自拟中药方联合重复经颅磁刺激对脑梗死后脑血流量及肢体运动障碍的影响

Effects of self-designed prescription combined with repeated transcranial magnetic stimulation on cerebral blood flow and limbdyskinesia after cerebral infarction

目的探讨自拟中药方联合重复经颅磁刺激对脑梗死后脑血流量及肢体运动障碍的影响。方法选取2017年6月—2018年6月长江航运总医院武汉脑科医院治疗的脑梗死亚急性期及恢复期患者60例作为研究对象,随机为研究组与对照组,每组30例。对照组给予常规治疗加以针灸、偏瘫肢体综合训练(PT),重复经颅磁刺激治疗;研究组在此基础上给予自拟中药方治疗,均治疗2个疗程。比较两组治疗前后Barthel指数、简化FuglMeyer量表、CT灌注脑部血流量。结果①治疗后,两组相对脑血流量(rCBF)、相对脑血容量(rCBV)较治疗前显著升高,相对平均通过时间(rMTT)均较治疗前显著下降,差异有统计学意义(P<0.05)。治疗后,研究组rCBF、rCBV显著高于对照组,rMTT显著低于对照组,差异有统计学意义(P<0.05)。②治疗后两组Fugl-Meyer评分均较治疗前显著提高,差异有统计学意义(P<0.05);治疗后研究组Fugl-Meyer评分高于对照组,差异有统计学意义(P<0.05)。③治疗后两组Barthel评分均较治疗前显著提高,差异有统计学意义(P<0.05);治疗后,研究组Barthel评分高于对照组(P<0.05)。治疗期间两组均无严重不良反应发生。结论自拟中药方联合重复经颅磁刺激可显著改善脑梗死后患者脑血流量及肢体运动障碍。

Objective To investigate the effects of self-designed prescription combined with repeated transcranial magnetic stimulation on cerebral blood flow and limb dyskinesia after cerebral infarction.Methods Sixty patients with subacute cerebral infarction and convalescent cerebral infarction treated in the General Hospital of Yangtze River Shipping from June 2017 to June 2018 were randomly divided into study group(30 cases)and control group(30 cases).The control group was given routine treatment accompanied with acupuncture,comprehensive training of hemiplegic limbs(PT),transcranial magnetic stimulation treatment.On this basis,the study group was treated with self-designed prescription.The two groups all received for two courses of treatment.Barthel index,simplified Fugl-Meyer scale and CT perfusion cerebral blood flow were compared before and after treatment.Results Regional cerebral blood flow(rCBF),regional cerebral blood volume(rCBV)were higher,and relative mean transmit time(rMTT)was lower after treatment than those befeore treatment in both groups(all P<0.05).After treatment,rCBF and rCBV were significantly higher,and rMTT was significantly lower in the study group than those in the control group(P<0.05).The Fugl-Meyer scores of the two groups were significantly higher after treatment than those before treatment(P<0.05);the Fugl-Meyer scores of the study group were higher than those of the control group(P<0.05).After treatment,the Barthel scores of both groups were significantly higher than those before treatment(P<0.05),especially in the study group(P<0.05).There was no serious adverse reaction in both groups.Conclusion Self-designed prescription combined with repeated transcranial magnetic stimulation can significantly improve cerebral blood flow and limb dyskinesia in patients with cerebral infarction.