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Objective:To explore the effect of prophylactic use of anti-osteoporosis drugs on hand function in hemiplegic patients after stroke.Methods:From January 2018 to October 2019, 66 patients with hemiplegia after stroke admitted to the Third Hospital of Quzhou were selected and randomly divided into observation group and control group according to the random digital table method, with 33 cases in each group.The control group was given routine rehabilitation treatment, the observation group was given calcium carbonate D3 combined with calcitriol preventive anti-osteoporosis treatment.The two groups were treated for 12 weeks.Before and after treatment, the Brunnstrom stage score, Fugl Meyer(FMA) score, Wolf exercise score, modified Barthel index score, bone mineral density(BMD) and bone markers were compared between the two groups.Results:After treatment for 4, 8, 12 weeks, the Brunnstrom stage scores of the observation group were (2.97±0.90)points, (3.89±1.04)points, (4.68±1.04)points, respectively, which were higher than those of the control group[(2.46±0.89)points, (3.13±0.97)points, (4.09±0.97)points]( t=2.315, 3.070, 2.383, all P<0.05)and the FMA scores of the observation group were (34.28±5.17)points, (49.12±6.24)points, (55.73±6.74)points, respectively, which were higher than those of the control group [(30.07±5.05)points, (44.78±6.03)points, (50.10±6.71)points] ( t=3.346, 2.873, 3.401, all P<0.05), and the Wolf exercise scores of the observation groupwere (1.83±0.45)points, (2.91±0.64)points, (3.96±0.91)points, which were higher than those of the control group [(1.49±0.49)points, (2.28±0.57)points, (3.42±0.83)points] ( t=2.936, 4.223, 2.519, all P<0.05), and the Barthel index scores of the observation group were (59.12±5.73)points, (71.34±6.03)points, (78.98±6.89)points, respectively, which were higher than those of the control group [(55.14±5.62)points, (65.23±6.19)points, (71.54±6.80)points] ( t=2.849, 4.062, 4.415, all P<0.05). After 4, 8 and 12 weeks of treatment, BMD level of lumbar spine and hip in the observation group were higher than those in the control group, and the differences were statistically significant(all P<0.05). After 4, 8 and 12 weeks of treatment, the total amino terminal propeptides of type I collagen in the observation group were (76.02±7.26)μg/L, (58.34±6.45)μg/L, (49.12±5.12)μg/L, respectively, which were lower than those in the control group[(79.98±7.13)μg/L, (64.48±6.71)μg/L, (54.29±5.15)μg/L]( t=2.236, 3.790, 4.090, all P<0.05), and the serum osteocalcin levels in the observation group were (3.41±0.53)ng/L, (4.75±0.49)ng/L, (6.09±0.72)ng/L, respectively, which were higher than those of the control group [(3.02±0.48)ng/L, (4.16±0.47)ng/L, (5.41±0.67)ng/L]( t=3.133, 4.992, 3.972, all P<0.05)and the 25 dihydroxyvitamin D3 levels in the observation group were (34.87±5.41)ng/L, (48.71±5.67)ng/L, (72.67±6.95)ng/L, respectively, which were higher than those of the control group [(30.22±5.30)ng/L, (42.35±5.12)ng/L, (64.62± 6.14)ng/L]( t=3.527, 4.782, 4.987, all P<0.05). Conclusion:The preventive use of anti-osteoporosis drugs in patients with hemiplegia after stroke has significant effect, which can improve the function of hands and upper limbs, improve the quality of life of patients, improve the bone density and improve the bone metabolism index of patients.
