中西医结合疗法对遗传性痉挛性截瘫的预后

Prognosis of hereditary spastic paraplegia treated with integrated traditional Chinese and Western Medicine

目的:探讨中西医结合疗法对遗传性痉挛性截瘫的临床效果。方法:将15例遗传性痉挛性截瘫患者分为西医治疗组(西医组,n=5)及中西医结合治疗组(联合组,n=10)。西医组采取手术、术后康复训练及口服药物巴氯芬治疗,联合组在西医组的基础上联合针刺、推拿等中医疗法。干预6个月后,采用改良Ashworth(MAS)量表评估患者下肢的痉挛程度,并分别采用Berg平衡评定量表(BBS)、Holden步行功能分级评估患者的平衡能力及步行功能,然后采用改良Barthel指数(MBI)评估患者的日常生活能力。结果:治疗后,联合组患者左下肢、右下肢MAS分级均低于治疗前及西医组(P<0.05),但联合组患者的BBS评分、Holden分级和MBI评分均高于治疗前及西医组(P<0.05)。结论:在西医治疗的基础上联合中医针刺、推拿治疗,有利于缓解遗传性痉挛性截瘫患者下肢的痉挛程度,改善其平衡能力及步行能力,提高生活质量。

Objective:To investigate the clinical effect of integrated traditional Chinese and Western Medicine on hereditary spastic paraplegia.Methods:15 patients with hereditary spastic paraplegia were divided into western medicine treatment group(Western medicine group,n=5)and integrated Chinese and Western medicine treatment group(combined group,n=10).The western medicine group was treated with surgery,postoperative rehabilitation training and oral medication baclofen,while the combined group was treated with acupuncture and tuina on the basis of Western medicine group.After 6 months,the modified Ashworth(MAS)scale was used to evaluate the spasticity of lower limbs.Berg Balance Scale(BBS)and Holden walking function classification were applied to assess the balance ability and walking function of the patients.Also,the ability of daily living of the two groups was measured through the modified Barthel Index(MBI).Results:After treatment,the MAS grade of left lower limb and right lower limb in combination group were significantly lower than those before treatment and Western medicine group(P<0.05),while their score of BBS,Holden grade and MBI were notably higher than those before treatment and Western medicine group(P<0.05).Conclusion:On the basis of Western medicine treatment combined with acupuncture and tuina therapy of traditional Chinese medicine is conducive to alleviate the spasticity of lower limbs of patients with hereditary spastic paraplegia,improving their balance ability,walking ability and the quality of life.