A型肉毒毒素治疗脑卒中或创伤性脑损伤后下肢痉挛的Meta分析  

The efficacy and safety of using botulinum toxin type A in treating spasticity resulting from stroke or traumatic brain injury:A systematic review with meta-analysis

作　　者：董燕[1] 吴涛[2] 王彤[3] Dong Yan;Wu Tao;Wang Tong(Department of Rehabilitation Medicine,Hangzhou Hospital of the Zhejiang Armed Police Force,Hangzhou 310051,China;Department of Rehabilitation Medicine,Sir Run Run Shaw Hospital,College of Medicine,Hangzhou 310016,China;Department of Rehabilitation Medicine,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]武警浙江省总队医院康复医学科二病区,杭州310051 [2]浙江大学医学院附属邵逸夫医院康复医学科,杭州310016 [3]南京医科大学附属第一医院康复医学科,南京210019

出　　处：《中华物理医学与康复杂志》2020年第12期1113-1120,共8页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的采用Meta分析评价A型肉毒毒素(BoNT-A)治疗脑卒中或创伤性脑损伤(TBI)后下肢痉挛的效果和安全性。方法检索PubMed,EBSCO host,OVID Medline,以及Web of Science等数据库从建库至2019年1月使用BoNT-A治疗脑卒中和TBI后下肢痉挛的随机对照试验。对符合纳入标准的,采用Stata 15.0版软件和RevMan5.3版软件进行Meta分析。结果共纳入7项研究,脑卒中和TBI患者共1334例。Meta分析结果显示,注射BoNT-A第4、8、12周后,BoNT-A组肌张力的改善均显著优于安慰剂组,差异有统计学意义(P<0.05)。BoNT-A组注射第4周后,主动踝背伸的改善角度显著优于对照组,差异有统计学意义(P<0.05)。2组的不良反应发生率、Fugl-Meyer评分、步行速度和步行距离组间比较,差异均无统计学意义(P>0.05)。结论A型肉毒毒素可有效地改善脑卒中或TBI患者的下肢痉挛程度,且安全性较好。Objective To evaluate the efficacy and safety of using botulinum toxin type A(BoNT-A)in treating lower limb spasticity resulting from a stroke or traumatic brain injury(TMI).Methods Reports of randomized and controlled trials of the effectiveness of BoNT-A treatment for lower limb spasticity resulting from stroke or TMI published before January 2019 were collected from the PubMed,EBSCO host,OVID Medline and Web of Science databases.Results Seven studies with 1334 participants were found.Meta-analysis showed that a significant decrease in muscle tone was observed at the 4th,8th and 12th weeks after BoNT-A injection compared to placebo injection.At the 4th week after the injection,active ankle dorsiflexion was also significantly improved.No significant differences were observed in the rate of adverse events,the average Fugl-Meyer scores,walking pace or walking distance between the two groups.Conclusion BoNT-A injections can safely and effectively improve lower limb spasticity after stroke or traumatic brain injury.

关 键 词：A 型肉毒毒素 痉挛 下肢 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R651.15[医药卫生—临床医学]