经颅磁刺激治疗脑梗死的临床疗效观察

Effects of Transcranial Magnetic Stimulation in Patients with Cerebral Infarction

目的观察经颅磁刺激(transcranial magnetic stimulation,TMS)对脑梗死患者的临床疗效。方法符合病例入选标准的脑梗死患者60例,随机分为试验组及对照组,每组各30例,试验组及对照组均给予常规药物治疗,试验组在常规治疗基础上给予TMS治疗,疗程10d,比较治疗前后患者的运动功能(Fugl-Meyer评分)、Barthel指数(Barthel index,BI)以及美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分。结果 NIHSS评分:试验组由治疗前的6.57±2.66减少到治疗后4.01±2.83,对照组由6.29±3.00减少到5.10±2.43;Barthel指数:试验组由治疗前47.33±14.31增加到治疗后60.83±18.53,对照组由45.50±13.91增加到53.67±15.97;FugI-Meyer评分:试验组由治疗前38.20±24.01增加到治疗后58.40±29.57,对照组由37.55±23.8增加到49.60±29.77,治疗前两组3项评分差异均无统计学意义,治疗后3项评分差异均有统计学意义(P分别为0.008、0.004和0.008)。结论 TMS对脑梗死患者肢体功能恢复有一定疗效,能提高患者的日常生活能力。

Objective To investigate the effects of transcranial magnetic stimulation（TMS） in patients with cerebral infarction. Methods Sixty patients who suffered cerebral infarction were assigned to experiment group and control group（30 cases each group）. Both groups received rehabilitation therapy. Experiment group received TMS. Ten days were one period of treatment. Fugl-Meyer scores, Barthel Index, National Institutes of Health Stroke Scale（NIHSS） scores were recorded before treatment and after treatment. Results NIHSS scores：experiment group decreased from 6.57±2.66 to 4.01±2.83, control group decreased from 6.29±3.00 to5.10±2.43; Barthel Index：experiment group increased from 47.33±14.31 to 60.83±18.53, control group increased from 45.50±13.91 to53.67±15.97; Fugl-Meyer scores：experiment group increased from 38.20±24.01 to 58.40±29.57, control group increased from 37.53±23.8 to 49.60±29.77. Before treatment, there was no statistic difference between two groups on NIHSS scores, Barthel Index and Fugl-Meyer scores（P〉0.05）. After treatment, there was significant difference between two groups on NIHSS scores, Barthel Index and Fugl-Meyer scores （P〈0.01）. Conclusion TMS can improve limb function in patients with cerebral infarction and increase the ability of daily living.