A型肉毒毒素治疗脑卒中后瘫痪肌痉挛的临床疗效

Therapeutic Effect of Botulinum Toxin A to Muscle Spasticity of Paralysis after Stroke

目的:探讨A型肉毒毒素治疗脑卒中后瘫痪肌痉挛的临床疗效与安全性。方法:44例脑卒中后瘫痪肢体肌痉挛患者分为2组,其中采用BTX-A治疗的21例为研究组;采用力奥来素治疗的23例为对照组。分别观察2组治疗2、4周后肢体肌力、肌张力及功能改变。结果:肌张力按改良Ashworth评分与治疗前比较,2组均降低(P<0.01);治疗2周时研究组低于对照组(P<0.01);4周时2组差异无显著性意义(P>0.05)。研究组在4周后步速、步长、Barthel指数评分与治疗前比较均明显提高(P<0.01、P<0.05、P<0.01),并优于对照组(P<0.05)。结论:BTX-A治疗瘫痪肌痉挛安全、简便、起效迅速,副作用小,值得在临床推广应用。

Objective： To observe the therapeutic effectiveness and safety of botulinum toxin A （BTXA） to muscle spasticity of paralysis after stroke. Methods： Forty four patients with muscle spasticity of paralysis were randomly divided into two groups. The patients in treatment group were treated with BTXA, while those in control group with Lioresal. The myodynamia of the limbs, the muscular tone （modified Ashworth score） and the function before and 2, 4 weeks after treatment were observed. Results： Ashworth score in two groups were all reduced significantly after treatment. And the score in BTXA treatment group was reduced more than in Lioresal group （P〈0.01） after two weeks. No significant difference was observed after 4-weeks treatment （P〉0.05）. In treatment group, pace velocity, stride length and Barthel score were remarkably increased after treatment （P〈0.01, P〈0.05 and P〈0.01 respectively）. Conclusion：The local use of BTXA for the muscle spasticity after stroke was effective, safe and rapid with little side effects.