肉毒素联合综合康复锻炼治疗脑出血后肩手综合征临床研究

Botulinum Toxin Combined with Comprehensive Rehabilitation Exercise on Shoulder Hand Syndrome after Intracerebral Hemorrhage

目的探讨肉毒素联合综合康复锻炼治疗脑出血后肩手综合征的临床疗效。方法选择医院2013年1月至2015年1月收治的脑出血后肩手综合征患者130例,按入院先后顺序依次编号,按随机数字表法分为观察组和对照组,各65例。对照组患者给予综合康复锻炼,观察组患者在对照组治疗基础上加用注射A型肉毒素治疗后,比较两组患者的上肢运动功能、疼痛程度及痉挛情况。结果治疗后,观察组上肢运动功能各项评分明显高于对照组,恢复情况明显优于对照组,差异均有统计学意义(P<0.01);观察组疼痛评分明显低于对照组,疗效明显优于对照组,差异均有统计学意义(P<0.01);观察组患者的痉挛程度(Ashworth)评分较治疗前明显降低(P<0.05),对照组患者治疗前后Ashworth评分比较,差异无统计学意义(P>0.05),组间比较,差异有统计学意义(P<0.05)。结论肉毒素联合康复锻炼治疗脑出血后肩手综合征疗效显著,值得临床推广。

Objective To investigate the efficacy of botulinum toxin combined with comprehensive rehabilitation exercise on shoulder hand syndrome after intracerebral hemorrhage. Methods 130 cases of patients with shoulder hand syndrome after cerebral hemorrhage from January 2013 to January 2015 were selected and divided into observation group and control group according to the random number table method,65 cases in each group. The upper limb motor function,pain and spasm of the two groups were compared after treatment. Results After treatment,the scores of upper limb motor function in the observation group were significantly higher than those in the control group,and the recovery was significantly better than that in the control group,the difference was statistically significant（ P〈0. 01）. The pain score was significantly lower than the control group,and the treatment effect was better than the control group,the differences were statistically significant（ P〈0. 01）. There was no significant difference in Ashworth score between the two groups（ P〈0. 05）. The Ashworth score of the observation group was significantly lower than that of the control group（ P〈0. 05）. There was no significant difference in the Ashworth score of the control group before and after treatment（ P〈0. 05）. The difference of Ashworth score between the two groups was statistically significant（ P〈0. 05）. Conclusion The efficacy of botulinum toxin combined with comprehensive rehabilitation exercise on shoulder hand syndrome after intracerebral hemorrhage is obvious,which is worthy of clinical protion.