A型肉毒毒素治疗脑卒中后上肢痉挛的疗效观察

摘要

目的：探讨A型肉毒毒素治疗脑卒中后上肢痉挛的的临床效果。方法：72例脑卒中后上肢痉挛的患者被随机分为两组，对照组行传统手法按摩及功能锻炼，实验组对痉挛的肱二头肌肌腹局部注射A型肉毒毒素；采用前臂及手腕改良Ashworth 量表（MAS），Carroll上肢功能实验（upper ex-tremities function test ，UEFT）评分分别对两组患者治疗前，治疗后2周，4周，8周时的上肢痉挛情况进行比较。结果：实验组患者MAS评分较治疗前明显改善（ P＜0．05），而对照组MAS评分较治疗前降低，但无明显改善（P＞0．05）；相同时间点与对照组比较，改善明显，差异显著（P＜0．05）。治疗后两组患者UEFT评分均较治疗前明显改善（ P＜0．05），但同时期实验组患者UEFT评分较对照组高，差异具有统计学意义（ P＜0．05）。结论：A型肉毒毒素能有效改善脑卒中后上肢痉挛症状，与传统治疗方式比较，具明显的优越性。%Objective:To investigate the effect of botulinum toxin type A on spastic upper limbs dysfunction after stroke . Method:72 patients with spastic upper limbs dysfunction after stroke were divided into experimental group ( 36 cases ) and control group (36 cases) randomly.The patients in control group were treated with the traditional massage , and those in experi-mental group were treated by injecting botulinum toxin type A to biceps brachii muscle belly .The modified Ashworth scale ( MAS) and Upper Extremities Functional Test ( UEFT) were employed to evaluate the condition the function of upper limbs in two groups before and 2, 4, and 8 weeks after treatment.Resu lt:The scores of MAS and UEFT in experimental group improved after treatment from2 weeks to 8 weeks ( P<0.05) .And improved much more significantly than those in control group at each time( P<0.05) .Conclusion:Botulinum toxin type A injection can improve function of upper limbs for stroke patients .