美多巴配合运动疗法提高运动干预脑梗死患者肢体功能的对照观察

Madopar associated with motor therapy to improve the limb function in patients with cerebral infarction

目的探讨脑梗死患者恢复期口服美多巴配合运动疗法能否增加运动疗法的效果和显著改善肢体运动功能。方法由CT或MRI证实为脑梗死患者40例,且已发病3周～6个月者为研究对象,排除有抑郁症或接受抗抑郁治疗的患者。将患者按入院先后顺序分为加用美多巴组和安慰剂组。采用Fugl-Meyer评分对所有患者进行运动功能评估。进入研究前1周,要求患者停用对体内去甲肾上腺素浓度有直接或间接影响的药物。美多巴组患者每天在运动治疗前30min服用美多巴0.25g,而对照组患者每天在运动治疗前30min则服用安慰剂。药物作用期间,两组患者均至少做45min的肢体运动治疗。两组在治疗3周后再进行Fugl-Meyer评分。结果美多巴治疗组与安慰剂组治疗前后Fugl-Meyer评分比较表明,美多巴组治疗前Fugl-Meyer评分122±8,治疗后Fugl-Meyer评分为164±8,t值为3.74,P<0.05。安慰剂组治疗前Fugl-Meyer评分为124±7,治疗后Fugl-Meyer评分为144±8,t值为3.68,P<0.05。同时,美多巴组治疗前后Fugl-Meyer评分增加值为41±7,安慰剂组治疗前后Fugl-Meyer评分增加值为22±8,两组增加值比较差异有显著意义(P=0.004)。结论脑梗死患者口服小剂量美多巴配合运动疗法能显著提高患者偏瘫侧肢体运动功能。

Aim To study the efficacy of madopar associated with motor therapy in improve the limb function in the patients with cerebral infarction at the recovery stage.Methods Forty patients with cerebral infarction were randomly divided into two groups: treatment group [11 males and 8 females with the average age of (71±5) years ] and control group [12 males and 9 females with the average age of (70±6) years]. The patients in the treatment group were asked to take 0.25g madopar orally at 30 min before motor therapy every day. The controls were asked to take placebo at 30 min before motor therapy. During the treatment all the patients in the two groups had to make limb motor therapy for 45 min at least. The Fugl Meyer scale was used to evaluate the motor function at the end of 3 weeks after treatment.Results The scores of Fugl Meyer scales before and after treatment were 122±8 and 164±8 in the treatment group (t=3.74,P< 0.05), 124±7 and 144±8 in the control group respectively (t=3.68,P< 0.05). The score increment before and after treatment was 41±7 in the treatment group, significantly higher than that in the control group(22±8, P=0.004). Conclusion Madopar associated with motor therapy significantly promotes the limb function in patients with cerebral infarction.