重复经颅磁刺激联合认知训练治疗非痴呆型血管性认知障碍疗效观察

Therapeutic effect of repetitive transcranial magnetic stimulation combined with cognitive training on non-dementia vascular cognitive impairment

目的探讨重复经颅磁刺激联合认知训练治疗非痴呆型血管性认知障碍的临床疗效。方法将68例非痴呆型血管性认知障碍患者随机分为2组,治疗组给予重复经颅磁刺激联合认知训练治疗,对照组仅给予认知训练治疗,2组均以15 d为1个疗程,连续治疗2个疗程。治疗前后应用蒙特利尔认知评估量表(MoCA)及洛文斯顿认知评价箱(LOTCA)评估2组患者认知功能。结果治疗组治疗后LOTCA各项评分和总分及对照组治疗后知觉、思维及注意力评分和总分均较治疗前明显提高(P均<0. 05),且治疗组治疗后定向、知觉、思维评分及总分均明显高于对照组(P均<0. 05)。治疗组治疗后MoCA各项评分和总分及对照组治疗后执行、注意、抽象、记忆、定向评分和总分均较治疗前明显提高(P均<0. 05),且治疗组治疗后抽象、记忆、定向评分及总分均明显高于对照组(P均<0. 05)。结论重复经颅磁刺激联合认知训练可提高非痴呆型血管性认知障碍患者认知功能,改善患者生活质量。

Objective It is to investigate the clinical efficacy of repetitive transcranial magnetic stimulation combined with cognitive training in the treatment of non-dementia-type vascular cognitive impairment. Methods 68 patients with non-dementia-type vascular cognitive impairment were randomly divided into two groups. The treatment group was given repetitive transcranial magnetic stimulation combined with cognitive training. The control group was only given cognitive training. 15 days as one treatment course, and both groups were continuously treated for 2 courses. The cognitive function of the two groups was evaluated before and after treatment using the Montreal Cognitive Assessment Scale （MoCA） and the Lovingston Cognitive Evaluation Box （LOTCA）. Results After treatment, the scores of each item and total scores of LOTCA in the treatment group and the scores of perception, thinking and attention and total scores in the control group were significantly higher than those before treatment （ P 〈0.05）, and the scores of perception, thinking and attention and total scores in the treatment group were significantly higher than those in the control group （ P 〈0.05）. After treatment, the scores of each item and total scores of MoCA scores in the treatment group, and attention, abstraction, memory, directional score and total score of the control group were significantly higher than those before treatment （ P 〈0.05）, and the abstraction, memory, orientation score and total score of the treatment group were significantly higher than those of the control group（ P 〈0.05）. Conclusion Repetitive transcranial magnetic stimulation combined with cognitive training can improve cognitive function and improve patients’ quality of life in patients with non-dementia vascular cognitive impairment.