前列地尔联合肌电生物反馈疗法对中风后痉挛性偏瘫患者肢体功能及脊髓运动神经元兴奋性的影响

doi:10.3969/j.issn.1006-6233.2018.12.020

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摘要 目的: 分析前列地尔联合肌电生物反馈疗法对中风后痉挛性偏瘫患者肢体功能及脊髓运动神经元兴奋性的影响。方法: 选择我院2016年1月至2017年10月收治的91例中风后痉挛性偏瘫患者,按随机数字表法分为43例对照组和48例观察组。对照组予以肌电生物反馈疗法,观察组在对照组基础上予以前列地尔治疗。比较两组改良Ashworth量表疗效,肢体功能,Hmax,Mmax及H/Mmax,神经功能缺损程度(NDS)、日常生活活动能力(ADL)评分。结果: 观察组有效率较对照组高,差异有统计学意义(P<0.05)。治疗前,两组上肢、下肢Fugl-Meyer功能量表差异无统计学意义(P>0.05);治疗后,两组上肢、下肢Fugl-Meyer功能量表均上升,观察组高于对照组,差异有统计学意义(P<0.05)。治疗前,两组Hmax、Mmax及H/Mmax比较无差异(P>0.05);治疗后,两组Hmax、Mmax及H/Mmax均下降,观察组低于对照组(P<0.05)。两组NDS评分均下降,ADL评分均上升,观察组变化更明显(P<0.05)。结论: 前列地尔联合肌电生物反馈疗法对中风后痉挛性偏瘫患者肢体功能的改善上有积极作用,可通过调节脊髓运动神经元兴奋性,降低肌张力,减轻痉挛状态。

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关键词 ：中风后痉挛性偏瘫, 前列地尔, 肌电生物反馈疗法, 肢体功能, 脊髓运动神经元兴奋性

Abstract：Objective: To analyze the effects of alprostadil combined with electromyographic biofeedback therapy on limb function and excitability of spinal motor neurons in patients with spastic hemiplegia after stroke. Methods: 91 patients with post-stroke spastic hemiplegia admitted to our hospital from January 2016 to October 2017 were divided into 43 cases of control group and 48 cases of observation group according to random number table method. The control group was treated with emg biofeedback therapy, and the observation group was treated with alprostadil based on the control group. Then modified Ashworth scale efficacy, limb function, Hmax, Mmax and H/Mmax, neurologic deficit (NDS) and daily life activity (ADL) scores in both groups were compared. Results: Effective rate in the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). Before treatment, Fugl-Meyer function for upper and lower limbs in both group were no statistically significant difference (P>0.05). After treatment, the fugl-meyer functional scale of upper and lower limbs in both group were increased, and the observation group was higher than the control group, with statistically significant difference (P<0.05). Before treatment, Hmax, Mmax and H/Mmax in both group were no difference (P>0.05). After treatment, Hmax, Mmax and H/Mmax in both groups were decreased, and the observation group was lower than the control group (P<0.05). NDS score in both group was rised, ADL score was falled,and the observation group were more significant change (P<0.05). Conclusion: Alprostadil combined with emg biofeedback therapy has a positive effect on the improvement of limb function in patients with post-stroke paralysis. It can reduce muscle tension and reduce spasm by regulating excitability of spinal motor neurons.

Key words： Post-stroke paralysis Alprostadil Emg biofeedback therapy Body function Neuronal excitability of spinal cord motor

基金资助:2018年度河北省医学科学研究重点课题计划,(编号:20181269)

引用本文:

孙俊慧,齐艳英,冯秀芳,邱林,杨帆. 前列地尔联合肌电生物反馈疗法对中风后痉挛性偏瘫患者肢体功能及脊髓运动神经元兴奋性的影响[J]. 河北医学, 2018, 24(12): 2016-2019.
SUN Junhui, QI Yanying, FENG Xiufang, et al. Effects of Alprostadil Combined with Electromyographic Biofeedback Therapy on Limb Function and Excitability of Spinal Motor Neurons in Patients with Spastic Hemiplegia after Stroke. HeBei Med, 2018, 24(12): 2016-2019.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.12.020 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I12/2016

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