CAJ | 학술논문

将脑卒中患者65例随机分为观察组32例和对照组33例,观察组患者则在开始常规康复训练治疗前,接受患侧下肢肌肉A型肉毒毒素局部注射治疗.观察两组患者治疗前及治疗4周后的F波波幅及M波比值(F/M值),肌张力及起立-行走计时测试(TUG)及10 m自由步行测试结果.观察组治疗2周及4周后,F波波幅及F/M值与治疗前比较均显著下降(P＜0.05);治疗后各时间点指标与对照组比较,差异有统计学意义(P＜0.05).对照组治疗前后肌张力评分比较,差异无统计学意义(P＞0.05);观察组治疗4周后,肌张力评分显著下降(P＜0.05),与对照组比较差异有统计学意义(P＜0.05).治疗前,两组患者的TUG测试及10 m自由步行测试比较差异无统计学意义(P＞0.05);观察组治疗4周后,TUG测试及10 m自由步行测试与治疗前比较差异有统计学意义(P＜0.05);而对照组治疗前后TUG测试及10 m自由步行测试比较差异无统计学意义(P＞0.05).提示,A型肉毒毒素局部注射可降低相应脊髓节段运动神经元的F波波幅,提高患者的步行能力.
장뇌졸중환자65례수궤분위관찰조32례화대조조33례,관찰조환자칙재개시상규강복훈련치료전,접수환측하지기육A형육독독소국부주사치료.관찰량조환자치료전급치료4주후적F파파폭급M파비치(F/M치),기장력급기립-행주계시측시(TUG)급10 m자유보행측시결과.관찰조치료2주급4주후,F파파폭급F/M치여치료전비교균현저하강(P＜0.05);치료후각시간점지표여대조조비교,차이유통계학의의(P＜0.05).대조조치료전후기장력평분비교,차이무통계학의의(P＞0.05);관찰조치료4주후,기장력평분현저하강(P＜0.05),여대조조비교차이유통계학의의(P＜0.05).치료전,량조환자적TUG측시급10 m자유보행측시비교차이무통계학의의(P＞0.05);관찰조치료4주후,TUG측시급10 m자유보행측시여치료전비교차이유통계학의의(P＜0.05);이대조조치료전후TUG측시급10 m자유보행측시비교차이무통계학의의(P＞0.05).제시,A형육독독소국부주사가강저상응척수절단운동신경원적F파파폭,제고환자적보행능력.
Sixty five stroke patients undergoing rehabilitation training in our hospital from May 2010 to May 2013 were randomly divided into study group (n =32) and control group (n =33).Patients in study group received intramuscular injection of botulinum toxin A (BTX-A) in the affected limbs before rehabilitation training started.The F wave amplitude and F/M value,muscle tension and TUG test and 10 m free walking test results of patients in two groups were observed before and 4 weeks after treatment.Compared to the results before treatment,the amplitude of F wave and F/M value after 2 and 4 weeks of treatment in study group decreased significantly (P ＜ 0.05).Compared to control group,the indexes at each time point after treatment in study group were significantly different (P ＜ 0.05).The muscle tension score in study group after 4 weeks of treatment decreased significantly (P ＜ 0.05),and also lower than that in control group (P ＜ 0.05).Before treatment there were no significant differences in TUG test and 10 m free walk test between two groups (P ＞0.05) ; while TUG test and 10 m free walk test in study group were better than those in control group after 4 weeks of treatment (P ＜ 0.05).The TUG test and 10 m free walk test had little improvement in control group after treatment (P ＞ 0.05).The results indicate that botulinum toxin A injection can reduce amplitude of F wave in the corresponding segment of spinal cord motor neurons and improve the walking ability of stroke patients.