摘要
目的探究标准化丰富环境(EE)对卒中后痴呆患者认知功能及血清脑源性神经营养因子(BDNF)水平的影响。方法前瞻性选取2021年1月-2023年5月解放军联勤保障部队第910医院中医康复科收治的80例卒中后痴呆患者,随机分为对照组、认知训练(COG)组、有氧运动训练(AE)组与EE组,每组20例。4组均接受常规治疗,COG组增加认知功能训练(30 min/次),AE组增加有氧运动训练(30 min/次),EE组增加有氧运动训练(15 min/次)和认知功能训练(15 min/次);训练均为1次/d、5 d/周,持续8周。于治疗前及治疗4、8周评定患者的简易精神状态检查(MMSE)、改良巴氏指数(MBI)、汉密尔顿抑郁量表(HAMD)、卒中专用生活质量(SS-QOL)评分并检测血清BDNF水平。结果治疗前,4组患者的一般资料和MMSE、MBI、HAMD、SS-QOL评分及血清BDNF水平比较差异均无统计学意义(P>0.05)。治疗4、8周,4组患者的上述指标均较治疗前改善,差异均有统计学意义(P<0.05)。组间比较显示,治疗4、8周,COG组、AE组和EE组的MMSE、MBI、SS-QOL评分及BDNF水平均高于对照组,HAMD评分低于对照组,差异均有统计学意义(P<0.05);EE组的MMSE、MBI、SS-QOL评分及血清BDNF水平均优于其他3组,而HAMD评分低于其他3组,差异均有统计学意义(P<0.05)。COG组与AE组的上述结局指标在治疗4周和8周时比较差异均无统计学意义(P>0.05)。结论EE可明显增强卒中后痴呆患者的认知功能、日常生活能力,缓解抑郁情绪及提高生活质量,其潜在机制可能与血清BDNF水平升高有关。
Objective To explore the effects of standardized environmental enrichment(EE)on cognitive function and serum brain-derived neurotrophic factor(BDNF)levels in patients with post-stroke dementia.Methods A prospective study was conducted,including 80 patients with post-stroke dementia admitted to Department of Traditional Chinese Medicine Rehabilitation,910th Hospital of the Joint Logistics Support Force of Chinese PLA from January 2021 to May 2023.Patients were randomly divided into control group,cognitive training(COG)group,aerobic exercise training(AE)group and environmental enrichment(EE)group,with 20 cases in each group.All patients received routine treatment,with COG group receiving additional cognitive function training(30 minutes each time),AE group receiving additional aerobic exercise training(30 minutes each time),and EE group receiving both aerobic exercise and cognitive function training(15 minutes of aerobic exercise training and 15 minutes of cognitive training each time).The training was conducted once a day,5 days a week,for a total of 8 weeks.The patients'mini-mental state scale(MMSE),modified Barthel index(MBI),Hamilton depression scale(HAMD),stroke-specific quality of life(SS-QOL)score and serum levels of BDNF were assessed before treatment,at 4 weeks and 8 weeks of treatment,respectively.Results Before treatment,there were no significant differences in general information,MMSE,MBI,HAMD,SS-QOL scores,and serum levels of BDNF among the four groups(P>0.05).After 4 and 8 weeks of treatment,the above indicators of the four groups were improved compared with those before treatment,with all differences being statistically significant(P<0.05).Inter-group comparison showed that after 4 and 8 weeks of treatment,MMSE,MBI,SS-QOL scores,and serum BDNF levels in COG,AE and EE groups were significantly higher than those in control group,and HAMD scores were significantly lower than those in control group(P<0.05).In addition,MMSE,MBI,SS-QOL scores and BDNF levels of group EE were better than those of other 3 gr
作者
周甜甜
苏文杰
林友聪
陈毕能
连松勇
Zhou Tian-Tian;Su Wen-Jie;Lin You-Cong;Chen Bi-Neng;Lian Song-Yong(Department of Rehabilitation Therapy,School of Clinical Medicine,Quanzhou Medical College,Quanzhou,Fujian 362000,China;Department of Traditional Chinese Medicine Rehabilitation,910th Hospital,Joint Logistics Support Force of Chinese PLA,Quanzhou,Fujian 362000,China)
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2024年第7期790-795,共6页
Medical Journal of Chinese People's Liberation Army
基金
泉州医学高等专科学校校级课题(XJK2216B)。
