乙哌立松对亚急性脊髓神经症的治疗作用研究

Study on the effect of Eperisone in the treatment of Subacute spinal cord neurosis

目的 探讨乙哌立松对亚急性脊髓神经症不完全性痉挛患者的治疗作用。方法 选取本院收治的亚急性脊髓联合变性双下肢不完全性痉挛患者48例随机分为对照组和研究组,各24例。对照组予以叶酸和甲钴胺治疗;研究组在叶酸和甲钴胺治疗基础上予以乙哌立松治疗,对照组与研究组共治疗14 d为1疗程,共治疗2个疗程,治疗前后对所有患者评定Ashworth痉挛量表、简式Fugl-Meyer评分量表、改良Barthel指数,测定双侧胫神经H反射状况,同时对比临床疗效及并发症状况。结果 与治疗前比较,2组治疗后膝关节屈曲、伸展活动度升高,Ashworth痉挛量表评分降低,治疗后下肢FMA和MBI评分均升高,治疗后胫神经H反射潜伏期升高,Hmax/Mmax降低（P〈0.05）;与对照组比较,研究组治疗后膝关节屈曲、伸展活动度较高,Ashworth痉挛量表评分较低,治疗后下肢FMA和MBI评分较高,治疗后胫神经H反射潜伏期较高,Hmax/Mmax较低（P〈0.05）;对照组有效率66.67%低于研究组有效率91.67%（P〈0.05）;对照组不良率25.00%与研究组不良率20.83%数据对比差异无统计学意义。结论 乙哌立松对亚急性脊髓神经症不完全性痉挛患者疗效确切,降低肌张力及痉挛状态,提高神经功能。

Objective To investigate the therapeutic effect of eperisone on patients with subacute spinal cord neuropathy with incomplete spasm. Methods Forty-eight patients with Subacute spinal cord neurosis combined degeneration of both lower extremity incomplete spasm in Department of Neurology, Zhejiang Quhua Hospital were selected and randomly divided into control group and study group. The control group were treated with folic acid and mecobalamin, the study group received more with eperisone, and 14days for one course, two groups were treated for two course. Ashworth spasm Scale, simple Fugl-Meyer score scale, improved Barthel index, bilateral H tibial nerve reflex status, clinical efficacy and complications were compared before and after the treatment. Results A f t e r t r e a t m e n t , levels o f the flexion and e x t e n s i o n of knee joint in 2 g r o u p s i n c r e a s e d , and the s c o r e s of Ashworth spasticity scale decreased, scores of FMA and MBI increased, the latency of H reflex latency increased, levels of Hmax/Mmax decreased （P 〈 0. 05） , compared with the control group, levels of the flexion and extension of knee joint in the study group were higher, and the scores of Ashworth spasticity scale were lower, scores of FMA and MBI were higher, the latency of H reflex latency were higher, levels of Hmax/Mmax were lower （P 〈0. 05） , the effective rate of the control group（66. 67% ） was l o w e r t h a n the s t u d y g r o u p （ 9 1 . 67% ） （P 〈0. 05）,the n o n - p e r f o r m i n g rate in 2 groups had no difference （25. 00% Vs 20. 83% ）. Conclusion E p e r i s o n e h a s definite effect o n patients w i t h s u b a c u t e sp i n a l c o r d n e u r o p a t h y w i t h incomplete spasms, it can decrease muscle tension and spasticity and improve neurological function.