Knutsson E, Martensson A
J Neurol Sci. 1976 Oct;29(2-4):195-212. doi: 10.1016/0022-510x(76)90171-4.
The effects of dantrolene sodium, an anti-spasticity drug with a site of action within the muscle fibres, were studied in 19 patients with spastic paresis. Oral doses were successively increased from 100 mg/day to a maximal tolerated level or up to 800 mg/day. Trial periods were 8-13 weeks. The responses of stretch reflexes to local cooling over the spastic muscles were used to differentiate alpha and gamma spasticity. In the knee extensor and flexor muscle groups, cryo-negative alpha-spasticity was seen in 25 and cryo-positive gamma-spasticity in 4 muscle groups. Ankle clonus was cryo-positive in 14 of 15 cases. Resistance to passive knee joint movements, ankle clonus and isometric or isokinetic muscle strength was determined quantitatively. The gait was recorded by intermittent-light photography and the muscle activation patterns in gait were studied in recordings of the average EMG from limb muscles. Functional disability and spasms were assessed from clinical examinations and interviews. Passive resistance at slow (6%/sec) and fast (30 degrees/sec) knee joint movements decreased by 32% in the extensor muscles (p = 0.005 resp. 0.001) and by 23-26% in the flexor muscles (not significant). Reduced passive resistance was observed in 16 of the muscles with alpha-spasticity and in all 4 of the muscle groups with gamma-spasticity. Clonus was diminished or abolished in 14 of 15 patients with this sign. Maximal isometric or isokinetic muscle strength was unaltered in the majority of the patients. In a few the strength was increased, in some it was decreased. The averaged EMG activity during walking as studied in 10 patients were increased in 35 of the 57 muscle groups examined. In some muscle groups, exaggerated activity attributable to spastic reflexes was reduced. Motor disability was decreased significantly in 10 patients. It was not significantly changed in 5 and deteriorated in 4 patients. Drowsiness and subjective muscle weakness were the most frequent side-effects. SGOT and SGPT were increased in 3 cases.
对19例痉挛性轻瘫患者研究了丹曲林钠（一种作用于肌纤维的抗痉挛药物）的疗效。口服剂量从100mg/天依次增加至最大耐受水平或直至800mg/天。试验期为8 - 13周。利用痉挛肌肉局部冷却时牵张反射的反应来区分α和γ痉挛。在膝伸肌和屈肌组中，25个肌肉组出现冷阴性α痉挛，4个肌肉组出现冷阳性γ痉挛。15例中有14例踝阵挛为冷阳性。定量测定了被动膝关节运动阻力、踝阵挛以及等长或等速肌力。通过间歇光摄影记录步态，并在肢体肌肉平均肌电图记录中研究步态中的肌肉激活模式。通过临床检查和访谈评估功能障碍和痉挛情况。膝关节缓慢（6°/秒）和快速（30°/秒）运动时的被动阻力，伸肌降低了32%（p分别为0.005和0.001），屈肌降低了23% - 26%（无显著性差异）。在16个有α痉挛的肌肉和所有4个有γ痉挛的肌肉组中观察到被动阻力降低。15例有此体征的患者中，14例的阵挛减轻或消失。大多数患者的最大等长或等速肌力未改变。少数患者肌力增加，部分患者肌力降低。在10例患者中研究的行走过程中的平均肌电图活动，在所检查的57个肌肉组中有35个增加。在一些肌肉组中，由痉挛反射引起的过度活动减少。10例患者的运动功能障碍显著降低。5例无显著变化，4例恶化。嗜睡和主观肌肉无力是最常见的副作用。3例患者的谷草转氨酶和谷丙转氨酶升高。
