肉毒毒素联合活血通络法治疗老年脑卒中后肌肉痉挛的临床疗效研究

Clinical Effect of Botulinum Toxin Combined with Promoting Blood Circulation and Dredging Collaterals Method in Treatment of Muscle Spasm after Stroke in the Elderly

目的 :探讨肉毒毒素联合活血通络法治疗老年脑卒中后肌肉痉挛的临床疗效。方法:研究对象为医院康复科治疗的脑卒中后肌肉痉挛老年患者84例,按随机数字表法分组,各42例,对照组予以常规治疗,研究组在常规治疗基础上予以肉毒毒素联合活血通络法治疗,共治疗4周为1疗程,采用相应标准评价上肢关节活动度、肌张力及活动功能状况,同时对比临床疗效及不良反应。结果:在临床疗效上,对照组有效率71.43%与研究组有效率90.48%数据对比,有差异(P<0.05);相对于治疗前,两组治疗后关节活动度升高,肌张力降低,FMA评分和FIM上肢评分均升高,正中神经和尺神经H反射潜伏期升高,Hmax/Mmax降低,有差异(P<0.05);相对于对照组,研究组治疗后关节活动度较高,肌张力较低,FMA评分和FIM上肢评分较高,正中神经和尺神经H反射潜伏期较高,Hmax/Mmax较低,有差异(P<0.05)。结论:肉毒毒素联合活血通络法治疗老年脑卒中后肌肉痉挛疗效确切,降低上肢肌张力,提高神经功能和关节活动度。

Objective： To investigate the clinical effect of botulinum toxin combined with promoting blood circulation and dredging collaterals method in the treatment of muscle spasm after stroke in the elderly. Methods： A total of 84 cases of muscle spasm after stroke in the elderly in the research were selected and divided into two groups according to a random number table,42 cases in each. The control group received conventional treatment and the study group received more with botulinum toxin combined with promoting blood circulation and dredging collaterals method,4 weeks for a course of treatment. The corresponding evaluation criteria of upper limb joint motion,muscle tension of functional status,the clinical efficacy and adverse reactions were compared. Results： The effective rate of control group（ 71. 43%） was lower than the study group＇s（ 90. 48%）. The difference was statistically significant（ P〈0. 05）. Compared with before treatment,joint activity score in two groups increased,muscle tone decreased,FMA score and FIM score of upper limb were increased,the median nerve and ulnar nerve H reflex latency increased,Hmax/Mmax decreased. The difference was statistically significant（ P〈0. 05）. Compared with the control group,joint activity score in the study group was higher,muscle tone was lower,FMA score and FIM score of upper limb were higher,median nerve and ulnar nerve H reflex latency were higher,Hmax/Mmax was lower. The difference was statistically significant（ P〈0. 05）. Conclusion： Botulinum toxin combined with promoting blood circulation and dredging collaterals method in the treatment of muscle spasm after stroke in the elderly was effective,and reduce the upper limb muscle tension,improve neurological function and joint mobility.