气压弹道式体外冲击波对脑卒中腓肠肌痉挛的疗效观察

Air pressure ballistic extracorporeal shock wave on spastic gastrocnemius curative effect observation of cerebral apoplexy

目的观察两种不同治疗参数下气压弹道式体外冲击波对脑卒中后下肢痉挛的疗效及差异,为今后气压弹道式体外冲击波治疗脑卒中后肌肉痉挛提供临床试验参考。方法采用二阶段交叉设计的试验方法,选择12例脑卒中后下肢肌肉痉挛患者,随机平均分为两组(A组和B组,每组各6例患者),在常规治疗的基础上,接受冲击波治疗1次,A组参数为(参数设置为压力强度1.0 bar,频率8 Hz),B组参数为(参数设置为压力强度1.6 bar,频率20 Hz),冲击次数均为3000次,在经过10天的清洗期后,两组交换,原A组的患者接受B组参数冲击,原B组的患者接受A组参数冲击。比较治疗前、治疗结束后即刻两组患者踝关节被动活动度(positive range of motion,PROM)、改良Tardieu量表(modified Tardieu scale,MTS)。结果两组的PROM和MTS中R1较治疗前均有所增加(P<0.01),MTS中(x)分级较治疗前有所下降,但无显著差异(P>0.05),两组比较PROM和R1,虽A组均数略低于B组,但两组比较差异无显著性。两组患者在整个试验过程中均未观察到任何不良反应。结论单次气压弹道式冲击波对脑卒中后腓肠肌痉挛有即时的缓解作用,但其最佳治疗参数仍有待进一步研究。

Objective To observe the efifcacy of tow type of pneumatic extracorporeal shock wave therapy post-stroke gastrocnemius spasticity. Method Two-period crossover design.12 patients with gastrocnemius spasticity after stroke were randomly divided into group A and group B. On the basis of conventional therapy, received shock wave therapy. The set of parameters for the group A （1.0 bar, 8 Hz）, while the group B parameters （1.6 bar, 20 Hz）, the impact of the number were 3000. After a 10-day washout period, case of the original group A accepted B set of parameters that impact, and vice versa. Compared ankle passive activity （positive range of motion, PROM）, modiifed tardieu scale （MTS） before treatment, immediately after treatment. Result After treatment the two groups of PROM and MTS R1 increased in both the front （P0.05） in PROM and R1 between the two groups, although the mean of group A was slightly lower than group B. No adverse reactions was not found in both groups. Conclusion The gastrocnemius muscle spasticity after stroke could be relief immediate after one time pneumatic extracorporeal shock wave therapy , but the optimal treatment parameters remain to be further studied.