刘志敏;杨永红;赵阳;高红;

• 1:华北石油管理局总医院

摘要(Abstract)：

目的 观察经颅直流电刺激联合肌电生物反馈治疗卒中后上肢痉挛的临床疗效。方法 选取2020-05—2021-12华北石油管理局总医院收治的106例卒中后上肢痉挛患者为治疗对象，随机抽签法分组为对照组、观察组各53例。对照组以肌电生物反馈治疗，观察组以经颅直流电刺激联合肌电生物反馈治疗。评估比较2组患者的症状评分、杨氏模量值、血清学指标水平、临床疗效、不良反应发生率等。结果 治疗后，观察组患者的痉挛指数量表（CSI）评分、改良Ash-worth肌张力评定量表（MAS）评分为（6.12±1.95）分、（3.04±0.67）分，均低于对照组的（8.28±2.02）分、（4.19±0.81）分，而上肢Fugl-Meyer量表（FMA）评分为（58.91±5.91）分，高于对照组的（51.02±5.76）分（t=5.122、4.006、8.447,P<0.05）。治疗后，观察组患者肱桡肌、肱肌、肱二头肌杨氏模量值为（49.23±5.98）kPa、（37.45±5.02）kPa、（72.22±8.31）kPa均低于对照组的（56.89±6.67）kPa、（44.62±6.05）k Pa、（85.37±9.02）kPa(t=5.802、7.473、5.676,P<0.05)。治疗后，观察组溶血磷脂酸（LPA）、沉默调节蛋白（SIRT1）、血小板反应蛋白1(THBS-1)水平为（19.23±3.93）ng/L、（77.84±9.08）ng/L、（50.29±6.12）ng/L，均低于对照组的（25.41±3.82）ng/L、（84.92±10.31）ng/L、（61.01±7.89）ng/L(t=4.669、3.821、8.301,P<0.05)。治疗后，观察组总有效率为90.57%(48/53)，高于对照组患者的75.47%(40/53)（χ2=4.283,P<0.05）。治疗期间，观察组、对照组不良反应发生率分别为13.21%(7/53)、9.43%(5/53)（χ2=0.376,P>0.05）。结论 经颅直流电刺激联合肌电生物反馈治疗卒中后上肢痉挛的疗效显著，能够改善患者的上肢痉挛症状和肌肉组织弹性，抑制血清LPA、SIRT1、THBS-1水平。

关键词(KeyWords)： 卒中后上肢痉挛;脑卒中;肌电生物反馈;经颅直流电刺激;杨氏模量值

Abstract:

Keywords:

基金项目(Foundation): 河北省中医药管理局科研计划项目（编号：2020252）

作者(Authors): 刘志敏;杨永红;赵阳;高红;

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