低频重复经颅磁刺激对脑卒中后手部运动功能康复疗效的荟萃分析

Meta-analysis of the Effect of Low-frequency Repetitive Transcranial Magnetic Stimulation on Paretic Hand Recovery after Stroke

低频重复经颅磁刺激（rTMs）作为一种非侵入性的脑部刺激技术，已用于脑卒中患者的康复治疗中。本文按照纳入排除标准检索了1990年1月～2012年4月在CNKI、VIP和万方数据库以及外文数据库PubMed、Ebseo、Ovid、CochraneI。ibrary中运用低频rTMS治疗脑卒中后恢复手部运动功能的文献，最终纳入7项独立研究（N=216），提取相关数据，利用ReviewManager5．1软件进行效应量合并，来探讨低频rTMS在脑卒中患者手功能康复中的疗效。通过本次荟萃分析发现低频rTMS能够改善手指运动功能（SMD=0．58），并且对手部整体功能有较为明显的促进作用（SMD=-0．98）。同时，低频rTMs在治疗过程中产生的副作用较少，不会对健侧手功能（SMD=O）造成影响，对脑卒中患者的患侧手部运动功能的恢复具有积极作用。

Low-frequency repetitive transcranial magnetic stimulation （rTMS） is a non-invasive brain stimulation method that has been used in the treatments of stroke patients. Our purpose was to investigate the effects of low-fre- quency rTMS on the hand motor function recovery for stroke patients. After searching from electronic database from January 1990 to April 2012, we collected randomized controlled trials explored the low-frequency rTMS effects on the hand motor function rehabilitation. A total of 7 comparisons （N：216） from 5 articles were included in this stud- y. We summarized the effect size by calculating the standardized mean difference （SMD）. Summary of effect size （SES） indicated positive effects of low-frequency rTMS on the finger motor ability （SMD：0.58） and hand function （SMD=-0.98）. Few adverse effects occurred. The evidence showed that low-frequency rTMS could improve the pa- retic hand recovery after stroke.