A型肉毒毒素与针刺联合上肢智能训练系统对脑梗死患者上肢功能的影响

Effect of botulinum toxin A and acupuncture combined with an upper-limb intelligent training system on upper limb function in patients with cerebral infarction

目的:探讨A型肉毒毒素与针刺联合上肢智能训练系统对脑梗死患者上肢运动功能的影响。方法:将脑梗死患者60例按随机数字表分为治疗组和对照1、2组,每组各20例。对照1组采用常规基础康复治疗,对照2组在对照1组的基础上采用注射A型肉毒毒素及针刺治疗,治疗组在对照2组的基础上辅以上肢智能训练系统训练。采用美国国立卫生研究院卒中量表(NIHSS)、Fugl-Meyer上肢运动功能评定量表(FMA)、改良Ashworth评分及肩关节前屈主动活动度评分比较3组治疗效果。结果:治疗后,3组NIHSS、FMA、改良Ashworth评分及肩关节前屈主动活动度评分较治疗前均有改善,且治疗组改善程度优于对照1、2组,对照2组又优于对照1组,差异均有统计学意义(P<0.05或P<0.01)。结论:在A型肉毒毒素注射和针刺治疗的基础上辅以上肢智能训练可更显著地改善脑梗死患者的上肢运动功能。

Objective: To investigate the effect of botulinum toxin A and acupuncture combined with an upper-limb intelligent training system on upper limb function in patients with cerebral infarction.Methods: A total of 60 patients with cerebral infarction were divided into treatment group, control group 1,and control group 2 using a random number table, with 20 patients in each group.The patients in the control group 1 were given conventional rehabilitation treatment, those in the control group 2 were given botulinum toxin A injection and acupuncture in addition to the treatment in the control group 1,and those in the treatment group were given training with an upper-limb intelligent training system in addition to the treatment in the control group 2.National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),modified Ashworth score, and active range of motion of shoulder joint flexion were used to evaluate treatment outcome.Results: After treatment, all three groups had improvements in NIHSS score, FMA score, modified Ashworth score, and active range of motion of shoulder flexion;the treatment group had significantly greater improvements than the control groups 1 and 2,and the control group 2 had significantly greater improvements than the control group 1(P<0.05 or P<0.01).Conclusion: Botulinum toxin A injection and acupuncture combined with an upper-limb intelligent training system can significantly improve upper limb function in patients with cerebral infarction.