脑性瘫痪肌痉挛患儿的药物治疗

Drug treatment of muscular spasm in children with cerebral palsy

目的:药物干预脑性瘫痪患儿的肌痉挛可改善功能、提高生活质量、方便其他活动、延迟手术干预时机,总结脑性瘫痪肌肉痉挛药物治疗的现状。资料来源:应用计算机检索湘雅医学院图书馆(http:www.xysm.net)2000-01/2004-12脑性瘫痪肌肉痉挛的有关药物干预的相关文献,检索词为“cerebralpalsy;spasticity;pharmacaltreatment”,并限定文献语言种类为English。资料选择:对资料进行初审,纳入与脑性瘫痪肌痉挛治疗相关的药物方面的文献,无论有无对照组,不排除未随机试验及盲法对照的文献。资料提炼:共收集与药物干预脑瘫肌痉挛相关的文献86篇,其中5篇文献与口服途径的药物相关,81篇与胃肠外给药途径相关。进一步查看全文,筛除明显重复或太陈旧及综述类文献,纳入28篇文献进行综述。资料综合:综合资料发现近几年脑性瘫痪肌痉挛的药物治疗进展不多,治疗的主要药物仍然是苯甲二氮草、巴氯芬、替扎尼定、无水乙醇、苯酚、A型肉毒毒素等常用药物,给药的途径主要有口服、鞘内注射或肌肉注射。同时对各药的优缺点进行了评述。结论:药物解除脑性瘫痪患儿肌痉挛是有效的,但需要了解其适应证、禁忌证和临床操作技术,且不能排除其他治疗需求。

OBJECTIVE： The intervention of drug on the muscular spasm of the children patients with cerebral palsy can improve function, increase the quality of life, provide convenience of other activities, delay the occasion of operation intervention, and summarize the present condition of drug treatment on spasm of muscle of cerebral palsy. DATA SOURCES： We searched the Library of Xiangya Medical College （http：www.xysm.net） from January 2000 and December 2004 for the literatures on the intervention of drug of spasticity of cerebral palsy, with the keywords of “cerebral palsy; spasticity; pharmacal treatment”and the language limited to “English”. STUDY SELECTION： After the firstly sdection of materials, those related to the aspects of drug on the treatment of muscular spasm of cerebral palsy were included. No matter with or without control group, the articles related to non-randomized trial and blind control were included. DATA EXTRACTION： Totally 86 articles on the drug intervention on the muscular spasm of cerebral palsy, including 5 articles about the drug of way of taking orally, 81 articles on the way of administration outside the stomach and bowel. To check the full text further, the repetitive or the old articles and reviews were excluded, and 28 articles were included to perform review. DATA SYNTHESIS： From the synthesis materials we found that there was little progress on the drug treatment of muscular spasm of cerebral palsy in recent years. The main drugs for treatment still were valium, baclofen, tizanidine, anhydrous alcohol, phenol, A-type borulinus toxin etc. common used drugs. The way of administration mainly had orally, intrathecal injection or muscle injection. Meanwhile, the advantage and disadvantage of every kinds of drug were judged. CONCLUSION： It is effective to relieve the muscular spasm of children patients with cerebral palsy by drugs, but the adaptation, abstinence and clinical operation technique should be understood, moreover, the other treatment requirement cannot be excluded.