摘要
中枢性肌肉痉挛主要以脑卒中和脑瘫后肌肉痉挛为主,会遗留不同程度的运动和功能障碍,给家庭、社会带来沉重负担。现有的治疗方法有保守治疗及手术治疗,保守治疗又分为药物治疗与非药物治疗,药物治疗以肉毒碱等注射为主,有一定疗效,但持续时间有限;非药物干预措施较多,但均疗效欠佳且缺乏高质量的证据。外科手术虽有效,但属有创治疗。因此,寻找一种安全有效非侵入性的控制肌肉痉挛的方法就显得非常必要。近年来,体外冲击波疗法治疗脑卒中后肌肉痉挛及小儿脑瘫肌肉痉挛显示了良好的疗效,研究发现体外冲击波可通过调控终末神经感受器传导控制中枢性肌肉痉挛。人体正常的肌肉组织具有一定的修复能力,当一些因素导致其受损时,肌肉组织会通过调控基因表达及生长因子等启动相关的肌肉合成途径来修复受损的部位。如何调控肌肉代谢和促进其修复损伤是近年来的热点,研究发现体外冲击波可通过调控肌肉组织的卫星细胞及相关生长因子等调节相关肌肉代谢,从而促进损伤修复。本文就体外冲击波疗法控制中枢性肌肉痉挛及促进肌肉代谢方面的研究进展进行综述。
Central muscle spasm are mainly the muscle spasm after stroke and cerebral palsy,which will leave behind impairment on exercise and function of different degree,bringing serious burden to the family and society.The existing treatment methods include conservative treatment and surgical treatment.Conservative treatment is divided into drug treatment and non-drug treatment.Drug treatment is mainly given out by botuline injection, with certain efficacy but limited duration.Many non-drug interventions exsist,but has the disadvantage of poor efficacy and lack of high-quality evidence.Surgery is effective,but it is an invasive treatment.Therefore,it is very necessary to find a safe and effective noninvasive way to control muscle spasms.In recent years,extracorporeal shock wave therapy has shown good efficacy in the treatment of poststroke muscle spasm muscle and muscle spasm in pediatric cerebral palsy.Studies have found that extracorporeal shock wave can control central muscle spasm through the regulation of terminal neuroreceptor conduction.The normal muscle tissue of the human body has a certain repair ability.When some factors lead to its damage,the muscle tissue will repair the damaged site by regulating gene expression and growth factors and other muscle pathways related to the muscle synthesis.How to regulate muscle metabolism and promote its repair of damage is a hot spot in recent years.Studies have found that in vitro shock wave can regulate related muscle metabolism by regulating satellite cells and related growth factors in muscle tissue,thus promoting damage repair.This article reviewed the research progress of extracorporeal shock wave therapy in controlling central muscle spasm and promoting muscle metabolism.
作者
肖健
梁豪君
纪宝尚
邢更彦
Xiao Jian;Liang Haojun;Ji Baoshang;Xing Gengyan(Department of Orthopedics,Third Medical Center of Chinese People’s Liberation Army General Hospital,Beijing 100039,China;Emergency Surgery,Qingdao Eight People's Hospital Qingdao 266000,Shandong,China)
出处
《中国医学前沿杂志（电子版）》
2022年第11期7-14,共8页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
首都临床特色应用研究项目(Z181100001718018)
国家自然科学基金面上项目(81873914)。
关键词
中枢性肌肉痉挛
肌肉代谢
体外冲击波
Central muscle spasticity
Muscle metabolism
Extracorporeal shock wave
