超声引导下BTX-A联合针刺对脑卒中痉挛性足下垂及足内翻患者步态功能的疗效观察  

作　　者：孙峰 丁永民 谢晶军[2] 

机构地区：[1]浙北明州医院,313000 [2]浙江省湖州市第一人民医院,313000

出　　处：《浙江临床医学》2023年第8期1166-1168,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省湖州市科技计划项目(2020GYB39)。

摘　　要：目的观察超声引导下A型肉毒毒素(BTX-A)联合针刺对脑卒中痉挛性足下垂与足内翻步态功能的疗效。方法经随机数字表法,将2021年6月至2022年12月浙北明州医院及湖州市第一人民医院96例脑卒中患者分为BTX-A组、针刺组和联合组,每组各32例。在常规康复训练的前提下,三组分别在治疗前,治疗后2周、8周和12周采用改良Ashworth评级(MAS)、下肢Fugl-Meyer量表(FMA)、10 m步行测定(10 m-WT)、步行能力分级(FAC)与日常生活活动(ADL)能力开展相关测评。结果治疗2、8、12周后,三组与组内治疗前比较,各观察指标评分均显著改善,差异有统计学意义(P<0.05);治疗后联合组与另两组同时段比较,各观察指标评分改善更明显,差异有统计学意义(P<0.05)。结论超声引导下BTX-A联合针刺能更有效地缓解因脑卒中诱发足下垂及足内翻相关痉挛肌群,能改善患者步行功能,为临床治疗提供一种新思路。Objective To observe the effect of botulinum toxin A(BTX-A)combined with acupuncture on spastic foot drop and varus gait function after stroke.Methods A total of 96 stroke patients from Zhebei Mingzhou Hospital and The First People's Hospital of Huzhou from June 2021 to December 2022 were divided into a BTX-A group,an acupuncture group and a combined group by random number table method,with 32 cases in each group.On the basis of routine rehabilitation training,the modified Ashworth scale(MAS),lower extremity Fugl-Meyer scale(FMA),10 m walking test(10M-WT),walking ability classification(FAC)and activities of daily living(ADL)were used to evaluate the three groups before the treatment and 2,8 and 12 weeks after the treatment.Results After 2,8 and 12 weeks of the treatment,the scores of each observation index in the three groups were significantly improved compared with those before the treatment,and the differences were statistically significant(P<0.05).Compared with the other two groups at the same time,the scores of each observation index in the combined group improved more significantly,and the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided botulinum toxin type A combined with acupuncture can more effectively relieve foot drop and foot varus related spastic muscle group induced by stroke,and improve the walking function of patients,which provides a new idea for clinical treatment.

关 键 词：A型肉毒毒素 针刺 足下垂 足内翻 步态功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]