A型肉毒毒素对脑卒中患者胫神经F波和步行能力的影响  

Effect of botulinum toxin A on tibial nerve F wave and walking ability in patients after stroke

作　　者：王明乐[1] 刘俊芳[1] 马妮娜[1] 

机构地区：[1]河南科技大学第一附属医院药学部,河南省洛阳市471003

出　　处：《中华全科医师杂志》2015年第1期52-55,共4页Chinese Journal of General Practitioners

摘　　要：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.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.

关 键 词：肉毒杆菌毒素 A型 脑血管意外 

分 类 号：R743.3[医药卫生—神经病学与精神病学]