【作者】 张永刚；

【导师】 刘世文；

【作者基本信息】 吉林大学 ， 康复医学与理疗学， 2005， 硕士

【摘要】 本文通过药物替扎尼定对脑卒中痉挛性偏瘫治疗,对上肢痉挛不同程度治疗和控制在不同程度,观察对患者上肢、手,日常生活能力改善有无影响。方法:随机抽取脑卒中患者120 例,按上肢肌张力改良Ashworth II 级分为A 组,改良Ashworth III、Ⅳ级分为B 组,A 组又分为试验组和对照组,A 组均接受神经内科常规治疗和康复训练,对试验组给予替扎尼定将肌张力从改良Ashworth II 级降为I 级,B 组患者均接受神经内科常规治疗和康复训练,试验组给予替扎尼定将肌张力从改良Ashworth III、IV 级降为改良Ashworth II 级,同时对所有患者试验前,试验8 周后,对上肢,手进行上田敏十二级评分,对日常生活能力,自我护理用FIM 进行评分试验。结论:脑卒中恢复期,在上肢,手,日常生活能力方面,在上肢肌张力从改良Ashworth II 级降为改良Ashworth I 级情况下,对功能恢复无影响。脑卒中恢复期,在上肢,生活自理方面,将上肢肌张力从改良Ashworth III、IV 级降为改良Ashworth II 级情况下对功能恢复有帮助。脑卒中恢复期,上肢肌张力在改良Ashworth III、IV 级情况下,降低痉挛和康复治疗共同作用有助于手功能恢复。脑卒中恢复期,康复治疗对患者上肢,日常生活能力,自我护理方面有功能恢复作用。更多还原

【Abstract】 Clinical investigation on Tizanidine influencing CVA patients’upper-limb’s fumction Objective: CVA patient’hemiplegia caused by upper-moving nervouscenter fault is spastic hemiplegia. We observe that the drug of tizamdine cure different degree spasm and control musde tention to some degree to influence hemiplegic patient’s upper-limb, hand, ADL recovery. Material and Methods: Onehudred-twenty hemiplegic patients caused by stroke were recruited and allocated into 2 groups according to muscle tension. A group (muscle tensin is reform Ashworth II lever) there are sixty patients, B group (Muscle tension is reform Ashworth III-IV level) there are sixty patients. A group is divided experimental group and comparable group. A group patients are treated with neuropathic conventional medicine and rehabilitation train. The drug of tizandine lower the muscle tension from reform Ashworth II lever to reform Ashworth I in experimental group. B group is divided experimental group and comparable group. B group patients are treated with neuropathic conventional medicine and recovery train. The drug of tizandine lower the muscle tension from reform Ashworth III IV level to reform Ashworth II level in experimental group. All patients are praded according to Shang tianmin level for upper-limb, hand, and Fim grade for ADL, self-nurse ability before therapy and eight weeks after therapy. Result: Experimental group isn’t obvious different in contrast to comparable group after therapy for the upper-limb function in A group (P>0.05). This indicate that there’s no influence for the upper-limb fumction when the drug of tizandinine lower the muscle tension from reform Ashworth II level to reform Ashworth I level. Experimental group is obvious difference in contrast to comparable group after, therapy for the upper-limb function in B group (P<0.01). This indicate that there’s influence for the upper-limb function when the drug of tizandine lower the muscle tension from reform Ashworth III~IV level to reform Ashworth II level. All patient’s upper-limb function is obvionsly improved in contrast to the primary situation (P<0.01). This indicate that rehabilitation therapy and the drug of Tizamdine or the simple rehabilitation therapy can obviously improve the upper-limb function. A group’s patient’s hand function isn’t improved in contrast to primary situation (P>0.05). This indicate that rehabilitation therapy and the drug of Tizandine or the simple rehabilitation therapy can’t improve the hand function. Experience group is obviously improved in contrast to primary situation for the hand function in B group (P<0.05). This indicate that the drug of Tizanidine and rehabilitation therapy hand improve the hand function. Comparable group isn’t improved in contrast to the primary situation for the hand function in B group (P>0.05). This indicate that simple rehabilitation therapy can’t improve hand function. Experimental group isn’t difference in contrast to comporable group after therapy for the hand function in all patients (P>0.05). This indicate that the muscle tension improvement can’t influence the hand function. All patients’ADL is improved in contrast to primary situation (P<0.01). This indicate that rehabilitationtherapy and the drug of Tizanidine or the simple rehabilitation therapy can obviously improve the ADL ability. Experimental group isn’t difference in contrast to comparable group after therapy for the ADL ability in all patients (P>0.05). This indicate that the muscle tension can’t influence the patients’ADL ability in all patients. FIM score include six sides contents, Because self-nurse ability is closely associated with the upper-limb and the hand, We list this project score. All patients’self-nurse ability is improved in contrast to primary situstion (P<0.01). This indicate that rehabilitation therapy and the drug of Tizanidine or the simple rehabilitation therapy can obviously improve the self-nurse ability. Experimental group isn’t difference in contrast to comparable group after therapy for self-nurse ability in A group (P>0.05). This indicate that there’s no influence for the self-nurse ability when the drug of tizanidine lower the muscle tension from reform Ashworth II level to reform Ashworth I level. Experimental group is obvious difference in contrast to comparable group after therapy for self-nurse ability in B group (P<0.05). This indicate the drug of Tizandine can improve self-nurse ability when it lower the muscle tension from reform Ashworth III, IV level to reform Ashworth II level. In reform Ashworth III IV level, the drug of Tizandine can’t influce the ADL ability, but can influence a certain subject. Conclusion: 1. The drug of tizandine can’t influence the upper-limb function, the hand function and ADL ability during the recovery period when it lower the musde tension from reform Ashworth II level to reform更多还原