苯海索治疗不同亚型不随意运动型脑瘫患儿运动功能的疗效观察

目的 观察苯海索治疗不同亚型不随意运动型脑瘫患儿运动功能的疗效差别。方法 随机选取符合诊断标准的不随意运动型脑瘫患儿36例，所有入组脑瘫患者按临床亚型分为3组,A组为舞蹈-徐动型，B组为肌张力障碍型，C组为徐动-痉挛型，在统一物理康复治疗的基础上，采用苯海索口服治疗，起始剂量给予0.5mg/d，缓慢加量，每周加量1mg至目标剂量4mg/d，每天剂量分2～3次服用。分别于入组时、治疗后（6个月后），对其进行GMFM、GMFCS、FMFM、WeeFIM评定，并记录其流涎及药物耐受情况。结果 3组患儿治疗后GMFM得分A组（35.490±19.327），B组（29.110±11.864），C组（15.540±11.598），差异有统计学意义（F=4.988，P〈0.05），A组、B组与C组比较差异均有统计学意义（P〈0.05），AB2组间对比差异无统计学意义。治疗后WeeFIM得分A组（49.000±22.520），B组（38.780±11.914），C组（27.000±12.179），差异有统计学意义（F=4.319，P〈0.05），A组、B组2组与C组患儿得分差异有统计学意义（P〈0.05），而A组、B组患儿间差异无统计学意义。治疗后3组患儿FMFM得分，GMFCS分级及流涎改善例数差异无统计学意义。痉挛徐动型患儿可观察到痉挛加剧。结论 苯海索治疗张力障碍型及舞蹈徐动型不随意运动型脑瘫患儿有助于提高其运动功能及独立生活能力，疗效优于痉挛徐动型患儿。其对于3组间大运动功能分级及精细运动功能的改善无明显区别。

Objective To observe the curative effect of treatment by trihexyphenidyl of different subtypes of in children with dyskinetic cerebral palsy. Methods Randomly selected in accordance with the diagnostic criteria of dyskinetic t of 36 cases of children with cerebral palsy, in the unity of physical therapy based on, trihexyphenidyl oral treatment, starting dose given 0.5mg, slow increase, weekly dosage 1mg to the target dose of 4mg / d, daily dose divided into 2 or 3 times service. Respectively into the group, after treatment （6 months after）, the were GMFM, GMFCS, FMFM and WeeFIM assessment, and record the salivation and drug resistance. Results The three groups after treatment in children with GMFM score [group A （35.490±19.327）, group B （29.110±11.864）, group C （15.540±11.598）] have significant difference （F=4.988, P〈0.05）, group AB and group C comparison were statistically significant （P〈0.05）, between the group AB compared with no significant difference. Have statistical difference （F= 4.319, P〈0.05） of three groups of children with WeeFIM scores [group A （49.000±22.520）, group B （38.780±11.914）, group C （27.000±12.179）], group A and group B with the score of patients compare with group C had signifcant difference （P〈0.05）, and in the groups A and B of children with no signifcant difference. There was no signifcant difference in GMFCS and FMFM between the three groups. Three groups of children with salivation were improved, no signifcant difference. The athetoid-spastic cerebral palsy children can be observed exacerbated with spastic. Conclusion Benzhexol hydrochloride in the treatment of chorea-athetoid and athetosis type of dyskinetic cerebral palsy （CP） is helpful to improve the motor function and the ability to live independently, curative effect is better than that of dystonic cerebral palsy children. There was no signifcant difference between the three groups in the classifcation of General motor function and the improvement of the Fine motor function.