一项关于肉毒杆菌毒素治疗偏瘫患者痉挛性足部的随机、双盲、安慰剂对照试验。
A randomised, double blind, placebo controlled trial of botulinum toxin in the treatment of spastic foot in hemiparetic patients.
作者信息
Burbaud P, Wiart L, Dubos J L, Gaujard E, Debelleix X, Joseph P A, Mazaux J M, Bioulac B, Barat M, Lagueny A
机构信息
Department of Neurophysiology, Hôpital Haut-Lévèque, Pessac, France.
出版信息
J Neurol Neurosurg Psychiatry. 1996 Sep;61(3):265-9. doi: 10.1136/jnnp.61.3.265.
OBJECTIVE
To confirm the apparent effectiveness of botulinum toxin (BTX) in hemiparetic patients with ankle plantar flexors and foot invertor spasticity.
METHODS
Twenty three hemiparetic patients with spasticity of the ankle plantar flexors and foot invertors were included in a randomised double blind, placebo controlled study with BTX. Patients were examined on days 0, 30, 90, and 120 and received one injection of BTX and one of placebo in a random order at day 0 and day 90.
RESULTS
Patients reported a clear subjective improvement in foot spasticity after BTX (P = 0.0014) but not after placebo. Significant changes were noted in Ashworth scale values for ankle extensors (P < 0.0001) and invertors (P = 0.0002), and for active ankle dorsiflexion (P = 0.0001). Gait velocity was slightly but not significantly (P = 0.0731) improved after BTX injections. The severity of spasticity did not modify treatment efficacy, but BTX was less effective in patients with longer duration of spasticity (P = 0.0081).
CONCLUSION
The efficacy of BTX injections in the treatment of spastic foot suggests that BTX may be particularly useful during the first year after a stroke.
目的
证实肉毒杆菌毒素（BTX）对偏瘫患者踝关节跖屈肌和足内翻肌痉挛的明显疗效。
方法
23例踝关节跖屈肌和足内翻肌痉挛的偏瘫患者纳入一项使用BTX的随机双盲、安慰剂对照研究。在第0、30、90和120天对患者进行检查，并在第0天和第90天以随机顺序分别接受一次BTX注射和一次安慰剂注射。
结果
患者报告BTX注射后足部痉挛有明显主观改善（P = 0.0014），而安慰剂注射后无改善。踝关节伸肌（P < 0.0001）和内翻肌（P = 0.0002）以及主动踝关节背屈（P = 0.0001）的Ashworth量表值有显著变化。BTX注射后步态速度略有改善，但无统计学意义（P = 0.0731）。痉挛严重程度不影响治疗效果，但BTX对痉挛持续时间较长的患者效果较差（P = 0.0081）。
结论
BTX注射治疗足部痉挛的疗效表明，BTX在中风后的第一年可能特别有用。
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