康复干预联合BTX-A肉毒毒素治疗脑源性痉挛的临床效果观察

Observation on the clinical effect of rehabilitation intervention combined with BTX-A botulinum toxin in the treatment of brain-induced spasm

目的分析脑源性痉挛患者用康复干预联合BTX-A肉毒毒素治疗后对疼痛程度和生活质量的影响。方法回顾性分析2020年10月至2021年10月经延安市人民医院确诊并进行治疗的40例脑源性痉挛患者作为研究对象,随机分为对照组和观察组,每组20例患者。对照组单纯用BTX-A型肉毒毒素局部肌肉注射治疗,观察组用BTX-A型肉毒毒素注射1周后启用康复干预。应用多伦多痉挛性斜颈量表(Toronto spastic torticollis scale,TWSTRS)分别对两组患者治疗前、BTX-A注射1周后与BTX-A注射8周后进行评价。疗效评价采用Tsui量表,日常生活质量的改变应用(SF-36)健康调查量表进行评估。结果观察组实施康复干预联合BTX-A注射8周后TWSTRS量表评分显示,躯体疼痛(3.9±1.7)分、病情严重程度(9.7±2.8)分、患者残疾程度(6.1±4.3)分,Tsui量表评分为(3.4±1.8)分,各项评分显著低于对照组,差异具有统计学意义(P<0.05)。同时观察组治疗8周后SF-36量表各项评分较对照组低,差异均有统计学意义(P<0.05)。结论康复干预联合BTX-A型肉毒毒素治疗脑源性痉挛后不仅可有效地减轻疼痛程度,还可改善患者日常生活质量,提高治疗效果。

Objective To analyze the effect of rehabilitation intervention combined with BTX-A botulinum toxin on pain and quality of life in patients with cerebral spasm.Methods A retrospective analysis of 40 patients with cerebral spasm diagnosed and treated by Yan’an People’s Hospital from October 2020 to October 2021 was selected as the research objects,and they were randomly divided into the control group and the observation group,with 20 cases in each group. The control group was treated with local intramuscular injection of BTX-A botulinum toxin alone,while the observation group was treated with BTX-A botulinum toxin injection for 1 week and then started rehabilitation intervention. The Toronto spastic torticollis scale(TWSTRS)was used to evaluate the two groups of patients before treatment,1 week after BTX-A injection and 8 weeks after BTX-A injection. The efficacy was evaluated using the Tsui scale. Changes in quality of life were assessed using the Health Survey(SF-36).Results After 8 weeks of rehabilitation intervention combined with BTX-A injection in the observation group,the TWSTRS showed that the scores of somatic pain(3. 9±1. 7)points,the severity of the disease(9. 7±2. 8)points,the degree of disability of the patient(6. 1±4. 3)points,the amount of Tsui(3. 4±1. 8)points,and the scores were significantly lower than those of the control group,and the difference was statistically significant(P<0. 05). At the same time,the scores of SF-36scale in the observation group after 8 weeks of treatment were lower compared with those in the control group,and the differences were statistically significant(P<0. 05).Conclusion Rehabilitation intervention combined with BTX-A botulinum toxin in the treatment of brain-derived spasm can not only effectively reduce the degree of pain,improve the quality of daily life of patients,and improve the therapeutic effect.