替扎尼定治疗卒中后肩关节疼痛的疗效观察

The Effect of Tizanidine on Shoulder Pain after Stroke

目的观察替扎尼定治疗卒中后肩关节疼痛的疗效,探讨其可能的作用机制。方法将卒中后肩关节疼痛患者103例随机分为实验组51例和对照组52例。两组患者均予以常规治疗。实验组同时给予患者口服替扎尼定。比较两组患者在实验前及实验开始第1、4、8、12周时肩关节疼痛程度、肩关节肌张力改善程度,并询问不良反应及监测肝肾功能、血压变化。结果治疗4周时,实验组患者肩关节疼痛与治疗前比较,有显著缓解(20.61±12.95VS 47.15±13.01,P<0.05)。治疗12周时,实验组患者肩关节疼痛与对照组比较,有显著性缓解(8.23±2.52VS 15.73±4.51,P<0.05)。治疗8周时,实验组患者肩关节肌张力与治疗前比较,有显著缓解(1.6±0.5VS 2.6±0.4,P<0.05)。治疗12周时,实验组患者肩关节肌张力与对照组比较,有显著缓解(1.2±0.2VS 1.7±0.3,P<0.05)。结论替扎尼定可以缓解卒中后肩关节疼痛,肩关节外展肌张力也可以得到改善,具有较好的临床疗效。但是,肩关节疼痛的缓解发生在肩关节肌张力缓解之前。因此,局部肌张力改善并非卒中后肩关节疼痛好转的唯一机制。

Objective To assess effect of tizanidine on shoulder pain after stroke, and discuss the possible mechanism. Methods 103 patients with shoulder pain after stroke were randomly divided into trial group（n=51） and control group （n= 52）. All patients were treated with conventional treatment, while patients of trial group were given tizanidine in addition. Shoulder pain, muscle tension in shoulder and adverse reactions were compared between before experiment and after 1st, 4th, 8th, 12th weeks respectly. Results After 4th week, shoulder pain in the trial group was significantly relieved, compared with that before treatment. After 12th week, shoulder pain in the trial group was significantly re- lieved, compared with that in the control group. After 8th week, muscle tension in shoulder in the trial group was significantly relieved, compared with that before treatment. After 12th week, muscle tension in shoulder in the trial group was significantly relieved, compared with that in the control group. Conclusion Tizanidine could relieve shoulder pain and muscle tension in shoulder after stroke. But the improvement of shoulder pain was earlier than muscle tension. Therefore, local muscle tension improvement was not the only index for tizanidine on the treatment of shoulder pain after stroke.