重复经颅磁刺激对脑梗死患者下肢运动功能的影响

Effects of repetitive transcranial magnetic stimulation on the lower Umbmotor functionof cerebral infarction patients

目的探讨重复经颅磁刺激（rTMS）对脑梗死患者下肢运动功能的影响。方法纳入脑梗死后下肢功能障碍患者60例，按照随机数字表法将其分为rTMS治疗组和对照组，每组30例。2组均给予常规药物和康复治疗，rTMS治疗组在此基础上加用健侧M1区rTMS治疗，疗程4周。2组分别于治疗前、治疗4周后（治疗后）及治疗完成后2周（治疗后2周）进行下肢简式Fugl-Meyer运动功能（FMA）和10m最大步行速度（10mMWS）测定，观察并记录治疗过程中及治疗后2周内有无明显不良反应。结果2组患者治疗前FMA、10mMWS比较，差异均无统计学意义（P〉0．05）。治疗后和治疗后2周，2组患者FMA、10mMWS均较组内治疗前有所改善（P〈0．05），且rTMS治疗组治疗后FMA[（28．2±2．8）分]、10mMWS[（56．78±20．15）m／min]及治疗后2周FMA[（27．8±2．9）分]、10111MWS[（55．89±21．06）m／min]均较对照组改善更明显（P〈0．05）。2组均未出现明显不良反应。结论rTMS治疗可提高脑梗死后患者的下肢运动功能，安全性较好，值得临床应用。

Objective To explore the effects of repetitive transcranial magnetic stimulation （rTMS） on the motor function of lower limbs of patients with cerebral infarction. Methods Sixty stroke survivors with lower limb dysfunctionwere randomly assigned to an rTMS treatment group or a control group, each of 30. Both groups were given routine medication and rehabilitation treatment, while the treatment group was additionally provided with 4 weeks of rTMS treatment of the contra-lesional M1 at 1 Hz and 90% motor threshold. The Fugl-Meyer motor assessment （FMA） and maximum walking speed （MWS） were used to assess both groups before and after the treatment and 2 weeks later. Adverse reactions were also recorded. Results Before the intervention, no differences were found between the two groups. After the treatment and two weeks after that, significant improvement was observed in the average FMA and 10 m MWS of both groups, with significantly more improvement in the treatment group than among the controls. No obvious adverse reactions were observed in either group. Conclusions rTMS can improve the motor function of the affected lower limbs of stroke patients safely.