| 郁正红,徐守宇.基于表面肌电图的A型肉毒毒素注射联合针灸干预治疗旋转型痉挛性斜颈的疗效观察[J].浙江中西医结合杂志,2017,27(8): |
| 基于表面肌电图的A型肉毒毒素注射联合针灸干预治疗旋转型痉挛性斜颈的疗效观察 |
| The effect of botulinum toxin A injection combined with acupunctureon rotational type spasmodic torticollis based on surface electromyography |
| 投稿时间：2016-12-07 修订日期：2017-02-03 |
| DOI： |
| 中文关键词: 针灸 旋转型痉挛性斜颈 表面肌电图 A型肉毒毒素 |
| 英文关键词:acupuncture rotational type spasmodic torticollis surface electromyography Botulinum toxin A |
| 基金项目: |
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| 摘要点击次数: 703 |
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| 中文摘要: |
| 目的：通过对A型肉毒毒素注射联合针灸干预治疗旋转型痉挛性斜颈患者早期不同时段的表面肌电图检测结果进行分析，探讨其治疗疗效及表面肌电图的应用价值。
方法：采用随机数字表法将30例旋转型痉挛性斜颈患者分为治疗组和对照组。两组患者均给予局部肌肉A型肉毒毒素注射，注射结束后治疗组立即给予4周的针灸治疗，对照组不予任何处理；于治疗前、治疗2周后、治疗4周后分别用表面肌电图采集痉挛严重侧的颈伸肌、胸锁乳突肌在最大等长收缩条件下的平均功率频率（MPF）、平均肌电值（AEMG）的变化并同时进行Tsui评分。
结果：治疗2周后与治疗前相比，两组患者颈伸肌、胸锁乳突肌MPF值、AEMG值差异显著(P<0.05)；治疗4周后与治疗前相比，两组患者颈伸肌、胸锁乳突肌MPF值差异显著(P<0.05)，但AEMG值，除治疗组颈伸肌具有统计学差异外，余均无差异。组间对比，治疗4周后，治疗组颈伸肌、胸锁乳突肌MPF值、AEMG值均高于对照组，差异显著(P<0.05)，但治疗前、治疗2周后，两组患者颈伸肌、胸锁乳突肌MPF值、AEMG值均无统计学差异。治疗2周后、治疗4周后，与治疗前相比，两组Tsui评分差异显著(P<0.05)；组间对比，治疗前、治疗2周后、治疗4周后两组Tsui评分均无统计学差异。
结论：在常规应用肉毒毒素基础上辅以针灸干预治疗旋转型痉挛性斜颈具有协同疗效，值得临床推广。表面肌电图作为一种量化、客观的评价手段，能更灵敏的反应其疗效的变化，具有较好的临床应用价值。 |
| 英文摘要: |
| Objective: By analyzing the surface electromyography (sEMG) detection about the effect of botulinum toxin A injection combined with acupuncture on rotational type spasmodic torticollis in different periods, to explore the effect and evaluate the application value of sEMG。
Method: Thirty rotational type spasmodic torticollis patients were randomly divided into control group (n=15) and treatment group (n=15), using a random number table. Both groups were given a local muscular injection of botulinum toxin A．After the injection, the treatment group accept 4 weeks of acupuncture therapy immediately, while the control group is given no treatment.The mean power frequency (MPF) and average EMG (AEMG) values of the more severe side of cervical extensor and sternocleidomastoid muscles on the basis of maximal voluntary isometric contractions are recorded with sEMG before treatment, 2 weeks after treatment and 4 weeks after treatment. And at the same time record the Tsui score.
Results: To compare it between before treatment and 2 weeks after treatment, MPF value and AEMG value of cervical extensor and sternocleidomastoid from both groups have significant discrepancy (P<0.05); To compare it between before treatment and 4 weeks after treatment, MPF value of cervical extensor and sternocleidomastoid has significant discrepancy of both groups,about AEMG value, both groups have no discrepancy,except the statistic discrepancy of cervical extensor in treatment group.To compare it between two groups, 4 weeks after treatment, the values of MPF and AEMG of cervical extensor and sternocleidomastoid are higher than control group with significant discrepancy (P<0.05). To compare it between before treatment and 2 weeks after treatment, the values of MPF and AEMG of cervical extensor and sternocleidomastoid of both groups have no statistic discrepancy.To compare it between after treatment (2 weeks and 4 weeks) and before treatment, the Tsui scores have significant discrepancy (P<0.05). However to compare it between the two groups, the Tsui scores have no statistic discrepancy at the time of before treatment, 2 weeks after treatment, and 4 weeks after treatment.
Conclusion: The combined use of acupuncture based on regular utility of botulinum toxin in curing rotational type spasmodic torticollis has synergetic medical effect，which is worth of clinical promotion. sEMG, as a quantitative、 objective evaluation means, can reflect the curative effect sensitively of botulinum toxin A injection combined with acupuncture on rotational type spasmodic torticollis, which has good clinical application value. |
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