims:To explore the effect of gastrointestinal rehabilitation(visceral fascial manipulation plus middle⁃frequency electrical stimulation)on quality of life,substance P(SP)and 5⁃hydroxytryptamine(5⁃HT)in constipation patients after stroke.Methods:Seventy constipation patients after stroke from Oct.2020 to Oct.2011 at Shanghai Tongren Hospital were enrolled and randomly divided into control group(lactulose treatment)and treatment group(gastrointestinal rehabilitation treatment).Montreal cognitive assessment(MoCA),Barthel index(BI),self⁃rating anxiety/depression scale(SAS/SDS),gastrointestinal symptom rating scale(GSRS),Wexner constipation scale,and patient assessment of constipation⁃quality of life(PAC⁃QOL)were performed before and after treatment.Serum SP,5⁃HT were determined by ELISA.Results:After the treatment,no significant difference in MoCA score was found in both two groups,and SAS score,SDS score,GSRS score,Wexner score and PAC⁃QOL score were significantly decreased(P<0.05).Repeated measures ANOVA showed that significant differences in SAS score,SDS score were found between the two groups(P<0.05),and the decreases of SAS score and SDS score were more obvious in treatment group.No significant differences in MoCA score,BI score,GSRS score,Wexner score and PAC⁃QOL score were found between the two groups(P>0.05).Serum SP,5⁃HT levels in treatment group were significantly higher than those in control group(P<0.05).Conclusions:In the treatment of constipation after stroke,the gastrointestinal rehabilitation therapy of‘visceral fascial manipulation plus middle⁃frequency electrical stimulation’has the therapeutic effects equivalent to drug therapy,and is worthy for promoting in clinical treatment.
作者
宋鸿寅
王震华
李艳
杨杨
SONG Hongyin;WANG Zhenhua;LI Yan;YANG Yang(Division of Gastroenterology and Hepatology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127;Department of Rehabilitation,Tongren Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai)
出处
《胃肠病学》
北大核心
2022年第4期239-244,共6页
Chinese Journal of Gastroenterology
关键词
卒中
便秘
胃肠康复治疗
生活质量
P物质
血清素
Stroke
Constipation
Gastrointestinal Rehabilitation
Quality of Life
Substance P
Serotonin
