摘要
目的比较A型肉毒毒素与酒精局部注射治疗脑卒中后下肢肌痉挛的效果。方法选取2014年7月—2017年7月无锡同仁康复医院收治的脑卒中后下肢肌痉挛患者128例,采用随机数字表法分为对照组和观察组,每组64例。在常规药物治疗和电针刺激治疗基础上,对照组患者给予酒精局部注射治疗,观察组患者给予A型肉毒毒素局部注射治疗。分别于注射前及注射后2、4、8周采用改良Ashworth分级量表(MAS)评价两组患者肌张力,通过测量起立行走3 m所用时间、步行10 m所用时间评价两组患者行动功能,采用改良Barthel指数评定量表(MBI)评价两组患者日常生活活动能力,并观察两组患者治疗期间不良反应发生情况。结果注射前、注射后2周两组患者MAS评分比较,差异无统计学意义(P>0.05);注射后4、8周观察组患者MAS评分低于对照组(P<0.05)。注射前及注射后2、4周两组患者起立行走3 m所用时间、步行10 m所用时间比较,差异无统计学意义(P>0.05);注射后8周观察组患者起立行走3 m所用时间、步行10 m所用时间短于对照组(P<0.05)。注射前两组患者MBI评分比较,差异无统计学意义(P>0.05);注射后2、4、8周观察组患者MBI评分高于对照组(P<0.05)。两组患者治疗期间均未出现明显不良反应。结论与酒精局部注射相比,A型肉毒毒素局部注射可更有效地降低脑卒中后下肢肌痉挛患者肌张力,提高患者行动功能和日常生活活动能力,且安全性较高。
Objective To compare the comparative study for therapeutic effect on lower limb muscle spasm after stroke between local injection of botulinum toxin A and alcohol. Methods A total of 128 patients with lower limb muscle spasm after stroke were selected in Tongren Rehabilitation Hospital of Wuxi from July 2014 to July 2017,and they were divided into control group and observation group according to random number table,each of 64 cases. Based on conventional medical treatment and electric needle stimulation treatment,patients in control group received local injection of alcohol,while patients in observation group received local injection of botulinum toxin A. Before injection,2 weeks,4 weeks and 8 weeks after injection,modified Ashworth scale（MAS）was used to evaluate the muscular tension,motor function was evaluated by measuring elapsed time for standing up and 3-meter walking,elapsed time for 10-meter walking,modified Barthel index（MBI）was used to evaluate the activities of daily living abilities,and incidence of adverse reactions was observed during treatment. Results No statistically significant differences of MAS score was found between the two groups before injection or 2 weeks after injection（P〉0.05）,while MAS score in observation group was statistically significantly lower than that in control group 4 weeks and 8 weeks after injection,respectively（P〈0.05）.No statistically significant differences of elapsed time for standing up and 3-meter walking,or elapsed time for 10-meter walking was found between the two groups before injection,2 weeks or 4 weeks after injection（P〉0.05）,while elapsed time for standing up and 3-meter walking,and elapsed time for 10-meter walking in observation group were statistically significantly shorter than those in control group 8 weeks after treatment（P〈0.05）. No statistically significant differences of MBI score was found between the two groups before injection（P〉0.05）,while MBI score in observation group was statistically significantly higher th
作者
龚雪阳
吴明
陈兰
GONG Xue-yang;WU Ming;CHEN Lan(Department of Rehabilitation Medicine,Tongren Rehabilitation Hospital of Wuxi（Mental Health Center of Wuxi）,Wuxi 214000,China)
出处
《实用心脑肺血管病杂志》
2018年第4期78-81,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
无锡市医院管理中心科研项目(YGZXZ1514)
关键词
卒中
下肢肌痉挛
A型肉毒毒素
酒精
疗效比较研究
Stroke
Lower limb muscle spasm
Botulinum toxin A
Alcohol
Comparative effectiveness research
