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一项关于心理和行为疗法对吉兰-巴雷综合征肌肉功能恢复影响的倾向评分匹配回顾性研究。

A propensity score matched retrospective study of psychological and behavioral therapy impact on muscle function recovery in Guillain Barré Syndrome.

作者信息

Lu Zhijie, Xie Xin, Rui Zhifeng, Zhang Le, Yang Xiaoli, Fan Jin, Wang Mingyu

机构信息

Department of Neurology, The General Hospital of Western Theater Command, 270 Tianhui Road, Chengdu, 610083, Sichuan, China.

Department of Outpatient Department (OPD), The General Hospital of Western Theater Command, Chengdu, 610083, Sichuan, China.

出版信息

Sci Rep. 2025 Aug 29;15(1):31880. doi: 10.1038/s41598-025-16482-8.

Abstract

Guillain-Barré Syndrome (GBS) is an autoimmune disorder that leads to acute flaccid paralysis and often results in long-term sequelae such as muscle weakness and sensory dysfunction. While recovery is possible, current rehabilitation strategies for muscle function and nerve regeneration often show limited effectiveness and require prolonged treatment. Psychological and behavioral therapy has shown promise in enhancing recovery by improving patient compliance and emotional stability. However, its impact on muscle function recovery in GBS patients remains poorly studied. This research aims to explore the role of psychological and behavioral therapy in improving muscle function and neurological recovery in GBS survivors. Patients diagnosed with classic or variant forms of GBS at the General Hospital of the Western Theater Command from January 2014 to January 2022 were included in this study. Based on the treatment measures received, the patients were divided into two groups: the treatment group received psychological and behavioral therapy in addition to conventional neuromuscular rehabilitation, while the control group received only conventional neuromuscular rehabilitation. The primary outcome measure was the Barthel Index for activities of daily living, and secondary measures included disability scores and sensory function scores. PSM was used to balance baseline characteristics between the two groups, and statistical analyses were performed to assess differences in therapeutic efficacy. After 1:1 Propensity Score Matching (PSM), 277 matched pairs were obtained. There were no significant differences in age, hypertension, diabetes, alcohol consumption, disability scores, sensory function scores, or Barthel Index scores between the two groups (P > 0.05). Comparison of functional assessments at discharge and 6 months after discharge. The results indicate that both the PI-Group and the NI-Group had significant recovery in functional scores (P < 0.05). In different subgroups, the results show that the more severe the condition, the higher the degree of benefit after psychobehavioral therapy (P < 0.05). The analysis suggests that the more severe the condition, the larger the SMD difference. Psychological and behavioral therapy significantly enhances daily functional independence and neuromuscular function recovery in patients with GBS sequelae. It can serve as an effective supplement to conventional rehabilitation. This therapy potentially improves patients' adherence to rehabilitation, alleviates anxiety, and motivates active participation in training, thereby accelerating the recovery of daily living and neuromuscular functions. Further studies are needed to explore its mechanisms and long-term efficacy to provide stronger scientific evidence for GBS rehabilitation.

摘要

吉兰-巴雷综合征(GBS)是一种自身免疫性疾病,可导致急性弛缓性麻痹,并常常导致长期后遗症,如肌肉无力和感觉功能障碍。虽然有可能康复,但目前针对肌肉功能和神经再生的康复策略往往效果有限,且需要长期治疗。心理和行为疗法已显示出通过提高患者依从性和情绪稳定性来促进康复的前景。然而,其对GBS患者肌肉功能恢复的影响仍研究不足。本研究旨在探讨心理和行为疗法在改善GBS幸存者肌肉功能和神经恢复中的作用。本研究纳入了2014年1月至2022年1月在西部战区总医院被诊断为经典型或变异型GBS的患者。根据所接受的治疗措施,将患者分为两组:治疗组在接受常规神经肌肉康复治疗的基础上还接受心理和行为疗法,而对照组仅接受常规神经肌肉康复治疗。主要结局指标是日常生活活动能力的巴氏指数,次要指标包括残疾评分和感觉功能评分。采用倾向得分匹配法(PSM)平衡两组的基线特征,并进行统计分析以评估治疗效果的差异。经过1:1倾向得分匹配(PSM)后,获得了277对匹配对。两组在年龄、高血压、糖尿病、饮酒情况、残疾评分、感觉功能评分或巴氏指数评分方面均无显著差异(P>0.05)。出院时和出院后6个月的功能评估比较。结果表明,干预组和非干预组的功能评分均有显著恢复(P<0.05)。在不同亚组中,结果显示病情越严重,心理行为治疗后的获益程度越高(P<0.05)。分析表明,病情越严重,标准化均数差的差异越大。心理和行为疗法显著提高了GBS后遗症患者的日常功能独立性和神经肌肉功能恢复。它可作为常规康复的有效补充。这种疗法可能会提高患者对康复的依从性,减轻焦虑,并激发其积极参与训练,从而加速日常生活和神经肌肉功能的恢复。需要进一步研究以探索其机制和长期疗效,为GBS康复提供更有力的科学证据。

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