重复经颅磁刺激结合针刺对脑梗塞患者血浆NSE的影响及MRS观察

Effect of Repetitive Transcranial Magnetic Stimulation Combined with Acupuncture on Serum NSE of Patients with Cerebral Infarction and MRS

目的:观察重复经颅磁刺激结合针刺对脑梗塞患者NSE水平的影响及磁共振波谱分析代谢物的变化。方法:将符合纳入标准的180例患者,按随机数字表法随机分成3组,每组60例,rTMS组给予重复经颅磁刺激治疗,针刺组给予针刺治疗,治疗组给予重复经颅磁刺激配合针刺治疗,一个疗程后进行相关疗效评定。结果:治疗组总有效率为96.67%,针刺组总有效率为88.33%,rTMS组总有效率为75.00%,治疗组的临床疗效明显优于针刺组和对照组,差异有统计学意义(P<0.05,P<0.01),针刺组优于rTMS组,差异有统计学意义(P<0.05)。治疗组在NIHSS、NSE、NAA、Lac、FMA和MBI方面均优于针刺组和rTM组,差异均有统计学意义(P<0.05);针刺组在NIHSS、FMA和MBI方面均优于rTMS组,差异均有统计学意义(P<0.05),在NSE、NAA和Lac方面针刺组和rTMS组差异无统计学意义(P>0.05)。结论:脑梗塞患者采用重复经颅磁刺激结合针刺治疗,能显著提高临床疗效,修复神经功能缺损,改善肢体运动能力和日常生活能力,并可降低NSE水平,提高NAA释放,加速Lac清除。

Objective：To observe the effect of repetitive transeranial magnetic stimulation combined with acu- puncture on NSE levels of patients with cerebral infarction and the influence of the metabolite changes in mag- netic resonance spectrum analysis. Methods： 180 patients who met the standard were randomly divided into three groups, each group with 60 cases. Give repetitive transeranial magnetic stimulation in rTMS group;acu- puncture group was given acupuncture treatment; the treatment group was given repetitive transcranial magnetic stimulation with acupuncture treatment, after one course to assess the curative effect. Results：Total effeetive rate in the treatment group was 96.67% ;the total effective rate in the acupuncture group was 88.33% ;the total effective rate in the rTMS group was 75.00%. The clinical curative effect in the treatment group was better than acupuncture group and the control group ,and the difference was statistically significant （P 〈 0.05 ,P 〈 0. 01 ）, and the acupuncture group was better than the rTMS group, the difference was statistically significant （P 〈 0. 05 ）. NIHSS, NSE, NAA, Lac, FMA and MBI in the treatment group were superior to the rTM group and ac- upuncture group, and the difference had a statistical significance （ P 〈 0.05 ） ; acupuncture group was superior to the rTMS group in the NIHSS, FMA and MBI, and the difference had a statistical significance （ P 〈 0.05 ） ; in the aspect of Lac, NSE and NAA in the acupuncture group and rTMS group there was no statistically signifieant difference （P 〉 0.05 ）. Conclusion： Patients with cerebral infarction by using repetitive transcranial magnetic stimulation combined with acupuncture treatment can significantly improve the clinical curative effect, and re- pair the nerve function defect, improve the body movement and daily life ability, and the method can decrease NSE level, improve the NAA release and accelerate the Lac.