肉毒毒素结合康复训练治疗痉挛型脑瘫

A Clinical Research on Local Intramuscular Injection of Botulinum Toxin A and Rehabilitation Training in the Treatment of Spastic Cerebral Palsy

目的:观察局部肌肉注射A型肉毒毒素(BTX-A)治疗痉挛型脑瘫的疗效。方法:83例痉挛型脑瘫患儿分为观察组53例和对照组30例,均采用BTX-A局部肌肉注射和推拿治疗;观察组同时结合系统的康复训练等。治疗前后均以改良阿氏量表(MAS)评分肌张力,运动评价量表(PRS)评定运动功能。结果:治疗3个月后与治疗前比较2组MAS评分均明显下降,PRS评分明显升高(均P<0.05);与对照组比较观察组表现更明显(P<0.05)。结论:局部肌肉注射BTX-A结合系统康复训练能有效缓解痉挛型脑瘫患儿的肌张力,改善步态、提高行走能力。

Objective： To study the curative effectiveness of botulinum toxin A （BTX-A） intramuscular injection and rehabilitation training in the treatment of spastic cerebral palsy. Methods Eighty three patients with spastic cerebral palsy were divided into following two groups; the treatment group received local intramuscular injection of BTX-A, mas sage therapy and rehabilitation training, and the control group receiving only local intramuscular injection of BTX A and massage therapy. The muscle tone was assessed with the Modified Ashworth Scale （MAS） and range of motion with Physical Rating Scale （PRS）. The muscle tone and PRS were observed before and 4 weeks after therapy. The data were analyzed, Results After treatment for 3 months, MAS scores were significantly decreased and PRS scores significantly increased in both two group as compared with those before therapy （both P〈0.05）. The muscle tone fraction of PRS in both two groups was significantly improved （P〈0.05）. There was significant difference between treatment group and control groups （P〈0.05）. Conclusion： Local intramuscular injection of BTX-A in combination with massage therapy and rehabilitation training can effectively decrease the muscle tone of the children with spastic cerebral palsy and significantly improve gait and walking ability.