刘晓春 钱江 刘贞仔 温优良 唐小冬

[摘要] 目的 探讨早期应用神经肌肉本体促进技术（PNF）联合药物治疗对老年脑卒中后偏瘫患者骨质疏松的预防作用。 方法 选择本院2014年1月～2015年4月住院治疗的80例脑卒中后偏瘫患者作为研究对象，随机分为治疗组和对照组，每组40例。两组均接受PNF技术，治疗组联合采用降钙素、碳酸钙D3抗骨质疏松治疗，对照组未进行任何抗骨质疏松药物治疗，检测、比较两组患者治疗前（入组时）、治疗8周后偏瘫侧股骨近端Ward 三角、第1腰椎、桡骨远端的骨密度。 结果 两组患者治疗前3个检测部位的骨密度差异无统计学意义（P>0.05）。治疗组、对照组治疗8周后的上述指标与治疗前差异有统计学意义（P<0.01、P<0.05）。治疗组治疗8周后的上述指标较对照组明显升高，差异有统计学意义（P<0.05）。 结论 脑卒中后偏瘫患者应尽早进行康复训练，联合抗骨质疏松药物治疗比单纯康复训练可显著增加骨密度，预防继发性骨质疏松的效果更佳。

[关键词] 脑卒中；偏瘫；骨质疏松；神经肌肉本体促进技术；药物治疗；骨密度

[中图分类号] R743.3 [文献标识码] A [文章编号] 1674-4721（2016）03（b）-0034-03

Effect study on early application of PNF technology combined with drug therapy for osteoporosis in elderly patients with hemiplegia after stroke

LIU Xiao-chun QIAN Jiang LIU Zhen-zi WEN You-liang TANG Xiao-dong

The Third Hospital Affiliated to Gannan Medical School，Rehabilitation Hospital Affiliated to Gannan Medical School in Jiangxi Province，Ganzhou 341000，China

[Abstract] Objective To discuss the preventive effect of early application of proprioceptive neuromuscular facilitation （PNF） technology combined with drug therapy for osteoporosis in elderly patients with hemiplegia after stroke. Methods 80 patients with hemiplegia after stroke treated by our hospital from January 2014 to April 2015 were selected and randomly divided into treatment group and control group，and there were 40 patients in each group.Patients in both groups were treated by PNF technology，and treatment group was added calcitonin and calcium carbonate D3 for anti-osteoporosis therapy，while control group was given no anti-osteoporosis therapy.The bone mineral density （BMD） of the affected side at proximal femur Ward triangle，distal radius，and the 1st lumbar vertebra was detected and compared respectively before treatment （when entering the groups） and after 8 weeks treatment. Results There was no significant difference in BMD of all the three detected sites between two groups before treatment （P>0.05）.There was a statistical difference of above-mentioned indexes after 8 weeks treatment compared with before treatment in treatment group and control group （P<0.01，P<0.05）.Above-mentioned indexes after 8 weeks treatment in treatment group was significantly increased compared with control group，and there was a statistical difference （P<0.05）. Conclusion Rehabilitation training should be conducted as early as possible for patients with hemiplegia after stroke.Combination with anti-osteoporosis therapy is more effective in obvious increase of BMD and prevention of secondary osteoporosis.

[Key words] Stroke；Hemiplegia；Osteoporosis；Proprioceptive neuromuscular facilitation； Drug therapy；Bone mineral density

近年来，随着社会老年人口的增多，脑卒中的发病率也在逐年增高。骨质疏松症作为老年脑卒中患者肢体瘫痪后最常见的并发症，由其造成的骨折是脑卒中患者高致残率、高病死率的主要原因[1]，因此，早期诊断、尽早采用康复训练并结合药物治疗，积极防止继发性骨质疏松，对改善患者预后及生活质量的意义重大。神经肌肉本体促进技术（proprioceptive neuromuscular facilitation，PNF）是通过对本体感受器进行刺激以促进神经、肌肉反应能力的一种常用现代康复易化技术[2]。本研究通过早期（发病2周内）对老年脑卒中后偏瘫患者应用PNF技术进行康复训练联合抗骨质疏松药物治疗，分析其对偏瘫后继发性骨质疏松的防治效果。