A型肉毒毒素治疗脑卒中后上肢肌痉挛的疗效分析

Therapeutic effect of botulinum toxin type A on upper extremity spasticity after stroke

目的探讨A型肉毒毒素（BTX—A）治疗脑卒中后肌痉挛的临床疗效。方法选择54例脑卒中后存在上肢肌肉痉挛的患者，按随机数字表法分为研究组和对照组（各27例）。两组患者均进行肢体康复训练，研究组加行注射BTX-A：分别观察比较两组治疗后2周、4周、12周的Fugl-Meyer运动功能评测、改良Ashworth肌痉挛量表评定情况及Barthel指数。结果治疗后2周、4周时，研究组与对照组的改良Ashworth评分评定比较差异具有统计学意义（P〈0．01）。治疗后4周、12周时，研究组与对照组的Fugl—Meyer评分变化、Barthel指数比较差异具有统计学意义伊〈0．01）。结论BTX—A治疔脑卒中后上肢肌痉挛安全、简便。起效迅速，同时积极配合康复功能训练，可以有效改善患者的运动功能和日常生活活动能力：

Objective To observe the therapeutic effect ofbotulinum toxin type A （BTX-A） on spastieity of the upper extremity after stroke. Methods Fifty-four patients with upper extremity spasticity after stroke were randomly divided into treatment group and control group. The patients in treatment group were treated with BTX-A and rehabilitation training, while those in control group only with rehabilitation training. The efficacy was assessed with Modified Ashworth Scale, Fugl-Meyer Assessment and Barthel index before and 2, 4 and 12 weeks after treatment. Results The Ashworth scale score in treatment group was reduced significantly as compared with that in control group after 2- and 4-week treatment （P〈0.01）. And there was significant difference in Fugl-Meyer Assessment and Barthel index between treatment group and control group after 4- and 12-week treatment （P〈0.01）. Conclusion The local injection of BTX-A for the muscle spasticity after stroke is effective and safe, and its combination with rehabilitation training can improve rapidly Fugl-Meyer scores and activities of daily living of patients.