替扎尼定联合康复训练治疗脑卒中后上肢痉挛的疗效观察  

Therapeutic effect of tizanidine hydrochloride treatment combined with rehabilitation training on upper limb spasticity in patients with stroke

作　　者：杨茹 Yang Ru(Department of Rehabilitation Medicine,Fenyang Hospital Affiliated to Shanxi Medical University,Fenyang Hospital of Shanxi Province,Fenyang 032200,Shanxi Province,China)

机构地区：[1]山西省汾阳医院、山西医科大学附属汾阳医院康复医学科,汾阳032200

出　　处：《中国基层医药》2024年第9期1311-1315,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：山西省汾阳医院科技攻关项目(202017)。

摘　　要：目的观察盐酸替扎尼定联合康复训练治疗脑卒中后上肢痉挛的临床效果。方法选择山西省汾阳医院2020年12月至2021年12月收治的脑卒中后上肢痉挛患者60例为研究对象,采用随机对照临床研究方法,根据随机数字表法分为对照组和观察组,各30例。对照组仅接受康复训练治疗,观察组在康复训练基础上联合替扎尼定治疗。采用Ashworth分级法来衡量上肢屈肌肌群的肌张力,采用简化Fugl-Meyer(FMA)衡量人体上肢活力,使用Barthel指数来评估患者日常生活能力。治疗后1个月,比较两组患者Ashworth分级、Fugl-Meyer评分、Barthel指数评分变化。结果治疗前,两组患者肌张力痉挛程度、FMA评分和Bathel指数等差异均无统计学意义(均P>0.05);治疗后1个月,两组患者肌张力痉挛等级程度均显著减轻,两组差异有统计学意义(Z=-2.02,P=0.043);观察组肌张力降低2级有16例,对照组有8例,两组差异有统计学意义(χ^(2)=4.44,P=0.035);治疗后1个月,观察组上肢功能FMA评分为(48.67±3.65)分,高于对照组的(37.00±3.55)分,差异有统计学意义(t=12.54,P<0.01);观察组治疗后Bathel指数为(46.83±5.94)分,高于对照组的(31.83±4.04)分,差异有统计学意义(t=11.43,P=0.015)。结论替扎尼定联合康复训练治疗脑卒中后上肢痉挛效果好,不仅能够降低肌肉紧张度,提升上肢运动功能,还能提高患者日常生活能力。Objective To investigate the therapeutic effect of tizanidine hydrochloride treatment combined with rehabilitation training on upper limb spasticity in patients with stroke.Methods Sixty patients with upper limb spasticity who received treatment at Fenyang Hospital of Shanxi Province from December 2020 to December 2021 were included in this study.Using a random control trial design,these patients were randomly divided into a control group and an observation group,with 30 patients per group,using a digital number table method.The control group received only rehabilitation training,while the observation group received tizanidine hydrochloride treatment combined with rehabilitation training.The Ashworth scale score was used to assess the muscle tone of the flexor muscle groups in the upper limbs.The Fugl-Meyer assessment scale was used to evaluate the upper limb function of participants.The Barthel Index was used to assess the patient's ability to perform daily living activities.At 1 month after treatment,the changes in the Ashworth scale score,Fugl-Meyer score,and Barthel Index score were compared between the two groups.Results Before treatment,there were no statistically significant differences in the severity of muscle spasticity,Fugl-Meyer Assessment Scale scores,or Barthel Index scores between the two groups(all P>0.05).At 1 month after treatment,the severity of muscle spasticity significantly decreased in both groups and differed significantly between the two groups(Z=-2.02,P=0.043).In the observation group,16 patients experienced a reduction of 2 levels in muscle tone,compared with 8 patients in the control group,which was statistically significant(χ^(2)=4.44,P=0.035).At 1 month after treatment,the Fugl-Meyer Assessment Scale score in the observation group was(48.67±3.65)points,which was significantly higher than that in the control group[(37.00±3.55)points,t=12.54,P<0.01].The Barthel Index score in the observation group was(46.83±5.94)points,which was significantly higher than that in the control group[(

关 键 词：偏瘫 肌痉挛状态 脑血管障碍 上肢 康复 替扎尼定 

分 类 号：R743.3[医药卫生—神经病学与精神病学]