本文選題：肌痙攣 + 脊髓損傷��； 參考：《福建中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的：探討電針聯(lián)合替扎尼定治療脊髓損傷后肌痙攣的臨床療效。方法：選取2013年11月至2014年12月因脊髓損傷出現(xiàn)肌痙攣就診于南京軍區(qū)福州總醫(yī)院的病例75例,隨機(jī)分成3組,治療組(電針+替扎尼定)、對(duì)照組1(電針)和對(duì)照組2(替扎尼定),每組25例。電針治療每周連續(xù)治療6天,休息1天,4周為1療程；替扎尼定1片,口服,3/日,連續(xù)治療4周。采用改良的痙攣程度量表Ashworth (modified Ashworth scale, MAS)和臨床痙攣指數(shù)(clinic spasticity index, CSI)評(píng)定痙攣狀態(tài),采用日常生活能力量表(modified Barthel index, MBI)評(píng)價(jià)患者日常生活能力。所有數(shù)據(jù)在SPSS 17.0統(tǒng)計(jì)軟件下分析。結(jié)果：1.基線比較：3組患者在年齡、性別、脊髓損傷程度及損傷節(jié)段上比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.改良Ashworth(MAS):治療前MAS評(píng)分治療組、對(duì)照組1和對(duì)照組2分別為(2.96±0.68),(2.94±0.61),(2.98±0.60)分,治療后分別為(1.27±0.31),(1.62±0.39),(2.12±0.46)分。治療前后MAS評(píng)分三組差異有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。與對(duì)照組1和對(duì)照組2比較,治療組MAS評(píng)分降低更明顯,差異有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。3.臨床痙攣指數(shù)(CSI)：治療前CSI評(píng)分治療組、對(duì)照組1和對(duì)照組2分別為(14.29±0.40),(14.26±0.56),(14.41±0.45)分,治療后分別為(8.16±0.51),(11.56±0.57),(12.06±0.48)分。治療前后CSI評(píng)分三組差異有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。與對(duì)照組1和對(duì)照組2比較,治療組CSI評(píng)分降低更明顯,差異有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。4.日常生活能力：治療前MBI評(píng)分治療組、對(duì)照組1和對(duì)照組2分別為(48.80±6.49),(46.20±6.15),(47.19±5.59)分,治療后分別為(69.81±5.67),(59.59±5.58),(58.24±6.10)分。治療前后日常生活能力三組差異有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。與對(duì)照組1和對(duì)照組2比較,治療組日常生活能力提高更明顯,差異有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。5.臨床療效：治療4周后,治療組的有效率為88.0%,對(duì)照組1的有效率為60.0%,對(duì)照組2的有效率為56.0%。治療組有效率高于對(duì)照組1和對(duì)照組2,差異有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：電針聯(lián)合替扎尼定治療、電針治療和替扎尼定治療均能有效緩解脊髓損傷后肌痙攣患者的痙攣狀態(tài),但電針聯(lián)合替扎尼定能更有效減輕肌痙攣患者的痛苦,提高生活質(zhì)量,是治療脊髓損傷后肌痙攣的有效方法。
[Abstract]:Objective: to investigate the clinical effect of electroacupuncture combined with tezanidine on muscle spasm after spinal cord injury. Methods: from November 2013 to December 2014, 75 cases of muscle spasm caused by spinal cord injury in Fuzhou General Hospital of Nanjing military region were selected and randomly divided into 3 groups. Treatment group (electroacupuncture), control group 1 (electroacupuncture) and control group 2 (tizanidine), 25 cases in each group. Electroacupuncture treatment lasted 6 days per week, rest 1 day for 4 weeks as a course of treatment, and tezanidine 1 tablet was given orally for 3 days for 4 weeks. Spasticity was assessed by modified Ashworth scale, MAS) and clinic spasticity index, CSI), and ADL was evaluated by modified Barthel index, MBI). All data were analyzed under SPSS 17.0 statistical software. The result is 1: 1. There was no significant difference in age, sex, degree of spinal cord injury and injury segment between the three groups. Before treatment, the scores of control group and control group were 2.96 鹵0.68 and 2.98 鹵0.60, respectively, and 1.27 鹵0.31 after treatment were 1.62 鹵0.39 and 2.12 鹵0.46, respectively. There was significant difference in MAS score between the three groups before and after treatment (P 0.05). Compared with control group 1 and control group 2, the MAS score in treatment group was significantly lower than that in control group (P < 0.05). Clinical spasticity index: before treatment, the scores of CSI score in control group and control group were 14.29 鹵0.40, 14.26 鹵0.56 and 14.41 鹵0.45, respectively. After treatment, the scores were 11.56 鹵0.57 and 12.06 鹵0.48, respectively. There was significant difference in CSI score between the three groups before and after treatment (P 0.05). Compared with control group 1 and control group 2, the CSI score in the treatment group was significantly lower than that in the control group (P 0.05. 05. 4). Activity of daily living (ADL): before treatment, the scores of MBI score in control group, control group and control group were 48.80 鹵6.49, 46.20 鹵6.15, 47.19 鹵5.59), and 69.81 鹵5.67, 59.59 鹵5.58, 58.24 鹵6.10, respectively. Before and after treatment, the difference of ADL among the three groups was statistically significant (P 0.05). Compared with control group 1 and control group 2, the activity of daily living in treatment group was improved more obviously, and the difference was statistically significant (P 0.05. 5). Clinical efficacy: after 4 weeks of treatment, the effective rate of the treatment group was 88.0, the effective rate of the control group was 60.0 and the effective rate of the control group was 56.0. The effective rate of treatment group was higher than that of control group 1 and control group 2, the difference was statistically significant (P 0.05). Conclusion: electroacupuncture combined with tezanidine, electroacupuncture and tezanidine can effectively relieve the spasticity of patients with spasm after spinal cord injury, but electroacupuncture combined with tezanidine can relieve the pain of patients with muscle spasm more effectively. Improving the quality of life is an effective method for the treatment of spasm after spinal cord injury.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R651.2

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