庄卫生,李弯月,钱宝延,等.A型肉毒毒素注射治疗卒中后肌张力障碍的临床观察[J].中华物理医学与康复杂志,2019,41(8):579-583
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| A型肉毒毒素注射治疗卒中后肌张力障碍的临床观察 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2019.08.005 |
| 中文关键词: 脑卒中 肌张力障碍 A型肉毒毒素 苯海索 |
| 英文关键词: Stroke Dystonia Botulinum toxin A Benzhexol |
| 基金项目:河南省医学科技攻关项目（2017075）；河南省卫生厅科技攻关项目（201702176） |
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| 中文摘要: |
| 目的 观察A型肉毒毒素注射治疗卒中后肌张力障碍患者的肌张力、残疾水平和日常生活活动（ADL）能力的影响。 方法 选取卒中后肌张力障碍患者32例，按随机数字表法分为观察组（16例）和对照组（16例），对照组失访1例，最终31例患者完成本研究。观察组患者给予靶肌肉注射A型肉毒毒素200～600 U，对照组给予盐酸苯海索片2 mg每日2次口服，逐渐加量至4 mg每日3次，共治疗12周。分别于治疗前及治疗2周后、治疗6周后和治疗12周后，采用改良版Ashworth量表（MAS）、残疾评估量表（DAS）、改良巴氏指数(MBI)量表分别评价2组患者的痉挛程度、残疾程度和ADL能力。 结果 治疗后,2组患者的MAS、DAS、MBI评分［观察组2周后MAS（1.50±0.53）分、DAS（2.10±0.83）分、MBI（58.50±8.86）分，6周后MAS（1.28±0.89）分、DAS（1.37±0.50）分、MBI（71.25±13.96）分，12周后MAS（2.03±0.59）分、DAS（1.50±0.63）分、MBI（73.1±12.35）分；对照组2周后MAS（3.00±0.46）分、DAS（2.58±0.64）分、MBI（54.66±7.18）分，6周后MAS（3.00±0.44）分、DAS（2.40±0.51）分、MBI（58.60±7.28），12周后MAS（2.53±0.51）分、DAS（2.21±0.45）分、MBI（63.86±7.41）分］均优于组内治疗前评分［观察组MAS（3.46±0.51）分、DAS（2.60±0.50）分、MBI（53.56±6.03）分;对照组MAS（3.50±0.52）分、DAS（2.61±0.62）分、MBI（53.06±7.23）分］，差异有统计学意义(P<0.05)。观察组治疗后MAS、DAS、MBI评分明显优于对照组，且治疗后同时间点比较，组间差异有统计学意义(P<0.05)。 结论 A型肉毒毒素治疗可显著改善卒中后肌张力障碍患者的肌张力和残疾程度。 |
| 英文摘要: |
| Objective To observe the effect of injecting botulinum toxin type A on muscle tension, disability level and ability in the activities of daily living in patients with post-stroke dystonia. Methods Thirty-two patients with post-stroke dystonia were divided into an observation group (n=16) and a control group (n=15). The patients in the observation group were injected with 200-600 U of botulinum toxin type A in the relevant muscles, while the patients in the control group were given 12 mg diphenhydrazole hydrochloride tablets orally. Before and 2, 6 and 12 weeks after the treatment, spasticity, disability and daily living ability were evaluated in both groups using the modified Ashworth scale (MAS), a disability assessment scale (DAS) and the modified Barthel index (MBI). Results After the treatment, the average MAS, DAS and MBI scores of both groups were significantly better than before the treatment. And the average MAS, DAS and MBI scores of the observation group were significantly better than those of the control group. Conclusion Botulinum toxin A injection can significantly improve dystonia and relieve disability among stroke survivors. |
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