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A型肉毒毒素注射联合痉挛肌治疗仪治疗脑卒中患者下肢痉挛的临床研究

Clinical study of botulinum toxin A injection combined with spasmodic muscle therapeutic instrument on lower limb spasticity in patients with stroke.

作者信息

Ding Xudong, Huang Li, Wang Qingsong, Liu Yanping, Zhong Jing, Chen Huaxian

机构信息

Department of Rehabilitation Medicine, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China.

Department of Ultrasound Imaging, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China.

出版信息

Exp Ther Med. 2017 Jun;13(6):3319-3326. doi: 10.3892/etm.2017.4376. Epub 2017 Apr 24.

Abstract

The clinical effect of botulinum toxin A (BTX-A) injection combined with spasmodic muscle therapeutic instrument with simple BTX-A injection was compared. Eighty patients with stroke were randomly divided into the treatment and control groups of 41 and 39 cases, respectively. The two groups of patients were given routine rehabilitation therapy. Ultrasound-guide positioning technology was used; treatment group was administered BTX-A injection combined spasmodic muscle therapeutic instrument while the control group received only BTX-A injection. Muscle tension and motor function were evaluated at 1, 4, 8 and 12 weeks after treatments by rehabilitation physician who was not aware of the grouping of the patients. Muscle tension was significantly reduced after BTX-A injection in the treatment and control groups. Modified Ashworth scale scores of the treatment and control groups 1 and 4 weeks after treatment were significantly lower than those before treatment. Motor function of lower limbs of patients, 1 and 4 weeks after treatment improved significantly. The comparison of step size and walking speed of the groups showed obvious differences with statistical significance (P<0.01). In conclusion, ultrasonic guidance BTX-A injection is easy to operate with good safety. It can effectively improve extensor myospasm of lower limb of patients with rapid onset and the spasm relief can last for three months. Spasmodic muscle therapeutic instrument can improve the spasm condition of lower limb muscle after stroke as well as motor function of lower limbs and activity of daily living, which can make spasmolysis of BTX-A last for a longer period of time.

摘要

比较A型肉毒毒素(BTX-A)注射联合痉挛肌治疗仪与单纯BTX-A注射的临床效果。80例脑卒中患者随机分为治疗组41例和对照组39例。两组患者均给予常规康复治疗。采用超声引导定位技术;治疗组给予BTX-A注射联合痉挛肌治疗仪,对照组仅给予BTX-A注射。由不了解患者分组情况的康复医师在治疗后1、4、8和12周评估肌张力和运动功能。治疗组和对照组BTX-A注射后肌张力均显著降低。治疗后1周和4周,治疗组和对照组的改良Ashworth量表评分均显著低于治疗前。治疗后1周和4周,患者下肢运动功能明显改善。两组步幅和步行速度比较差异有统计学意义(P<0.01)。综上所述,超声引导下BTX-A注射操作简便、安全性好。能有效改善脑卒中患者下肢伸肌痉挛,起效快,痉挛缓解可持续3个月。痉挛肌治疗仪可改善脑卒中后下肢肌肉痉挛状态以及下肢运动功能和日常生活活动能力,可使BTX-A的解痉作用持续更长时间。

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