摘要
目的观察经颅磁刺激（TMS）联合高压氧（HBO）治疗脑梗死的临床疗效。 方法采用随机数字表法将120例脑梗死患者分为联合治疗组、HBO组及对照组，每组40例。对照组患者给予常规治疗（包括常规康复训练及药物对症处理），HBO组患者在常规干预基础上辅以HBO治疗，联合治疗组患者则在常规干预基础上辅以HBO及TMS联合治疗。上述治疗均以10d为1个疗程，共治疗2个疗程。于治疗前、治疗2个疗程后采用美国国立卫生研究院卒中量表（NIHSS）比较各组患者神经功能缺损程度，并同时于上述时间点检测各组患者中枢运动传导时间（CMCT）及血清中脑源性神经营养因子（BDNF）、神经生长因子（NGF）表达情况。 结果各组患者分别经2个疗程治疗后，发现联合治疗组NIHSS评分［（7.35±1.98）分］、总有效率（92.5%）均显著优于HBO组及对照组水平（均P〈0.05）；另外联合治疗组血清中BDNF含量［（4.96±1.20）ng/ml］与NGF含量［（152.36±18.01）pg/ml］均较治疗前明显升高（P〈0.05），与对照组及HBO组间差异亦具有统计学意义（均P〈0.05）。 结论TMS联合HBO治疗脑梗死具有协同作用，能进一步改善患者受损神经功能及日常生活质量，其治疗机制可能与增强神经营养因子表达有关。
Objective To explore the effectiveness of transcranial magnetic stimulation （TMS） combined with hyperbaric oxygen （HBO） in treating cerebral infarction. Methods Totally 120 patients with cerebral infarction were randomly divided into a control group, a treatment group A and a treatment group B, 40 cases in each group. The control group was given conventional treatment, the treatment group A was treated by HBO on the basis of conventional therapy, and the treatment group B was treated by HBO combined with TMS, 10 d for a period of treatment. Before and after 2 courses of treatment, all patients＇ neurological defect was evaluated using National Institutes of Health Stroke Scale （NIHSS）. Their central motor conduction time （CMCT） and the expression of brain derived neurotrophie factor （BDNF） and nerve growth factor （NGF） were also assessed. Results After treatment, the average NIHSS score and effective rate of the treatment group B was （7.35 ± 1.98） and 92.5% respectively, significantly better than the other two groups. Moreover, the average BDNF content [ （4.96 ± 1.20） ng/ml] and NGF content [ （ 152.36 ± 18.01 ） pg/ml] of the treatment group B after treatment were significantly better than before treatment, and those of the other two groups after treatment. Conclusion TMS combined with HBO is effective in treating cerebral infarction. This may relate to its strengthening the expression of neurotropic factors.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2015年第7期522-526,共5页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
脑梗死
高压氧
经颅磁刺激
神经功能改善
Cerebral infarction
Hyperbaric oxygen
Transeranial magnetic stimulation
Neurological function improvement
Stroke