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Objective@#To analyze the clinical effect of fluoxetine in the treatment of patients with post-cerebral infarction depression (PSD) and its influence on neurological rehabilitation.@*Methods@#From February 2017 to February 2018, 92 PSD patients received treatment in the department of neurology of the Third People's Hospital of Quzhou were included in the study.The patients were randomly divided into two groups according to the digital table, with 46 cases in each group.The control group was treated with specialist symptomatic therapy, while the study group was treated with fluoxetine intervention for 4 weeks.The Hamilton anxiety scale (HAMD), neurological deficit scale (NIHSS) and daily living capacity scale (ADL) were used to evaluate the clinical effects of the two groups, and the adverse reactions of the two groups were observed.@*Results@#One week before treatment, the HAMD, NIHSS and ADL scores of the study group were (28.37±2.18)points, (23.10±3.16)points and (40.61±3.52)points, respectively, which of the control group were (28.30±2.24)points, (22.91±3.20)points and (41.15±3.35)points, respectively, there were no statistically significant differences between the two groups (t=0.223, 1.522, 0.761, all P>0.05). After 2 weeks of treatment, the HAMD, NIHSS and ADL scores of the study group were (21.08±2.33)points, (19.27±2.89)points and (49.26±2.88)points, respectively, which were higher than those of the control group[(24.15±2.43)points, (21.16±2.18)points, (44.26±2.54)points](t=4.384, 10.216, 8.276, all P<0.05). After 4 weeks of treatment, the HAMD, NIHSS and ADL scores of the study group were (12.61±1.87)points, (10.12±1.30)points, (70.13±2.16)points, respectively, which were higher than those of the control group[(15.20±2.06)points, (17.45±2.66)points, (51.19±2.46)points](t=7.273, 18.283, 5.371, all P<0.05). The total effective rate of neurological recovery in the study group was 91.30%(42/46), the total effective rate of depression treatment was 84.78%(39/46), which in the control group were 76.09%(35/46) and 65.22%(30/46), respectively, the differences were statistically significant (χ2=3.903, 4.696, all P<0.05).@*Conclusion@#The application of fluoxetine in the treatment of PSD can effectively improve the patients' depressive symptoms, promote the recovery of neurological function, improve self-care ability, and has high safety.It has important clinical value.
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Objective To analyze the clinical effect of fluoxetine in the treatment of patients with post-cerebral infarction depression ( PSD) and its influence on neurological rehabilitation.Methods From February 2017 to February 2018,92 PSD patients received treatment in the department of neurology of the Third People ＇s Hospital of Quzhou were included in the study.The patients were randomly divided into two groups according to the digital table , with 46 cases in each group.The control group was treated with specialist symptomatic therapy ,while the study group was treated with fluoxetine intervention for 4 weeks.The Hamilton anxiety scale (HAMD),neurological deficit scale (NIHSS) and daily living capacity scale (ADL) were used to evaluate the clinical effects of the two groups ,and the adverse reactions of the two groups were observed.Results One week before treatment,the HAMD,NIHSS and ADL scores of the study group were (28.37 ±2.18)points,(23.10 ±3.16)points and (40.61 ±3.52)points,respectively, which of the control group were (28.30 ±2.24)points,(22.91 ±3.20)points and (41.15 ±3.35)points,respectively, there were no statistically significant differences between the two groups (t＝0.223,1.522,0.761,all P＞0.05). After 2 weeks of treatment ,the HAMD,NIHSS and ADL scores of the study group were (21.08 ±2.33) points, (19.27 ±2.89) points and (49.26 ±2.88) points,respectively,which were higher than those of the control group [(24.15 ±2.43)points,(21.16 ±2.18)points,(44.26 ±2.54)points](t＝4.384,10.216,8.276,all P＜0.05). After 4 weeks of treatment ,the HAMD,NIHSS and ADL scores of the study group were (12.61 ±1.87) points, (10.12 ±1.30 ) points, (70.13 ±2.16) points, respectively, which were higher than those of the control group [(15.20 ±2.06)points,(17.45 ±2.66)points,(51.19 ±2.46)points](t＝7.273,18.283,5.371,all P＜0.05). The total effective rate of neurological recovery in the study group was 91.30%(42／46),the total effective rate of depression treatment was 84.78%(39／46),which in the control group were 76.09%(35／46) and 65.22%(30／46),respectively,the differences were statistically significant (χ2 ＝3.903,4.696,all P＜0.05).Conclusion The application of fluoxetine in the treatment of PSD can effectively improve the patients ＇depressive symptoms,promote the recovery of neurological function ,improve self-care ability,and has high safety.It has important clinical value.