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A型肉毒素水电针腧穴注射治疗脊髓损伤后肌痉挛的临床研究
Hits: 2666   Download times: 1493   Received:January 19, 2010    
作者Author单位UnitE-Mail
邢时通 XING Shi-tong 湖州市第一人民医院骨科,浙江 湖州 313000 Department of Orthopaedics,the 1st People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China wangdan1964@163.com 
王丹 WANG Dan 湖州市第一人民医院骨科,浙江 湖州 313000 Department of Orthopaedics,the 1st People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China  
温晓红 WEN Xiao-hong 湖州市第一人民医院骨科,浙江 湖州 313000 Department of Orthopaedics,the 1st People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China  
武中庆 WU Zhong-qing 湖州市第一人民医院骨科,浙江 湖州 313000 Department of Orthopaedics,the 1st People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China  
孙琦 SUN Qi 湖州市第一人民医院骨科,浙江 湖州 313000 Department of Orthopaedics,the 1st People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China  
张东伟 ZHANG Dong-wei 湖州市第一人民医院骨科,浙江 湖州 313000 Department of Orthopaedics,the 1st People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China  
成逸 CHENG Yi 湖州市第一人民医院骨科,浙江 湖州 313000 Department of Orthopaedics,the 1st People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China  
严冬 YAN Dong 湖州市第一人民医院骨科,浙江 湖州 313000 Department of Orthopaedics,the 1st People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China  
俞菲 YU Fei 湖州市第一人民医院骨科,浙江 湖州 313000 Department of Orthopaedics,the 1st People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China  
期刊信息:《中国骨伤》2010年23卷,第5期,第350-353页
DOI:10.3969/j.issn.1003-0034.2010.05.0010
基金项目:浙江省中医药科技计划项目(编号:2008CB070)


目的:探讨A型肉毒素(BTX-A)水电针腧穴注射治疗脊髓损伤后肌痉挛的安全性及疗效。

方法:2006年12月至2009年12月,收治脊髓损伤后出现肌痉挛的患者38例,男26例,女12例;年龄21~68岁,平均45.4岁。按入院时间随机分为3组,A组13例,采用BTX-A水电针腧穴注射;B组13例,单纯注射BTX-A;C组12例,单纯电针刺激。治疗后第6个月时对患者进行改良Ashworth(MAS)评分及临床痉挛指数CSI评分。

结果:治疗后第6个月时38例患者获得随访,治疗前3组患者MAS评分分别为(3.10±0.14),(3.20±0.17),(3.10±0.16)分,CSI评分分别为(14.10±0.14),(14.30±0.11),(14.20±0.12)分,两项评分术前差异无统计学意义 (P>0.05);治疗后第6个月时3组患者MAS评分分别为(1.10±0.16),(2.10±0.13),(2.00±0.14)分,CSI评分分别为(9.10±0.11),(12.10±0.14),(13.10±0.12)分,A组两项评分明显优于B、C组(P<0.05).

结论:中医水电针、腧穴与BTX-A注射有机结合,互相弥补不足,能达到综合治疗的目的,可以安全、快速的减少肌痉挛患者的痛苦,提高生活质量,是治疗脊髓损伤后肌痉挛的全新、效佳的方法。
[关键词]:肌痉挛状态  脊髓损伤  肉毒毒素类  针刺穴位  临床对照试验
 
Clinical research of electroacupuncture combined with acupoint-injection of botulinum toxin A in treating the muscle spasticity by spinal cord injury
Abstract:

Objective: To explore clinical safety and efficiency of electroacupuncture combined with acupoint-injection of botulinum toxin A for the treatment of muscle spasticity by spinal cord injury.

Methods: Thirty-eight patients with muscle spasticity by spinal cord injury were treated from December 2006 to December 2009 including 26 males and 12 females,with an average age of 45.4 years old ranging from 21 to 68 years. The patients were randomly divided into 3 groups according to admission time,13 patients in group A were treated with electroacupuncture combined with acupoint-injection of botulinum toxin A,and 13 patients in group B were treated with acupoint-injection botulinum toxin A and 12 patients in group C were treated with electroacupuncture. After 6 months these patients were evaluated by improved muscle Ashworth scoring(MAS) and clinical spasticity index(SCI).

Results: Thirty-eight patients were followed-up at 6 months after the treatment. The result showed that the MAS scores of group A,B,C before treatment were(3.10±0.14),(3.20±0.17),(3.10±0.16) respectively and the CSI scores were (14.10±0.14),(14.30±0.11),(14.20±0.12) respectively;there were no statistical different among the three groups(P>0.05). After 6 months of treatment,the MAS scores were(1.10±0.16),(2.10±0.13),(2.00±0.14) respectively and the CSI scores were(9.10±0.11),(12.10±0.14),(13.10±0.12) respectively. The MAS scores and CSI scores of group A were better than the other two groups(P<0.05).

Conclusion: The combination of Chinese hydropower needles and acupoints with BTX-A injection can achieve a comprehensive treatment and reduce pain and improve life quality quickly. The electroacupuncture combined with acupoint-inject botulinum toxin A is a noval safe and effective technique for the treatment of muscle spasticity by spinal cord injury.
KEYWORDS:Muscle spasticity  Spinal cord injuries  Botulinum toxins  Acupuncture points  Controlled clinical trials
 
引用本文,请按以下格式著录参考文献:
中文格式:邢时通,王丹,温晓红,武中庆,孙琦,张东伟,成逸,严冬,俞菲.A型肉毒素水电针腧穴注射治疗脊髓损伤后肌痉挛的临床研究[J].中国骨伤,2010,23(5):350~353
英文格式:XING Shi-tong,WANG Dan,WEN Xiao-hong,WU Zhong-qing,SUN Qi,ZHANG Dong-wei,CHENG Yi,YAN Dong,YU Fei.Clinical research of electroacupuncture combined with acupoint-injection of botulinum toxin A in treating the muscle spasticity by spinal cord injury[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(5):350~353
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