重复经颅磁刺激联合苯海索治疗局灶型肌张力障碍的效果分析

Effect of repetitive transcranial magnetic stimulation combined with benzhexol on focal dystonia

目的探讨重复经颅磁刺激联合苯海索治疗局灶型肌张力障碍的临床效果。方法抽取2021年6月至2022年8月郑州大学附属郑州中心医院收治的局灶型肌张力障碍患者70例,按随机数字表法分为对照组与研究组,每组35例。对照组采用苯海索治疗,研究组采用重复经颅磁刺激联合苯海索治疗。比较两组书写痉挛评分量表(WCRS)评分、Burke-Fahn-Marsden(BFM)评分、西多伦多痉挛性倾斜(TWSTRS)评分、书写时间、视觉模拟评分法(VAS)评分、生活障碍评分及不良反应发生率。结果治疗前,两组WCRS、BFM、TWSTRS评分比较差异未见统计性意义(P>0.05);治疗后,研究组WCRS、BFM、TWSTRS评分低于对照组(P<0.05)。治疗前,两组书写时间比较差异未见统计学意义(P>0.05);治疗后,研究组书写时间短于对照组(P<0.05)。治疗前,两组VAS、生活障碍评分比较差异未见统计学意义(P>0.05);治疗后,研究组VAS、生活障碍评分低于对照组(P<0.05)。研究组不良反应发生率(2.86%,1/35)与对照组(8.57%,3/35)比较差异未见统计学意义(P>0.05)。结论重复经颅磁刺激联合苯海索治疗局灶型肌张力障碍可改善患者书写痉挛程度、肌张力情况及痉挛性倾斜,缓解疼痛程度,减轻生活障碍,存在安全性。

Objective To investigate the clinical effect of repetitive transcranial magnetic stimulation combined with benzhexol in the treatment of focal dystonia.Methods Seventy patients with focal dystonia treated in Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2021 to August 2022 were selected,and they were divided into control group and study group by random number table method,with 35 cases in each group.The control group was treated with benzhexol,and the study group was treated by repetitive transcranial magnetic stimulation combined with benzhexol.The writer’s cramp rating scale(WCRS)score,Burke-Fahn-Marsden(BFM)score,Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS)score,writing time,visual analogue scale(VAS)score,life disorder score and incidence of adverse reaction were compared between the two groups.Results Before treatment,there was no significant difference in WCRS score,BFM score or TWSTRS score between the two groups(P>0.05);after treatment,the scores of WCRS,BFM and TWSTRS of the study group were lower than those of the control group(P<0.05).Before treatment,there was no significant difference in the writing time between the two groups(P>0.05);after treatment,the writing time of the study group was shorter than that of the control group(P<0.05).Before treatment,there was no significant difference in scores of VAS and life impairment between the two groups(P>0.05);after treatment,the scores of VAS and life impairment of the study group were lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group(2.86%,1/35)and the control group(8.57%,3/35),P>0.05.Conclusions Repetitive transcranial magnetic stimulation combined with benzhexol in the treatment of focal dystonia can improve the degree of writing spasm,muscle tension and spasmodic tilt,and it can relieve pain degree and life disorders,with good safety.