低频重复经颅磁刺激治疗小脑梗死后平衡障碍的疗效分析

Clinical Observation on Low Frequency Repetitive Transcranial Magnetic Stimulation for the Treatment of Balance Disorders after Cerebellar Infarction

目的探讨低频重复经颅磁刺激(LF-rTMS)治疗小脑梗死后平衡障碍的临床疗效。方法选择小脑梗死病人40例,按照完全随机对照分为rTMS组和对照组,各20例。rTMS组采用LF-rTMS+常规平衡障碍康复训练;对照组采用伪线圈rTMS+常规平衡障碍康复训练。纳入后即开始康复训练,两组病人刺激每日1次,每次20min,连续28d。记录两组病人治疗前和治疗后(第7天、第14天、第28天)Burg平衡量表(BBS)评分和Tinetti步态量表评分。结果治疗后rTMS组病人BBS评分增加,平衡功能恢复良好,疗效明显优于对照组(P<0.01);rTMS组病人Tinetti步态量表评分增长快,平衡及步态功能康复理想,疗效显著优于对照组(P<0.01)。结论 LF-rTMS可显著改善小脑梗死后平衡障碍及步态康复,且远期疗效显著优于近期疗效,证实LF-rTMS治疗小脑梗死后平衡障碍病人疗效的可靠性及有效性。

Objective To explore the clinical effect of low frequency repetitive transcranial magnetic stimulation（LF-rTMS）in the treatment of balance disorders after cerebellar infarction.Methods Forty patients with cerebellar infarction were randomly divided into two groups：control group（n =20）treated with pseudo-coil rTMS plus routine rehabilitation training of balance disorders,and treatment group（n =20）treated with LF-rTMS plus routine rehabilitation training of balance disorders for 14 days.The scores of Berg Balance Scale（BBS）,Tinetti Gait and Balance Scale（TGBS）were observed before treatment and after treatment of 7 days,14 days,28 days.Results BBS scores increased quickly,the balance function recovered well in treatment group,which was better than that in control group（P〈0.01）.TGBS scores increased quickly,the balance and gait rehabilitation recovered well in treatment group,which was better than that in control group（P〈0.01）.The long-term efficacy was better than short-term one.Conclusion LF-rTMS can significantly improve the balance disorder and gait rehabilitation after cerebral infarction,and the long-term efficacy was better than the short-term one.It was confirmed that the reliability and validity of LF-rTMS in the treatment of balance disorders after cerebellar infarction.