体外冲击波治疗脑卒中患者肱二头肌痉挛状态的疗效

目的：探讨体外冲击波治疗脑卒中患者肱二头肌痉挛状态的临床疗效，阐明其可能机制。方法：选择脑卒中后肱二头肌痉挛状态患者48例，按随机数字表法随机分为对照组和联合治疗组，每组24例。2组患者均接受常规康复治疗，联合治疗组患者在常规康复治疗的基础上联合体外冲击波治疗。于治疗前、治疗2周时采用改良Ashworth量表（MAS）和简化的Fugl-Meyer评分法（FMA）评定2组患者肱二头肌痉挛状态和上肢运动功能。结果：治疗前2组患者肱二头肌MAS和FMA评分组间比较差异无统计学意义（P>0.05）；与治疗前比较，治疗2周时，联合治疗组患者肱二头肌MAS和FMA评分均明显改善（P<0.05），且联合治疗组患者肱二头肌MAS评分明显低于对照组（P=0.001），FMA评分明显高于对照组（P=0.023）。治疗过程中联合组患者均无不良反应发生。结论：应用体外冲击波治疗可有效改善脑卒中患者肱二头肌痉挛状态，且联合治疗组的有效率明显优于对照组。

Efficacy of extracorporeal shock wave in treatment of spasticity of biceps brachii in stroke patients

Objective: To discuss the clinical efficacy of extracorporeal shock wave therapy(ESWT) in the treatment of spasticity of biceps brachii in the stroke patients,and to elucidate its possible mechanism.Methods: A total of 48 patients with spasticity of biceps brachii after stroke were selected divided into control group and combined treatment group according to the table of random number(n=24).All patients in two groups received routine rehabilitation treatment. Based on routine treatment, the patients in combined treatment group received ESWT.Modified Ashworth Scale(MAS) and simplified Fugl-Meyer(FMA) were used to evaluate the spasticity of biceps brachii and upper limb motor function of the patients in two groups before treatment and 2 weeks after treatment.Results: Before treatment, there was no significant difference in the MAS score and FMA score of biceps brachii of the patients between two groups(P>0.05).Compared with before treatment,the scores of MAS and FMA of biceps brachii of the patients in combined treatment group were significantly improved(P<0.05).The MAS score of biceps brachii of the patients in combined treatment group 2 weeks after treatment was lower(P=0.001) while the FMA score was significantly higher than those in control group(P=0.023).There were no adverse reactions in the patients in combined treatment group.Conclusion: Aplication of ESWT can effectively relieve the spasticity of biceps brachii of the stroke patients,and the effective rate in combined treatment group was greatly superior to control group.