康复疗法与口服替扎尼定联合治疗脑卒中偏瘫肌痉挛疗效观察_医学论文.docVIP

康复疗法与口服替扎尼定联合治疗脑卒中偏瘫肌痉挛疗效观察_医学论文 康复疗法与口服替扎尼定联合治疗脑卒中偏瘫肌痉挛疗效观察_医学论文 作者：李江 朱其秀 孙希美 魏小丽 秦广平 王强 【关键词】 ,脑卒中；肌痉挛；替扎尼定；康复疗法 　 【摘要】 目的 观察康复疗法联合口服替扎尼定（Tizanidine）治疗脑卒中后偏瘫肌痉挛的效果。方法 将46例脑卒中所致偏瘫患者随机分为治疗组和对照组。其中对照组23例采用综合康复治疗方法，包括抗痉挛体位摆放、被动关节活动、持续牵张运动、手法按摩、肢体空气压力治疗、站立训练、健康教育等；治疗组23例，在康复治疗的基础上采用口服替扎尼定治疗。采用修订的Ashworth分级法(MAS)和改良的巴氏指数评定法(MBI)对两组患者治疗前后肌张力、日常生活活动能力（ADL）进行评定。结果 经过治疗，两组患者肌张力较治疗前均有明显降低(005)，生活自理能力较治疗前有明显提高(001)，且治疗组疗效明显优于对照组(005)。结论 替扎尼定联合康复疗法对脑卒中所致偏瘫肌痉挛有显著的改善作用，同时可提高患者生活自理能力，值得推广。 【关键词】 脑卒中；肌痉挛；替扎尼定；康复疗法 【Abstract】 Objective To observe the effects of tizanidine plus comprehensive rehabilitation therapy in treating patients with hemiplegic muscle spasticity after stroke.Methods Forty six patients were divided randomly into two groups. Twenty three patients of control group were treated only with comprehensive rehabilitation therapy and twenty three patients of therapy group were treated by combining tizanidine and comprehensive rehabilitation therapy.The muscular tension and self care ability between pretreatment and post treatment in two group were assessed by Modified Ashworth Scale(MAS) and Modified Barthel Index(MBI). Results The muscular tension was significantly decreased in patients after treatment (005). The self care ability was significantly increased in patients after treatment (0001). Meanwhile the above two parameters in post treatment were also significantly different between the two groups(005).Conclusion Tizanidine plus comprehensive rehabilitation therapy is effective for hemiplegic muscle spasticity after stroke,and it may also improve self care ability in those patients,and this should be generally applied. 【Key words】 stroke, muscle spasticity,tizanidine,rehabilitation therapy 脑卒中后偏瘫患者常出现痉挛，其运动障碍的特点为偏瘫侧肢体肌张力增高、腱反射亢进，出现阵挛及肌强直［1］。但并不是所有痉挛都需要治疗，适度的痉挛是有益的，但过度的痉挛常使患者出现疼痛，影响肢体的随意运动，妨碍护理，影响日常生活能力。严重者甚至影响患者的正常睡眠［2］。因此我们采用替扎尼定与综合康复疗法联合治疗患者38例，观察其对肌痉挛的疗效，现报告如下。 1 资料与方法 1.1 研究对象 46例患者均为我科2004年3月至2005年10月间住院的脑卒中偏瘫患者，均符合脑卒中的诊断标准［3］并经头颅CT或MRI证实为脑卒中（脑梗