高频重复经颅磁刺激对脑卒中患者手功能康复的疗效

Effect of High-frequency Repetitive Transcranial Magnetic Stimulation on Hand Function in Patients after Stroke

目的探讨高频重复经颅磁刺激对脑卒中患者手功能康复的疗效。方法 2016年6月至2017年9月将本科30例脑卒中患者根据随机数字表法分为对照组(n=15)和实验组(n=15)。实验组给予3 Hz的r TMS治疗及常规康复训练,对照组给予伪r TMS治疗及常规康复训练,每天1次,每周5 d,共10次。治疗前后采用Fugl-Meyer评定法(手指部分,FMA)、改良Ashworth评分(MAS)评估手功能恢复情况,改良Barthel指数(MBI)评估患者日常生活活动能力。结果共27例患者完成实验。治疗后,两组FMA评分均有提高(Z>2.070,P<0.05),实验组提高差值高于对照组(Z=-2.296,P<0.05);对照组MAS评分无变化(Z=-0.816,P>0.05),实验组MAS评分改善(Z=-2.456,P<0.05),实验组差值明显高于对照组(Z=-2.792,P<0.01);两组MBI评分均明显提高(t>3.085,P<0.01),两组间MBI评分及差值无显著性差异(t<0.246,P>0.05)。结论高频重复经颅磁刺激可以促进脑卒中患者手功能的康复。

Objective To observe the effect of high-frequency repetitive transcranial magnetic stimulation(r TMS) on hand function in patients after stroke.Methods From June, 2016 to September, 2017, 30 stroke patients were randomly divided into control group(n=30) and experimental group(n=30). Both groups received routine training after sham rTMS or 3 Hz rTMS. Fugl-Meyer Assessment(FMA), modified Ashworth Scale(MAS) and modified Barthel Index(MBI) were used to evaluate the hand function and the activities of daily living before and after treatment.Results Finally 27 patients completed the experiment. After treatment, the FMA score increased in both groups(Z>2.070, P<0.05), and the difference value was higher in the experimental group than in the control group(Z=-2.296, P<0.05); the MAS score improved in the experimental group(Z=-2.456, P<0.05), no difference was found in the control group(Z=-0.816, P>0.05), and the difference value was higher in the experimental group than in the control group(Z=-2.792, P<0.01); the MBI score improved in both groups(t>3.085, P<0.01), however, no difference was found in the MBI score and the difference value between two groups(t<0.246, P>0.05).Conclusion High-frequency r TMS could promote the hand function in patients after stroke.