Effects of psychotherapy combined with early comprehensive rehabilitation therapy on cerebral infarction / 中国基层医药

ABSTRACT

Objective:To investigate the clinical efficacy of psychotherapy combined with early comprehensive rehabilitation therapy in the treatment of acute cerebral infarction and the possible mechanism of action.Methods:Eighty-four patients with acute cerebral infarction who received treatment in Yuhang Fifth People's Hospital, China between June 2018 and February 2020 were included in this study. They were randomly divided into an observation group ( n = 44) and a control group ( n = 40). The control group was treated with conventional therapy. The observation group was subjected to early comprehensive rehabilitation therapy combined with psychotherapy based on conventional therapy. All patients were treated for 1 month. Clinical efficacy, the percentage of highly glycosylated type I transmembrane glycoprotein-positive cells and vascular endothelial growth factor receptor-2-positive cells (CD 34+KDR +) in monocytes, and serum level of stromal cell-derived factor-1α were compared between the observation and control groups. Results:After treatment, the scores of Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and National Institutes of Health Stroke Scale (NIHSS) were (16.4 ± 3.8) points, (17.9 ± 5.2) points, (3.56 ± 0.46) points, respectively, which were significantly lower than those in the control group [(23.4 ± 5.6) points, (23.7 ± 6.4) points, (5.39 ± 0.87) points, t = 7.896, 7.258, 6.935, all P < 0.05]. Barthel Index, Fugl-Meyer score, and Functional Independence Score in the observation group were (79.7 ± 20.8) points, (54.6 ± 17.2) points, (96.8 ± 8.5) points, respectively, which were significantly higher than those in the control group [(60.4 ± 17.6) points, (39.6 ± 14.8) points, (83.1 ± 9.7) points, t = 8.123, 7.251, 8.009, all P < 0.05]. After treatment, the percentage of CD34 +KDR + in monocytes and serum level of stromal cell-derived factor-1α in the observation group were (1.58 ± 0.19)% and (1.84 ± 0.11) μg/L, respectively, which were significantly higher than those in the control group [(0.73 ± 0.20)% and (1.34 ± 0.09) μg/L, t = 7.125, 6.983, both P < 0.05). Conclusion:Based on conventional treatment, psychotherapy combined with early rehabilitation treatment can improve the clinical efficacy in the treatment of acute cerebral infarction possibly through increasing the percentage of CD 34+KDR + in monocytes and the serum level of stromal cell-derived factor-1α.