【摘要】：目的觀察迷迭香吸嗅方法在腦梗死后認知障礙患者中的干預(yù)效果。 方法選取腦梗死后存在認知障礙的患者66例，隨機分為三組，分別為吸嗅組、奧拉西坦組和對照組，每組均為22例。三組均給予常規(guī)治療，包括控制合并癥，預(yù)防并發(fā)癥，康復(fù)功能訓練，物理因子治療以及活血擴管藥物治療等。在此基礎(chǔ)上，吸嗅組予以迷迭香提取物吸嗅，0.4mL，用20ml常溫純凈水稀釋后放人擴香儀托盤中，放在50cm×40cm×30cm的密閉塑料盒中，利用燈泡加熱，使用鼻導管一端開口于塑料盒，另一端放在患者鼻孔內(nèi)，吸入時間為30min，每天三次。奧拉西坦組予以奧拉西坦靜滴4g溶于250ml生理鹽水或5%葡萄糖水中，靜滴，每天一次。對照組予以常規(guī)治療外，不予特殊處理。三組療程均為4w。分別在干預(yù)前、干預(yù)2w、干預(yù)4w用MMSE（Mini-mental State Examination）及MBI（ModifiedBarthel Index）對三組患者進行評定及療效評估，并記錄數(shù)據(jù)。數(shù)據(jù)結(jié)果應(yīng)用SPSS17.0軟件進行統(tǒng)計學分析。 結(jié)果①吸嗅組MMSE評分干預(yù)前后分別為13.18±3.83（干預(yù)前），16.72±2.93（干預(yù)2W），18.50±3.11（干預(yù)4w），MBI評分干預(yù)前后分別為41.04±6.33（干預(yù)前），54.54±6.70（干預(yù)2w），68.22±5.98（干預(yù)4w）。奧拉西坦組MMSE評分干預(yù)前后分別為11.90±4.15（干預(yù)前），17.13±4.34（干預(yù)2w），19.45±3.71（干預(yù)4w），MBI評分干預(yù)前后分別為39.18±4.96（干預(yù)前），53.50±6.02（干預(yù)2w），66.45±5.30（干預(yù)4w）。對照組MMSE評分分別為12.54±3.20（干預(yù)前），13.31±3.42（干預(yù)2w），14.72±3.46（干預(yù)4w），，MBI評分干預(yù)前后分別為39.31±5.25（干預(yù)前），48.31±4.33（干預(yù)2w），59.04±3.65（干預(yù)4w）。②吸嗅組和奧拉西坦組干預(yù)2w、4w的MMSE評分均較干預(yù)前升高（P0.05），而對照組干預(yù)前后的MMSE評分不具有統(tǒng)計學意義（P0.05）,兩組干預(yù)2w及4w的評分分別與對照組相比有統(tǒng)計學差異（P0.05），且MMSE評分吸嗅組與奧拉西坦組比較無統(tǒng)計學差異（P0.05)，但奧拉西坦組總有效率（86.36%）較吸嗅組（72.27%）高。③3組的MBI評分干預(yù)2w，4w均較干預(yù)前升高（P0.05），吸嗅組與奧拉西坦組的評分和對照組比較升高更明顯，且有統(tǒng)計學差異（P0.05） 結(jié)論①常規(guī)的康復(fù)治療結(jié)合迷迭香吸嗅具有改善腦梗死后認知障礙患者的認知功能及日常生活活動能力的近期療效。②腦梗死患者認知功能的改善程度與日常生活活動能力密切相關(guān)，說明改善認知功能可提高腦梗死患者的日常生活活動能力，提高康復(fù)治療效果。
[Abstract]:Objective to observe the effect of rosemary sniffing in patients with cognitive impairment after cerebral infarction. Methods Sixty-six patients with cognitive impairment after cerebral infarction were randomly divided into three groups: olfactory sniffing group, oxiracetam group and control group, with 22 cases in each group. All the three groups were given routine treatment, including control of complications, prevention of complications, rehabilitation training, physical factor therapy and drug therapy for promoting blood circulation. On this basis, rosemary extract was given in the sniffing group, 0.4 mL, diluted with 20ml pure water at room temperature, placed in the sealed plastic box of 50cm 脳 40cm 脳 30cm, heated by light bulb, and opened at one end of nose tube in plastic box. Place the other end in the nostrils for 30 mins, three times a day. In the oxiracetam group, 4 g of oxiracetam was given intravenously in 250ml saline or 5% glucose solution, once a day. The control group was given routine treatment, without special treatment. All the three groups were treated for 4 ws. MMSE (Mini-mental State Examination) and MBI (ModifiedBarthel Index) were used to evaluate and evaluate the curative effect of the three groups before and after intervention for 2 weeks and 4 weeks, and the data were recorded. The data were analyzed by SPSS17.0 software. Results 1the MMSE score of the sniffing group was 13.18 鹵3.83 (before intervention), 16.72 鹵2.93 (intervention 2W), 18.50 鹵3.11 (), MBI score 4w) before and after intervention, respectively (41.04 鹵6.33 before intervention). 54.54 鹵6.70 (2 weeks), 68.22 鹵5.98 (4 weeks). The MMSE scores before and after intervention were 11.90 鹵4.15 (pre-intervention), 17.13 鹵4.34 (2 weeks) and 19.45 鹵3.71 (39.18 鹵4.96 before and after 4 weeks of intervention) in olaxetam group, respectively. 53.50 鹵6.02 (2 weeks), 66.45 鹵5.30 (4 weeks). The MMSE scores of the control group were 12.54 鹵3.20 (before intervention), 13.31 鹵3.42 (intervention 2 weeks), 14.72 鹵3.46 (before and after 4 weeks intervention), 39.31 鹵5.25 (before intervention) and 48.31 鹵4.33 (intervention 2 weeks), respectively. 59.04 鹵3.65 (4w). 2 the MMSE scores of the olfactory suction group and olaxetam group were higher than those before and after intervention (P0.05), but the MMSE scores of the control group were not statistically significant (P0.05). The scores of 2 weeks and 4 weeks of intervention in the two groups were significantly different from those in the control group (P0.05), and there was no significant difference in MMSE score between the olfactory suction group and olaxetam group (P0.05). However, the total effective rate of oloxetam group (86.36%) was higher than that of sniffing group (72.27%). The MBI score of 33 group was significantly higher than that of pre-intervention group (P0.05), and the score of olfactory suction group and oloxetam group was higher than that of control group. And there was significant difference (P0.05) conclusion: 1 routine rehabilitation therapy combined with rosemary sniffing can improve cognitive function and daily living ability of patients with cognitive impairment after cerebral infarction. 2 recent curative effect of cerebral infarction. The improvement of patients' cognitive function is closely related to their activities of daily life. It shows that improving cognitive function can improve the activity of daily life of patients with cerebral infarction and improve the effect of rehabilitation treatment.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R749.13

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