中药熏蒸结合下肢康复机器人辅助步行训练治疗脊髓损伤后肌张力增高临床研究

Clinical Study on Chinese Medicine Fumigation Combined with Walking Training Assisted by Lower-Limb Rehabilitation Robot for Muscular Hypertonia After Spinal Cord Injury

目的:观察中药熏蒸结合下肢康复机器人辅助步行训练治疗脊髓损伤后肌张力增高的临床效果。方法:选取106例脊髓损伤后肌张力增高患者,采用随机数字表法分为对照组与观察组各53例,2组均予下肢康复机器人辅助步行训练,观察组加用身痛逐瘀汤熏蒸治疗。2组均治疗8周。治疗前、治疗8周后测定下肢肌群积分肌电值(i EMG)、运动功能[Fugl-Meyer运动功能评定量表下肢部分(FMA-L)评分,Berg平衡量表(BBS)评分,10 m最大步行速度测试(10 mMWS)值],比较2组的临床疗效和不良反应发生率。结果:治疗8周后,观察组、对照组的临床疗效总有效率分别为94.34%、81.13%,2组比较,差异有统计学意义(P<0.05)。2组腓肠肌、股二头肌、腘绳肌的iEMG均较治疗前下降,差异均有统计学意义(P<0.01);观察组上述指标值均低于对照组,差异均有统计学意义(P<0.01)。2组FMA-L评分、BBS评分、10 mMWS值均较治疗前增加,差异均有统计学意义(P<0.01);观察组上述指标值均高于对照组,差异均有统计学意义(P<0.01)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:采用中药熏蒸结合下肢康复机器人辅助步行训练治疗脊髓损伤后肌张力增高患者效果确切,可明显改善下肢的肌张力及运动功能,且具有较高的安全性。

Objective:To observe the clinical effect of Chinese medicine fumigation combined with walking training assisted by lower-limb rehabilitation robot for muscular hypertonia after spinal cord injury.Methods:A total of 106 cases of patients with muscular hypertonia after spinal cord injury were selected and divided into the control group and the observation group according to the random number table method,with 53 cases in each group.Both groups were treated with walking training assisted by lowerlimb rehabilitation robot,and the observation group was additionally treated with Chinese medicine fumigation with Shentong Zhuyu tang based on the treatment of the control group.Both groups were treated for eight weeks.Before and after eight-week treatment,the integrated electromyography(iEMG) of lower limb muscle group,and motor function evaluated by Fugl Meyer Assessment of lower limbs(FMA-L),Berg Balance Scale(BBS),and 10-meter maximum walking speed test(10 mMWS) were measured,and clinical effects and incidence of adverse reactions were compared between the two groups.Results:After eight-week treatment,the total effective rates in the observation group and the control group were 94.34% and 81.13% respectively,the difference being significant(P<0.05).After treatment,iEMG of gastrocnemius,biceps femoris,and hamstring in the two groups were decreased when compared with those before treatment,differences being significant(P<0.01);the above indexes in the observation group were lower than those in the control group,differences being significant(P<0.01).Scores of FMA-L and BBS,and values of 10 mMWS in the two groups were increased when compared with those before treatment,differences being significant(P<0.01),and the above three indexes in the observation group were higher than those in the control group,differences being significant(P<0.01).There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Chinese medicine fumigation combined with walking training assisted by lower-limb rehabilitation robot has a defined curative effect and relatively high safety in the treatment of patients with muscular hypertonia after spinal cord injury,and can effectively improve muscular tone and motor function of lower limb muscle.