神经松动术和神经肌肉电刺激及二者联合治疗上肢周围神经损伤的疗效对比  

Therapeutic effects of nerve mobilization technique,neuromuscular electrical stimulation and their combination on peripheral nerve injury of upper limb:a comparative study

作　　者：江泽平[1] 黄珍[1] 陈耀东 陈梓恩 JIANG Ze-ping;HUANG Zhen;CHEN Yao-dong;CHEN Zi-en(Department of Rehabilitation Medicine,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]广东省佛山市中医院康复医学科,佛山市528000

出　　处：《广西医学》2021年第14期1682-1685,1707,共5页Guangxi Medical Journal

基　　金：广东省佛山市卫生和计生局医学科研课题(20180085);广东省佛山市自筹经费类科技计划(2018AB001471)。

摘　　要：目的对比神经松动术(NMT)、神经肌肉电刺激(NMES)及二者联合治疗上肢周围神经损伤(PNI)的疗效。方法将90例上肢PNI患者随机分为NMT组、NMES组、NMT联合NMES组(联合组),每组30例。在常规基础治疗基础上,NMT组行张力手法为主的NMT治疗,NMES组行NMES治疗,联合组先行NMT治疗再行NMES治疗,疗程均为4周。治疗前、治疗4周后比较3组患者的日常生活活动能力、周围神经运动传导速度(MCV)、感觉神经传导速度(SCV);治疗4周后比较3组患者的临床疗效,记录不良事件发生情况。结果联合组临床总有效率高于NMT组(P<0.05)。治疗4周后,3组患者改良Barthel(mBI)积分均高于治疗前,周围神经MCV及SCV快于治疗前,且NMT组、NMES组、联合组mBI积分依次升高,MCV及SCV依次增快(均P<0.05)。3组治疗过程中均未见明显不良反应发生。结论NMT与NMES治疗均能促进上肢PNI后神经功能恢复,改善患者的日常生活活动能力,且联合治疗效果更佳。Objective To compare the effects of nerve mobilization technique(NMT),neuromuscular electrical stimulation(NMES)and their combination for the treatment of peripheral nerve injury(PNI)of upper limb.Methods Ninety patients with upper limb PNI were randomly assigned to NMT group,NMES group,or NMT combined with NMES group(combination group),with 30 cases in each group.Based on conventional basic treatment,the NMT group was given NMT therapy commonly comprising tension manipulation,the NMES group was treated with NMES,and the combination group was treated with NMT followed by NMES.The course of treatment was four weeks.The activities of daily living(ADL),peripheral nerve motor conduction velocity(MCV),and sensory nerve conduction velocity(SCV)were compared among the three groups before and four weeks after treatment;clinical effects were compared among the three groups four weeks after treatment,and the incidence of adverse events was recorded.Results The total clinical effective rate in the combination group was higher than that in the NMT group(P<0.05).After four weeks of treatment,modified Barthel index(mBI)scores were higher and peripheral nerve MCV and SCV were faster in the three groups in contrast with those before treatment,and mBI scores rose and MCV and SCV increased in the order of the NMT group,the NMES group and the combination group(all P<0.05).No evident adverse reactions occurred in the three groups during treatment.Conclusion Both NMT and NMES therapy can promote the recovery of neurological function and improve patients′ADL following upper limb PNI,and the combined therapy exerts a better efficacy.

关 键 词：周围神经损伤 上肢 神经松动术 神经肌肉电刺激 肌电图 联合治疗 

分 类 号：R745[医药卫生—神经病学与精神病学]