不同剂量肉毒毒素A和/或功能训练治疗痉挛型小儿脑瘫的动态对比研究

目的研究大小剂量和/或功能训练对痉挛型小儿脑瘫的治疗效果.方法对比60例痉挛型小儿脑瘫患儿在4个治疗组:A大剂量肉毒毒素B大剂量肉毒毒素 功能训练C小剂量肉毒毒素 功能训练D运动疗法中肌张力、下肢运动月龄随治疗时间15d、3、6、12个月的变化.结果肌张力:A、B、C 3组在15d、1、3、6个月明显下降,在12个月都回升,A组最明显;下肢运动月龄:在12个月,C组最高,B组次之,D组再次,A组最低.结论肉毒毒素仅能在一段时间内改善肌张力,必须结合功能训练才能最终提高下肢运动功能.

A study of managing spastic pediatric cerebral palsy using botulinum toxin A and/or physiotherapy

Objective To investigate the effect of two doses of Botulinum toxin A (BTX-A) and/or physiotherapy (PT) in children with spastic cerebral palsy (SCP).Methods Double-blind ramdomized comparison of four groups: (1)High dose BTX-A;(2)High dose BTX-A PT;(3) Low dose BTX-A PT;(4)PT in sixty children with SCP was undertaken. Using modified Ashworth scale (MAS), we evaluated muscle tone, lower limb motor function was calculated using Gross Motor Function Measure(GMFM) including low limb motor function month,both at the time of 0 month,0.5 month,3 month,6 month,12 month.Statistical data was tested with analysis of variance.Results Muscle tone: there was significant decrease in group A,B,C at the time of 0.5month, 3month, 6month, while significant raising again in group A was observed at 12 month. Low limb motor function: at 12 month, group C was the highest, then group B, then group D, group A was the lowest.Conclusion Botulinum toxin A just can improve muscle tone in a certain time, it can not enhance GMFM until combined by function treatment.