A型肉毒毒素注射联合悬吊训练治疗痉挛型脑性瘫痪尖足的短期疗效观察  

Short-term efficacy of botulinum toxin type A injection combined with suspension training in the treatment of spastic cerebral palsy with pointed feet

作　　者：陈露露 苏峰 许金波 朱清 罗媛媛 梁栋 李红 CHEN Lulu;SU Feng;XU Jinbo;ZHU Qing;LUO Yuanyuan;LIANG Dong;LI Hong(Rehabilitation Department,Anhui Provincial Children´s Hospital,National Children´s Regional Medical Center,Hefei,Anhui 230051,China;College of Pharmacy,China Pharmaceutical University,Nanjing,Jangsu 211198,China;Hefei Industrial Pharmaceutical Institute Co.,Ltd.,Hefei,Anhui 230088,China)

机构地区：[1]安徽省儿童医院、国家儿童区域医疗中心康复科,安徽合肥230051 [2]中国药科大学药学院,江苏南京211198 [3]合肥医工医药股份有限公司,安徽合肥230088

出　　处：《安徽医药》2024年第7期1394-1398,共5页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省儿童医院中青年优秀科技人才项目(20etyy007)。

摘　　要：目的研究A型肉毒毒素(BTX-A)注射联合悬吊训练治疗痉挛型脑性瘫痪尖足的短期疗效。方法收集2021年1—12月就诊于安徽省儿童医院康复科痉挛型脑性瘫痪尖足病例共63例,按随机数字表法分成对照组30例,观察组33例,对照组给予常规康复治疗联合悬吊训练,观察组在对照组基础上联合A型肉毒毒素注射,分别在治疗前、治疗4周后对两组病儿进行改良Tardieu量表(MTS)评估、改良Ashworth量表(MAS)评估、粗大运动功能测试量表(GMFM-88)评估。结果治疗4周后,两组病儿的MTS得分、MAS得分、GMFM-88 D区和E区得分均较治疗前改善,且观察组MTS得分[伸膝位R1(-7.88±1.40)分、R2(16.36±1.19)分、R2-R1(24.24±2.56)分;屈膝位R1(10.18±1.30)分、R2(22.58±1.62)分、R2-R1(12.39±0.75)分]、MAS得分[(1.82±0.85)分]、GMFM-88区得分[(33.42±5.20)分]、E区得分[(50.88±5.32)分]的改善程度优于对照组[MTS伸膝位R1(-10.60±1.13)分、R2(12.23±1.33)分、R2-R1(22.83±0.53)分;屈膝位R1(5.03±0.72)分、R2(18.40±1.16)分、R2-R1(13.37±0.85)分;MAS(2.37±1.03)分;GMFM-88D区(30.40±4.67)分,E区(43.83±4.33)分,均P<0.05]。结论A型肉毒毒素注射联合悬吊训练治疗短期内能提高痉挛型脑性瘫痪尖足的临床疗效。Objective To study the short-term efficacy of botulinum toxin type A(BTX-A)injection combined with suspension training in the treatment of spastic cerebral palsy with pointed feet.Methods A total of 63 cases of spastic cerebral palsy with pointed feet attending the Rehabilitation Department of Anhui Provincial Children´s Hospital from January to December 2021 were collected and randomly assigned into 30 cases in the control group and 33 cases in the observation group.The control group was given conventional rehabilitation practice combined with suspension training,and the observation group was combined with BTX-A injection on the basis of the control group.The children in both groups were evaluated with the modified Tardieu scale(MTS),modified Ashworth scale(MAS),and Gross Motor Function Test Scale(GMFM-88)before and after 4 weeks of treatment.Results After 4 weeks of treatment,the MTS scores,MAS scores,GMFM-88 Zone D scores and Zone E scores in both groups improved compared with those before treatment.The improvement of MTS score[R1(−7.88±1.40)points,R2(16.36±1.19)points,R2−R1(24.24±2.56)points in extended knee position;R1(10.18±1.30)points,R2(22.58±1.62)points,R2−R1(12.39±0.75)points in flexed knee position],MAS score[(1.82±0.85)points],GMFM-88 zone score[(33.42±5.20)points],and E zone score[(50.88±5.32)points]improved better than those in the control group[MTS score in extended knee position R1(-10.60±1.13),R2(12.23±1.33),R2−R1(22.83±0.53)points;MTS score in flexed knee position R1(5.03±0.72)points,R2(18.40±1.16)points,R2−R1(13.37±0.85)points;MAS score(2.37±1.03)points;GMFM-88 D zone score(30.40±4.67)points,E zone score(43.83±4.33)points,all P<0.05].Conclusion BTX-A injection combined with suspension training treatment can improve the short-term clinical efficacy of spastic cerebral palsy acromegaly with pointed feet.

关 键 词：脑性瘫痪 尖足 A型肉毒毒素 悬吊训练 临床疗效 

分 类 号：R742.3[医药卫生—神经病学与精神病学]