经直肠盆底肌及坐骨神经电刺激配合蒙药熏蒸治疗颈脊髓损伤肌肉痉挛疗效分析  

Effect of Mongolian medicine fumigation combined with sciatic nerve and rectal probe pelvic floor electrical stimulation on muscle spasticity of cervical spinal cord injury

作　　者：张淑莲[1] 闫金玉[1] 李晓涛[1] 杨丹[1] 刘培英[1] 张世红[1] 王婧娟[1] 李剑锋[1] 苏娅 ZHANG Shulian;YAN Jinyu;LI Xiaotao;YANG Dan;LIU Peiying;ZHANG Shihong;WANG Jingjuan;LI Jianfeng;SU Ya(Department of Rehabilitation,the Second Ajfiliated Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia 010030,P.R.China;First-aid Center,Ajfiliated Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia 010050,P.R.China)

机构地区：[1]内蒙古医科大学第二附属医院康复科,呼和浩特010030 [2]内蒙古医科大附属医院急救中心,呼和浩特010050

出　　处：《华西医学》2019年第5期526-530,共5页West China Medical Journal

基　　金：内蒙古自治区自然科学基金(2015MS0898);内蒙古医科大学科技百万工程联合项目(YKD2017KJBW(LH)040)

摘　　要：目的观察经直肠盆底肌及坐骨神经电刺激配合蒙药熏蒸治疗颈脊髓损伤肌肉痉挛的临床疗效,探索脊髓损伤临床治疗的新方法。方法 2012年1月—2018年1月将65例颈脊髓损伤肌肉痉挛患者利用随机数字表法随机分成治疗组(32例)和对照组(33例),治疗组采用经直肠盆底肌及坐骨神经电刺激配合蒙药熏蒸治疗,对照组主要采用药物、物理治疗及运动疗法等其他康复治疗方法。经8周治疗后分别对治疗组和对照组进行美国脊髓损伤协会(American Spinal Injury Association,ASIA)评分、改良Ashworth评分及Barthel指数评分比较。结果治疗前,两组ASIA轻触觉、疼痛觉及左右侧关键肌肌力评分以及Barthel指数评分差异均无统计学意义(P>0.05);治疗后,两组上述评分均较治疗前改善(P<0.05)。治疗组和对照组治疗后ASIA评分中左右侧关键肌肌力项评分分别为(58.55±10.83)、(50.69±11.32)分,差异有统计学意义(P<0.05);治疗组和对照组治疗后Barthel指数总分分别为(74.22±11.53)、(68.46±9.92)分,差异有统计学意义(P<0.05)。治疗后治疗组与对照组根据改良Ashworth评分的有效率分别为84.4%和60.6%,差异有统计学意义(P<0.05)。结论经直肠盆底肌及坐骨神经电刺激配合蒙药熏蒸治疗颈脊髓损伤肌肉痉挛可以有效改善患者肌肉痉挛症状及日常生活能力,在相同的治疗时间后效果明显优于对照组。Objective To observe the effect of Mongolian medicine fumigation combined with sciatic nerve and rectal probe electrical stimulation on muscle spasticity of spinal cord injury.Methods Between January 2012 and January2018,a total of 65 patients with muscle spasticity after spinal cord injury were randomly divided into two group: the observation group(32 cases) and the control group(33 cases).The patients in the observation group were treated with Mongolian medicine(Wu Wei Gan Lu-Decoction) fumigation combined with sciatic nerve and rectal probe electrical stimulation,while the patients in the control group were treated with medicine,physical therapy,and exercise therapy.Both two groups were treated for 8 weeks.The patients were scored with Ashworth Score,American Spinal Injury Association(ASIA) score,and Barthel Index before and after treatment.Results The pre-treatment ASIA scores(light touch sensation,pain sensation,and muscle strength) and Barthel Index of the two groups were not statistically significant(P>0.05).The post-treatment ASIA scores and Barthel Index of both groups performed significantly better than the pretreatment levels(P<0.05).The post-treatment ASIA muscle strength item was 58.55±10.83 in the observation group and50.69±11.32 in the control group(P<0.05).The post-treatment Barthel Index was 74.22±11.53 in the observation group and 68.46±9.92 in the control group(P<0.05).The effective rate in the observation group was significantly better than that in the control group(84.4% vs.60.6%,P<0.05).Conclusion Mongolian medicine fumigation combined with sciatic nerve and rectal probe electric stimulation could improve the muscle spasticity of spinal cord injury and patients’ ability of daily life effectively.

关 键 词：肌肉痉挛 颈脊髓损伤 蒙药熏蒸 坐骨神经 盆底肌电刺激 

分 类 号：R651.2[医药卫生—外科学]