摘要
目的探讨重复经颅磁刺激(rTMS)联合磁刺激内关、三阴交穴治疗缺血性脑卒中(IS)伴偏瘫患者的效果及对功能影像学特征的影响。方法纳入2019年9月至2021年5月陕西省中医医院收治的98例IS伴偏瘫患者,根据治疗方法的不同将其分为rTMS组和联合组,各49例。rTMS组在常规康复训练的基础上采用rTMS治疗,联合组在rTMS组的基础上使用磁刺激患侧内关穴和三阴交穴。比较两组的运动功能、平衡功能、神经功能缺损情况、功能独立性及功能磁共振成像(fMRI)特征。结果治疗后,两组的上肢、下肢运动功能评分及Fugl-Meyer运动功能评分量表(FMA)总分高于治疗前,且联合组高于rTMS组,差异具有统计学意义(P<0.05)。治疗后,两组的Berg平衡量表(BBS)、功能独立性评定量表(FIM)评分高于治疗前,美国国立卫生院卒中评价量表(NHISS)评分低于治疗前,且联合组优于rTMS组,差异具有统计学意义(P<0.05)。治疗后,两组的双侧脑功能激活区体积大于治疗前,双侧大脑初级运动皮层(M1)区功能连接值高于治疗前,且联合组优于rTMS组,差异具有统计学意义(P<0.05)。结论rTMS联合磁刺激内关、三阴交穴治疗IS伴偏瘫能够改善患者的运动功能、平衡功能、功能独立性,这可能与其能够显著提高脑功能激活区体积和M1区功能连接值等相关。
Objective The investigate the effect of repetitive transcranial magnetic stimulation(rTMS)combined with magnetic stimulation of Neiguan and Sanyinjiao points in the treatment of patients with ischemic stroke(IS)complicated with hemiplegia and its influence on functional imaging features.Methods A total of 98 patients with IS complicated with hemiplegia admitted in Shaanxi Provincial Hospital of Chinese Medicine from September 2019 to May 2021 were included and divided into rTMS group and combined group according to the different treatment methods,with 49 cases in each group.The rTMS group was treated with rTMS on the basis of routine rehabilitation training,and the combined group used magnetic stimulation of Neiguan and Sanyinjiao points of affected side on the basis of the rTMS group.The motor function,balance function,neurological function deficit,functional independence and functional magnetic resonance imaging(fMRI)features of the two groups were compared.Results After treatment,the motor function scores of upper and lower limbs and total score of Fugl-Meyer assessment scale(FMA)in the two groups were higher than those before treatment,those in the combined group were higher than the rTMS group,and the differences were statistically significant(P<0.05).After treatment,the Berg balance scale(BBS)and functional independence measure(FIM)scores in the two groups were higher than those before treatment,the national institutes of health stroke scale(NHISS)score was lower than that before treatment,those in the combined group were better than the rTMS group,and the differences were statistically significant(P<0.05).After treatment,the volume of bilateral brain function activation area in the two groups was larger than that before treatment,the bilateral brain primary motor cortex(M1)area functional connection value was higher than that before treatment,those in the combined group were better than the rTMS group,and the differences were statistically significant(P<0.05).Conclusion The rTMS combined with magnetic stimulation of Neiguan and Sanyinjiao points in the treatment of IS complicated with hemiplegia can improve patients'motor function,balance function and functional independence,which may be related to its ability to significantly increase the volume of brain function activation area and the M1 area functional connection value.
作者
郭华峰
陈杰
袁捷
丁晓晨
GUO Huafeng;CHEN Jie;YUAN Jie;DING Xiaochen(Image Center,Shaanxi Provincial Hospital of Chinese Medicine,Xi'an 710003,China)
出处
《临床医学研究与实践》
2022年第23期27-30,共4页
Clinical Research and Practice
基金
陕西省重点研发计划项目(No.2021SF-375)。
关键词
重复经颅磁刺激
缺血性脑卒中
运动功能障碍
功能磁共振成像
repetitive transcranial magnetic stimulation
ischemic stroke
hemiplegia
functional magnetic resonance imaging
