重复经颅磁刺激联合发散式冲击波治疗创伤性脊髓损伤患者肌肉痉挛的疗效观察

关键词：创伤性脊髓损伤  肌肉痉挛  重复经颅磁刺激  发散式冲击波

Keywords:traumatic spinal cord injury  muscle spasms  repetitive transcranial magnetic stimulation  divergent shock wave

摘要：

      摘要 目的：观察重复经颅磁刺激联合发散式冲击波治疗创伤性脊髓损伤患者肌肉痉挛的临床疗效，探索该病症临床治疗新方法。 方法：于2017年1月—2021年6月期间选取在院治疗的59例创伤性脊髓损伤伴肌肉痉挛患者，利用随机数字表法随机分成观察组（30例）和对照组（29例），两组患者均接受包括运动疗法、针灸、推拿在内的常规康复治疗，观察组患者在此基础上应用重复经颅磁刺激联合发散式冲击波治疗，而对照组患者在此基础上接受巴氯芬治疗，治疗时间均为8周，并分别在治疗前、后对观察组和对照组患者的改良Ashworth评分、Barthel指数及SF-36评分进行比较。 结果：治疗后，观察组有效率为86.67%，其疗效显著高于对照组，差异有显著性意义（P＜0.05）；两组患者的Barthel指数总分和SF-36评分均较治疗前显著增加，差异有显著性意义（P＜0.05）；且观察组患者Barthel指数和SF-36评分显著高于对照组，差异有显著性意义（P＜0.05）。 结论：重复经颅磁刺激联合发散式冲击波可有效改善创伤性脊髓损伤患者肌肉痉挛症状，且能充分提高其日常生活能力和生存质量，取得了良好的临床疗效。

Abstract:

      Abstract Objective：To observe the effects of repetitive transcranial magnetic stimulation combined with divergent shock wave on muscle spasm in patients with traumatic spinal cord injury， and to explore a new clinical treatment method for the disease. Method：Fifity-nine patients with traumatic spinal cord injury with muscle spasm from January 2017 to June 2021 were selected and randomly divided into the observation group（n=30） and the control group（n=29） with the method of random number table. The patients in the observation group received repeated transcranial magnetic stimulation combined with divergent shock wave therapy，while the patients in the control group received baclofen treatment. Both groups received conventional rehabilitation therapy， including exercise therapy， acupuncture and massage. The treatment time was 8 weeks. The modified Ashworth score，Barthel index and SF-36 score of the patients in the observation group and the control group were compared before and after treatment. Result：After treatment， the effective rate of the observation group was 86.67%， which was significantly higher than that of the control group （P<0.05）. The total score of Barthel index and SF-36 score of the two groups were significantly increased compared with those before treatment （P<0.05）. The Barthel index and SF-36 score in the observation group were significantly higher than those in the control group （P<0.05）. Conclusion：Repetitive transcranial magnetic stimulation combined with divergent shock wave can effectively improve the symptoms of muscle spasm in patients with traumatic spinal cord injury and can fully improve their ability of daily life and quality of life, which has achieved good clinical efficacy.