CAJ | 학술논문

目的：观察舒筋活络洗剂联合A型肉毒毒素注射对脑卒中后上肢屈肌痉挛的影响。方法选取2013年2月~2014年3月在广东省中医院康复科住院的41例脑卒中后上肢痉挛患者，随机分为治疗组(n越20)和对照组(n越21)，治疗组采用舒筋活络洗剂联合A型肉毒毒素注射治疗，对照组只进行A型肉毒毒素注射治疗，两组均进行常规康复训练。于注射前及注射后2、4、8周进行疗效评定，评定指标包括改良Ashworth评级(MAS)、Fugly-Meyer上肢功能评分、功能独立性评定法(FIM)中与上肢相关的自我照顾项评分。结果治疗组和对照组在注射后2、4、8周MAS情况、Fugly-Meyer上肢功能评分、FIM自我照顾项评分均较治疗前显著改善，差异有统计学意义(P<0.05)，治疗组在注射后4、8周，上述分值的改善均优于对照组(P<0.05)。结论采用舒筋活络洗剂联合A型肉毒毒素注射治疗脑卒中后上肢屈肌痉挛，效果优于只采用A型肉毒毒素注射。
목적：관찰서근활락세제연합A형육독독소주사대뇌졸중후상지굴기경련적영향。방법선취2013년2월~2014년3월재광동성중의원강복과주원적41례뇌졸중후상지경련환자，수궤분위치료조(n월20)화대조조(n월21)，치료조채용서근활락세제연합A형육독독소주사치료，대조조지진행A형육독독소주사치료，량조균진행상규강복훈련。우주사전급주사후2、4、8주진행료효평정，평정지표포괄개량Ashworth평급(MAS)、Fugly-Meyer상지공능평분、공능독립성평정법(FIM)중여상지상관적자아조고항평분。결과치료조화대조조재주사후2、4、8주MAS정황、Fugly-Meyer상지공능평분、FIM자아조고항평분균교치료전현저개선，차이유통계학의의(P<0.05)，치료조재주사후4、8주，상술분치적개선균우우대조조(P<0.05)。결론채용서근활락세제연합A형육독독소주사치료뇌졸중후상지굴기경련，효과우우지채용A형육독독소주사。
Objective To observe the effect of Shujin Huoluo Lotion and Botulinum Toxin A Injection treat the patients with upper extremity spasticity after stroke. Methods 41 patients with upper extremity refractory spasticity after stroke in Department of Rehabilitation Medicine in Guangdong Provincial Traditional Chinese Medicine Hospital from Febru-ary 2013 to March 2014 were chosen. The patients were randomly divided into two groupsShujin Huoluo Lotion com-bined with Botulinum Toxin A Injection (treatment group, n = 20) and single Botulinum Toxin A Injection (control group, n = 21). Both groups were taken conventional rehabilitation training. The results were evaluated by modified Ashworth scale (MAS), Fugle-Meyer assessment-upper limb (FMA-upper limb) and motor-functional independence measure-upper limb (mot-FIM-upper limb) at the baseline, 2-week, 4-week and 8-week after treatment. Results The sores of MAS, FMA-upper limb and FIM upper limb after 2, 4, 8 weeks in treatment group and control group were sta-tistically improvcd compared with before treatment (P< 0.05). Patients in treatment group on indexes above after treat-ment for 4, 8 weeks were better than control group (P< 0.05). Conclusion Shujin Huoluo Lotion combined with Bo-tulinum Toxin A Injection is likely to be an effective technique to treat upper extremity spasticity, which is better than Botulinum Toxin A Injection simply.