肉毒毒素联合活血通络法治疗老年脑卒中后肌肉痉挛的临床疗效研究

发布时间：2018-05-17 19:53

  本文选题：肉毒毒素 + 活血通络法　； 参考：《中华中医药学刊》2017年06期

【摘要】：目的 :探讨肉毒毒素联合活血通络法治疗老年脑卒中后肌肉痉挛的临床疗效。方法:研究对象为医院康复科治疗的脑卒中后肌肉痉挛老年患者84例,按随机数字表法分组,各42例,对照组予以常规治疗,研究组在常规治疗基础上予以肉毒毒素联合活血通络法治疗,共治疗4周为1疗程,采用相应标准评价上肢关节活动度、肌张力及活动功能状况,同时对比临床疗效及不良反应。结果:在临床疗效上,对照组有效率71.43%与研究组有效率90.48%数据对比,有差异(P0.05);相对于治疗前,两组治疗后关节活动度升高,肌张力降低,FMA评分和FIM上肢评分均升高,正中神经和尺神经H反射潜伏期升高,Hmax/Mmax降低,有差异(P0.05);相对于对照组,研究组治疗后关节活动度较高,肌张力较低,FMA评分和FIM上肢评分较高,正中神经和尺神经H反射潜伏期较高,Hmax/Mmax较低,有差异(P0.05)。结论:肉毒毒素联合活血通络法治疗老年脑卒中后肌肉痉挛疗效确切,降低上肢肌张力,提高神经功能和关节活动度。
[Abstract]:Objective: to investigate the clinical effect of botulinum toxin combined with activating blood circulation and dredging collaterals in the treatment of muscle spasm after stroke in the elderly. Methods: 84 elderly patients with muscle spasm after stroke were divided into two groups according to random digital table method. The control group was treated with routine therapy. On the basis of routine treatment, the study group was treated with botulinum toxin combined with activating blood circulation and dredging collaterals for a course of 4 weeks. The corresponding criteria were used to evaluate the upper limb joint motion, muscle tension and activity function. At the same time, the clinical efficacy and adverse reactions were compared. Results: the effective rate of the control group was 71.43% compared with that of the study group (90.48%), there was a difference between the two groups (P 0.05), the joint motion increased, the muscle tension decreased and the FIM upper limb score increased after treatment. The latency of H reflex of median nerve and ulnar nerve was increased and the Hmax / Mmax was decreased (P < 0.05). Compared with the control group, the patients in the study group had higher joint motion, lower muscle tension and higher FIM upper limb score than those in the control group. The latency of H reflex of median nerve and ulnar nerve was higher and Hmax / Mmax was lower than that of median nerve and ulnar nerve (P 0.05). Conclusion: Botulinum toxin combined with activating blood circulation and dredging collaterals is effective in the treatment of muscle spasm after stroke in elderly patients, which can reduce muscle tension of upper limb and improve nerve function and joint activity.
【作者单位】： 金华市中心医院康复科;
【基金】：金华市科学技术研究计划项目(2009-3-024)
【分类号】：R743.3
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本文编号：1902642