功能性伸展运动联合巴氯芬、重复经颅磁刺激对脑卒中后下肢痉挛性偏瘫患者的临床疗效

Clinical Efficacy of Treating Spastic Hemiplegia with Functional Stretching Exercises Combined with Baclofen Tablets and Repetitive Transcranial Magnetic Stimulation in Patients after Stroke

目的:对功能性伸展运动(FSE)联合巴氯芬、重复经颅磁刺激(rTMS)治疗脑卒中后痉挛性下肢偏瘫患者的临床疗效。方法:脑卒中后下肢痉挛性偏瘫患者177例按随机数字表法分为对照组88例和联合组89例;对照组给予巴氯芬、rTMS治疗,联合组在对照组治疗的基础上增加FSE治疗;比较2组治疗前后的步行功能(10MWT、TUG评分)、下肢功能活动(FMA、STREAM评分)、下肢痉挛情况(MAS、CSI评分)、平衡能力(Mini-BES Test、BBS、FTSST评分)及神经功能(NIHSS)和生活质量(FIM、BI评分)情况,并对2组患者的临床疗效进行研究。结果:2组治疗后的步行功能、下肢功能活动、下肢痉挛情况、平衡能力及神经功能和生活质量均显著好于各组治疗前,且联合组治疗后的各项评分优于对照组治疗后(P<0.05);联合组的临床疗效总有效率显著高于对照组(P<0.05)。结论:FSE联合巴氯芬、rTMS能有效改善脑卒中后痉挛性下肢偏瘫患者的步行功能、下肢功能活动、下肢痉挛、平衡能力及神经功能和生活质量。

Objective:To study the clinical efficacy of treating spastic hemiplegia with functional stretching exercises(FSE)combined with baclofen tablets and repetitive transcranial magnetic stimulation(rTMS)in patients after stroke.Methods:A total of 177 cases of spastic hemiplegia after stroke were randomly divided into the control group(n=88)and the combined group(n=89).Patients in the control group were treated with baclofen tablets and rTMS,and patients in the combined group were treated with FSE combined with baclofen tablets and rTMS.The walking ability(10MWT and TUG scores),lower-limb functional activity(FMA and STREAM scores),lower-limb spasticity(MAS and CSI scores),balance ability(Mini-BES Test,BBS,and FTSST scores),neurological function(NIHSS score),and quality-of-life(FIM and BI scores)of the two groups were compared before and after treatment.The clinical efficacy of the treatment in each group was evaluated.Results:The walking ability,lower-limb functional activity,lower-limb spasticity,balance ability,neurological function,and quality-of-life in both groups were improved compared to those before treatment(P<0.05).Furthermore,after treatment,all scores in the combined group were better than those in the control group(P<0.05).The total effective rate of the combined group was significantly higher than that of the control group(P<0.05).Conclusion:FSE combined with baclofen tablets and rTMS may be an effective way to improve walking ability,lower-limb functional activity,lower-limb spasticity,balance ability,neurological function,and quality of life in patients with hemiplegia after stroke.