电针联合替扎尼定治疗脊髓损伤后肌痉挛的疗效观察

发布时间：2018-05-09 20:04

本文选题：肌痉挛 + 脊髓损伤　；参考：《福建中医药大学》2015年硕士论文

【摘要】：目的：探讨电针联合替扎尼定治疗脊髓损伤后肌痉挛的临床疗效。方法：选取2013年11月至2014年12月因脊髓损伤出现肌痉挛就诊于南京军区福州总医院的病例75例,随机分成3组,治疗组(电针+替扎尼定)、对照组1(电针)和对照组2(替扎尼定),每组25例。电针治疗每周连续治疗6天,休息1天,4周为1疗程；替扎尼定1片,口服,3/日,连续治疗4周。采用改良的痉挛程度量表Ashworth (modified Ashworth scale, MAS)和临床痉挛指数(clinic spasticity index, CSI)评定痉挛状态,采用日常生活能力量表(modified Barthel index, MBI)评价患者日常生活能力。所有数据在SPSS 17.0统计软件下分析。结果：1.基线比较：3组患者在年龄、性别、脊髓损伤程度及损伤节段上比较差异无统计学意义(P0.05)。2.改良Ashworth(MAS):治疗前MAS评分治疗组、对照组1和对照组2分别为(2.96±0.68),(2.94±0.61),(2.98±0.60)分,治疗后分别为(1.27±0.31),(1.62±0.39),(2.12±0.46)分。治疗前后MAS评分三组差异有显著统计学意义(P0.05)。与对照组1和对照组2比较,治疗组MAS评分降低更明显,差异有显著统计学意义(P0.05)。3.临床痉挛指数(CSI)：治疗前CSI评分治疗组、对照组1和对照组2分别为(14.29±0.40),(14.26±0.56),(14.41±0.45)分,治疗后分别为(8.16±0.51),(11.56±0.57),(12.06±0.48)分。治疗前后CSI评分三组差异有显著统计学意义(P0.05)。与对照组1和对照组2比较,治疗组CSI评分降低更明显,差异有显著统计学意义(P0.05)。4.日常生活能力：治疗前MBI评分治疗组、对照组1和对照组2分别为(48.80±6.49),(46.20±6.15),(47.19±5.59)分,治疗后分别为(69.81±5.67),(59.59±5.58),(58.24±6.10)分。治疗前后日常生活能力三组差异有显著统计学意义(P0.05)。与对照组1和对照组2比较,治疗组日常生活能力提高更明显,差异有显著统计学意义(P0.05)。5.临床疗效：治疗4周后,治疗组的有效率为88.0%,对照组1的有效率为60.0%,对照组2的有效率为56.0%。治疗组有效率高于对照组1和对照组2,差异有显著统计学意义(P0.05)。结论：电针联合替扎尼定治疗、电针治疗和替扎尼定治疗均能有效缓解脊髓损伤后肌痉挛患者的痉挛状态,但电针联合替扎尼定能更有效减轻肌痉挛患者的痛苦,提高生活质量,是治疗脊髓损伤后肌痉挛的有效方法。
[Abstract]:Objective: to investigate the clinical effect of electroacupuncture combined with tezanidine on muscle spasm after spinal cord injury. Methods: from November 2013 to December 2014, 75 cases of muscle spasm caused by spinal cord injury in Fuzhou General Hospital of Nanjing military region were selected and randomly divided into 3 groups. Treatment group (electroacupuncture), control group 1 (electroacupuncture) and control group 2 (tizanidine), 25 cases in each group. Electroacupuncture treatment lasted 6 days per week, rest 1 day for 4 weeks as a course of treatment, and tezanidine 1 tablet was given orally for 3 days for 4 weeks. Spasticity was assessed by modified Ashworth scale, MAS) and clinic spasticity index, CSI), and ADL was evaluated by modified Barthel index, MBI). All data were analyzed under SPSS 17.0 statistical software. The result is 1: 1. There was no significant difference in age, sex, degree of spinal cord injury and injury segment between the three groups. Before treatment, the scores of control group and control group were 2.96 卤0.68 and 2.98 卤0.60, respectively, and 1.27 卤0.31 after treatment were 1.62 卤0.39 and 2.12 卤0.46, respectively. There was significant difference in MAS score between the three groups before and after treatment (P 0.05). Compared with control group 1 and control group 2, the MAS score in treatment group was significantly lower than that in control group (P < 0.05). Clinical spasticity index: before treatment, the scores of CSI score in control group and control group were 14.29 卤0.40, 14.26 卤0.56 and 14.41 卤0.45, respectively. After treatment, the scores were 11.56 卤0.57 and 12.06 卤0.48, respectively. There was significant difference in CSI score between the three groups before and after treatment (P 0.05). Compared with control group 1 and control group 2, the CSI score in the treatment group was significantly lower than that in the control group (P 0.05. 05. 4). Activity of daily living (ADL): before treatment, the scores of MBI score in control group, control group and control group were 48.80 卤6.49, 46.20 卤6.15, 47.19 卤5.59), and 69.81 卤5.67, 59.59 卤5.58, 58.24 卤6.10, respectively. Before and after treatment, the difference of ADL among the three groups was statistically significant (P 0.05). Compared with control group 1 and control group 2, the activity of daily living in treatment group was improved more obviously, and the difference was statistically significant (P 0.05. 5). Clinical efficacy: after 4 weeks of treatment, the effective rate of the treatment group was 88.0, the effective rate of the control group was 60.0 and the effective rate of the control group was 56.0. The effective rate of treatment group was higher than that of control group 1 and control group 2, the difference was statistically significant (P 0.05). Conclusion: electroacupuncture combined with tezanidine, electroacupuncture and tezanidine can effectively relieve the spasticity of patients with spasm after spinal cord injury, but electroacupuncture combined with tezanidine can relieve the pain of patients with muscle spasm more effectively. Improving the quality of life is an effective method for the treatment of spasm after spinal cord injury.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.2

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