经颅磁刺激联合巴氯芬治疗对脊髓损伤后肌痉挛患者肢体功能及生活质量的影响

Effect of Transcranial Magnetic Stimulation Combined with Baclofen on Limb Function and Quality of Life in Patients with Muscle Spasm after Spinal Cord Injury

目的探讨经颅磁刺激联合巴氯芬治疗对脊髓损伤后肌痉挛患者肢体功能、生活质量的影响。方法选取2020年5月至2021年4月濮阳市安阳地区医院66例脊髓损伤后肌痉挛患者,采用随机数字表法分为联合组(n=33)与巴氯芬组(n=33)。巴氯芬组予以巴氯芬治疗,联合组在巴氯芬组的基础上进行经颅磁刺激法治疗。统计两组治疗有效率,治疗前、治疗3个月后的改良版Ashworth痉挛量表(MAS)评分、Fugel-Meyer肢体运动功能(FMA)评分、日常生活能力指数(Barhtel)、简明健康状况量表(SF-36)评分。结果联合组治疗有效率(96.97%)高于巴氯芬组(81.82%),差异有统计学意义(P<0.05);治疗前两组MAS评分相近,差异无统计学意义(P>0.05);治疗3个月后两组MAS评分较治疗前低,且联合组低于巴氯芬组,差异有统计学意义(P<0.05);治疗前两组患者上肢FMA、下肢FMA对比,差异无统计学意义(P>0.05);治疗3个月后联合组上肢FMA评分、下肢FMA评分高于巴氯芬组,差异有统计学意义(P<0.05);治疗前两组Barthel评分比较,差异无统计学意义(P>0.05);治疗后3个月两组Barthel评分均较治疗前上升,且联合组Barthel评分高于巴氯芬组,差异有统计学意义(P<0.05);治疗前两组患者躯体疼痛、生理功能、社会功能评分对比,差异无统计学意义(P>0.05);治疗3个月后联合组患者的躯体疼痛、生理功能、社会功能评分高于巴氯芬组,差异有统计学意义(P<0.05)。结论经颅磁刺激联合巴氯芬对脊髓损伤后肌痉挛患者进行治疗,可提升治疗效果,缓解了患者肌痉挛,同时改善了患者的肢体功能,提高患者日常生活能力及生活质量。

Objective To investigate the effects of transcranial magnetic stimulation combined with baclofen on limb function and quality of life in patients with muscle spasms after spinal cord injury.Methods A total of 66 patients with muscle spasms after spinal cord injury in Anyang District Hospital of Puyang City from May 2020 to April 2021 were selected and divided into combination group(n=33)and baclofen group(n=33)by random number table method.The baclofen group was treated with baclofen,and the combined group was treated with transcranial magnetic stimulation based on the baclofen group.The effective rate of treatment,modified ashworth spasticity scale(MAS)score,fugel-meyer limb motor function(FMA)score,activity of daily living index(Barhtel),and short form health survey(SF-36)score before treatment and 3 months after treatment were compared between the two groups.Results The effective rate of the combination group(96.97%)was higher than that of the baclofen group(81.82%),and the difference was statistically significant(P<0.05).Before treatment,the MAS scores of the two groups were similar,and there was no statistical significance(P>0.05).After 3 months of treatment,MAS scores in the two groups were lower than before treatment,and the combined group was lower than the baclofen group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in upper limb FMA and lower limb FMA between the two groups(P>0.05).After 3 months of treatment,the FMA score of the upper limb and the FMA score of the lower limb in the combined group were higher than those in the baclofen group,and the differences were statistically significant(P<0.05).There was no significant difference in Barthel score between the two groups before treatment(P>0.05).At 3 months after treatment,Barthel's score in both groups was higher than that before treatment,and Barthel's score in the combination group was higher than that in the baclofen group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the scores of physical pain,physiological function,and social function between the two groups(P>0.05).After 3 months of treatment,the scores of physical pain,physiological function,and social function in the combination group were higher than those in the baclofen group,and the differences were statistically significant(P<0.05).Conclusion Transcranial magnetic stimulation combined with baclofen in the treatment of patients with muscle spasms after spinal cord injury can improve the therapeutic effect,relieve muscle spasms,improve limb function,and improve patients'daily living ability and quality of life.