本文關(guān)鍵詞： A型肉毒毒素 腦卒中 痙攣 療效 系統(tǒng)評(píng)價(jià)　出處：《新疆醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：評(píng)價(jià)A型肉毒毒素(Botulinum Toxin Type A)對腦卒中后上肢痙攣的治療效果。證實(shí)使用治療A型肉毒毒素與腦卒中后痙攣上肢的活動(dòng)能力及性能的恢復(fù)相關(guān)。方法：計(jì)算機(jī)檢索2004年～2013年1月期間的PubMed、中國學(xué)術(shù)期刊網(wǎng)全文數(shù)據(jù)庫(CNKr)、中國萬方醫(yī)學(xué)網(wǎng)文獻(xiàn)數(shù)據(jù)庫、Cochrane、Ovid電子圖書館臨床對照試驗(yàn)資料庫。檢索語種不限。納入比較單純康復(fù)治療與康復(fù)治療結(jié)合肉毒毒素兩種方案治療腦卒中后上肢痙攣療效的隨機(jī)對照試驗(yàn),并觀察經(jīng)兩種方式治療后的腦卒中患者的Ashworth分級(jí)(Modified Ashworthscale, MAS)、 Fugl-Meyer上肢運(yùn)動(dòng)評(píng)測(Fugl-Meyer assessment scale, FMA)、功能獨(dú)立性評(píng)(Functional Independence Measure, FIM)、 Barthel指數(shù)(Barthel Index)o由2名評(píng)價(jià)員獨(dú)立評(píng)價(jià)并核對研究質(zhì)量。采用RevMan5.2版軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果：共7個(gè)隨機(jī)對照試驗(yàn)317例患者被納入該項(xiàng)研究。Meta分析結(jié)果顯示：單純康復(fù)治療組與康復(fù)治療結(jié)合A型肉毒毒素治療組的治療效果相比較,二者在Fugl-Meyer上肢運(yùn)動(dòng)評(píng)測[MD=-9.13,95%CI(-12.59,-5.67), P0.00001]. Ashworth分級(jí)[MD=0.66,95%CI(038,0.94), P0.00001]、Barthel指數(shù)[OR=-15.01,95%CI(-23.84,-6.17),P0.0009]、功能獨(dú)立性評(píng)鋇[MD=-2.53,95%CI(-4.77,0.08), P=0.06]方面的差異具有統(tǒng)計(jì)學(xué)意義。結(jié)論：康復(fù)治療結(jié)合A型肉毒毒素治療較單純康復(fù)治療在經(jīng)治療12周后Ashworth分級(jí)、Fugl-Meyer上肢運(yùn)動(dòng)評(píng)測、功能獨(dú)立性評(píng)測、Barthel指數(shù)方面體現(xiàn)出更好的治療效果,該項(xiàng)結(jié)果證實(shí)了使用A型肉毒毒素與腦卒中后上肢的活動(dòng)能力及性能的恢復(fù)相關(guān),康復(fù)治療聯(lián)合A型肉毒毒素治療是一種更為合理的康復(fù)治療方式。
[Abstract]:Objective: to evaluate the therapeutic effect of Botulinum Toxin Type A (Botulinum Toxin Type A) on upper limb spasm after stroke. A computer-based search of PubMede from 2004 to January 2013, CNKran, CNKran, and CochraneOvid Electronic Library Clinical controlled trial Database of China Wanfang Medical Network. The search languages are not limited. A randomized controlled trial of therapeutic and rehabilitative therapy combined with botulinum toxin in the treatment of upper limb spasm after stroke. The Ashworth grade modified Ashworth scale, MASA, Fugl-Meyer upper limb motor evaluation, Fugl-Meyer assessment scale, FMAA, functional Independence measure, Barthel index Barthel Index)o were independently evaluated by two evaluators and the quality of the study was checked by two evaluators. Results: a total of 317 patients in 7 randomized controlled trials were included in the study. Meta-analysis showed that the therapeutic effects of rehabilitation alone group and rehabilitation combined with botulinum toxin A group were compared. The two were evaluated by Fugl-Meyer upper limb motion [MD-9.13C95 CI-12.59 CI-5.67, P0.00001] .The difference of Ashworth grading [MD-0.6695 CI: 0380.94m, P0.00001] Barthel index [OR-15.01C95 CI-23.84-6.170.0009], functional independence barium [MD-2.5395CI-4.7CI-4.7C- 0.080.080.06] conclusion: rehabilitation therapy combined with rehabilitation therapy is more effective than rehabilitation therapy alone in the treatment of Botulinum toxin A (Botulinum toxin A). Conclusion: rehabilitation therapy combined with botulinum toxin A therapy is more effective than rehabilitation therapy alone in the treatment of botulinum toxin A. After 12 weeks, Ashworth grading and Fugl-Meyer upper limb motion assessment were performed. The evaluation of functional independence showed a better therapeutic effect in terms of Barthel index, which confirmed that the use of botulinum toxin A was associated with recovery of upper limb activity and performance after stroke. Rehabilitation therapy combined with botulinum toxin A therapy is a more reasonable rehabilitation therapy.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.32

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本文編號(hào)：1554994