体外冲击波联合反复促通疗法对卒中后上肢痉挛患者的疗效研究  

Effect of extracorporeal shock wave therapy combined with repeated facilitation on upper limb spasticity post-stroke

作　　者：曹宇 周达岸 CAO Yu;ZHOU Da’an(Department of Rehabilitation Medicine,Third Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning 121000,China)

机构地区：[1]锦州医科大学附属第三医院康复医学科,辽宁锦州121000

出　　处：《重庆医学》2025年第4期840-844,共5页Chongqing Medical Journal

基　　金：辽宁省自然科学基金项目(20180551081);吴阶平医学基金会临床科研专项(320.6750.2021-06-2)。

摘　　要：目的探讨体外冲击波疗法(ESWT)联合反复促通疗法对卒中后上肢痉挛患者的治疗效果。方法选取2023年1-12月在该院康复医学科住院治疗的50例卒中后上肢痉挛患者为研究对象。按随机数字表法分为观察组和对照组,每组25例。对照组行常规康复训练及ESWT,观察组在对照组基础上加用反复促通疗法,连续治疗4周。采用Fugl-Meyer评定量表中的上肢部分(FMA-UE)评定运动功能,采用Carroll手功能评定(UEFT)量表评定手功能,采用改良Barthel指数(MBI)量表评定日常生活活动能力,采用改良Ashworth量表(MAS)评定肌张力,比较治疗前后两组运动功能、手功能、日常生活活动能力及肌张力情况。结果治疗前,两组FMA-UE、UEFT量表、MBI量表评分和MAS分级比较,差异无统计学意义(P>0.05)。与治疗前比较,治疗后两组FMA-UE、UEFT量表、MBI量表评分和MAS中0、1级占比升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论ESWT联合反复促通疗法可改善上肢痉挛程度,提高运动功能。Objective To investigate the therapeutic effect of extracorporeal shock wave therapy(ESWT)combined with repeated stimulatory therapy on upper limb spasm after stroke.Methods Fifty patients with upper limb spasm after stroke who were hospitalized in the rehabilitation medicine department of the hospital from January to December 2023 were selected as the study objects.They were divided into observation group and control group by a table of random numbers,with 25 cases in each group.The control group received routine rehabilitation training and ESWT,and the observation group was treated for 4 weeks in addition to the control group.Motor function was assessed by Fugl-Meyer upper limb(FMA-UE),hand function was assessed by Carroll Hand Function Rating(UEFT),and activity of daily living was assessed by modified Barthel Index(MBI).The modified Ashworth scale(MAS)was used to evaluate muscle tension.The motor function,hand function,activity of daily living and muscle tension of the two groups were compared before and after treatment.Results Before treatment,there was no significant difference in FMA-UE,UEFT scale,MBI scale score and MAS classification between the two groups(P>0.05).Compared with before treatment,the proportions of FMA-UE,UEFT scale,MBI scale score and MAS grade 0 and 1 were increased in the two groups after treatment,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).Conclusion ESWT combined with repeated stimulatory therapy can improve spasticity of upper limb and improve motor function.

关 键 词：体外冲击波 反复促通疗法 卒中 上肢 痉挛 

分 类 号：R743.3[医药卫生—神经病学与精神病学]