经颅直流电刺激联合镜像疗法对脑卒中后上肢及手功能恢复的影响

Effects of transcranial direct current stimulation combined with mirror therapy on functional recovery of upper limbs and hands after stroke

目的探究经颅直流电刺激(transcranial direct current stimulation,tDCS)联合镜像疗法(mirror therapy,MT)对脑卒中后上肢及手功能恢复的影响。方法选取2019年3月~2021年9月本院收治的脑卒中患者93例,根据随机数字表法分为观察组(47例)及对照组(46例)。对照组进行tDCS,观察组进行tDCS同时配合MT。4周后,比较两组患者不同时间点的双上肢的体感诱发电位值(somatosensory evoked potentials,SEP),上肢、手功能及日常生活能力。结果与治疗前比较,两组患侧治疗4周及治疗后3个月的SEP值降低,Fugl-Meyer量表上肢部分(Fugl-Meyer Assessment-Upper Extremity,FMA-UE)评分、Brotez评分及Barthel指数均升高(P<0.05);与治疗4周比较,治疗后3个月的SEP值降低,FMA-UE评分、Brotez评分及Barthel指数升高(P<0.05);与对照组比较,观察组治疗前SEP值、FMA-UE评分、Brotez评分及Barthel指数差异无统计学意义(P>0.05),治疗4周及治疗后3个月的SEP值降低,FMA-UE评分、Brotez评分及Barthel指数升高(P<0.05)。结论tDCS联合MT能够改善脑卒中后上肢及手功能,同时有利于提高患者日常生活能力。

Objective To explore the effect of transcranial direct current stimulation(tDCS)combined with mirror therapy(MT)on the recovery of upper limb and hand function after stroke.Methods A total of 93 stroke patients admitted to our hospital from March 2019 to September 2021 were selected as the research subjects,and they were divided into observation group(47 cases)and control group(46 cases)by random number table method.The control group was given tDCS,and the observation group was given tDCS and MT.The somatosensory evoked potentials(SEP)of both upper limbs,upper limbs and hand functions,and activities of daily living were compared between the two groups after 4 weeks.Results Compared with before treatment,the SEP value of the affected side in the two groups were decreased after 4 weeks of treatment and 3 months after treatment,and the Fugl-Meyer Assessment-Upper Extremity(FMA-UE)score,Brotez score and Barthel index were increased(P<0.05).The SEP value at 3 months after treatment was decreased,and the FMA-UE score,Brotez score and Barthel index were increased(P<0.05)compared with 4 weeks of treatment.There was no significant difference in the SEP value,FMA-UE score,Brotez score and Barthel index of the observation group compared with the control group before treatment(P>0.05),the SEP value was decreased at 4 weeks and 3 months after treatment,and the FMA-UE score,Brotez score and Barthel index were increased(P<0.05).Conclusion tDCS combined with MT can improve the upper limb and hand function after stroke,and it is also beneficial to improve the daily living ability of patients.