乙哌立松缓解脑卒中后肌张力增高:随机对照观察

Eperisone in the treatment of hypermyotonia following stroke:a rando mized controlled observation

目的:观察乙哌立松对脑血管疾病后肌张力增高的作用及其对脑卒中后早期康复的作用。方法:将60例脑血管意外后早期肌张力增高患者随机分成治疗组、对照组。治疗组用乙哌立松50mg,3次/d,总疗程为1个月。观察两组在第2,4周时的Ashworth评分和Brunstrum分级。结果:Ashworth评分显示两组在服药前上下肢肌张力高低程度差异无显著性意义(χ2=1.42,P>0.05),治疗后2周,两组上下肢肌张力改变情况差异有显著性意义(χ2=20.42,P<0.01),4周后差异仍存在非常显著性意义(χ2=22.49,P<0.01)。Brunstrum分级显示两组治疗前运动障碍程度差异无显著性意义(χ2=2.24,P>0.05),治疗后2周,治疗组运动障碍明显好转(χ2=21.87,P<0.01),治疗后4周,治疗组1级1例,2级3例,3级9例,4级10例,5级5例,6级2例;对照组1级1例,2级5例,3级13例,4级7例,5级4例,两组差异仍存在非常显著性意义(χ2=22.50,P<0.01)。结论:乙哌立松对脑卒中后肌张力增高、痉挛有改善作用,明显促进运动功能的提高。

AIM: To explore the effects of eperisone on thehypermyotonia after cerebrovasc ular diseases and post-stroke early rehabilitation. METHODS:Sixty patients withhypermyotonia at the early stage after cerebrovascu lar accident were randomly divided into two equal groups.Thirty patients in the treatment group were given 50 mg eoperisone,three times every day,continuously f or 1 month.Comparative analysis was made between the two groups in the scoring o f Ashworth and grading of Brunstrum 2 and 4 weeks after treatment. RESULTS:Ashworth scoring indicated that no difference was found between the de gree of muscular tension in the two groups before treatment(χ2=1.42,P< 0.01),wh ile remarkable changes in the muscular tension existed in the 2nd week(χ2=20.42 ,P< 0.01) till the 4th week(χ2=22.49,P< 0.01).Brunstrum grading showed that th ere was no significant difference in the severity of motor disorder between the two groups before treatment(χ2=2.24,P >0.05 ),while remarkable improvement in t he motor disorder was found in the treatment group 2 weeks after treatment (χ2= 21.87,P< 0.01).Four weeks after treatment, Brunstrum grading showed that,in the treatment group,there were 1 case of grade 1,3 of grade 2,9 of grade 3,10 of gra de 4,5 of grade 5 and 2 of grade 6,while,correspondingly,there were 1,5,13,7,4 a nd 0 case in the control group.Significant difference was found between the two groups(χ2=22.50,P< 0.01). CONCLUSION:Eperisone can improve hypermyotonia and myoclonia following stroke and promote motor function.