不同部位经颅重复高频磁刺激治疗孤独症谱系障碍的疗效对比

Comparison of the Therapeutic Effect of Transcranial High Frequency Magnetic Stimulation in the Treatment of Autism Spectrum Disorders

目的探讨不同部位经颅重复高频磁刺激治疗孤独症谱系障碍(ASD)的疗效。方法选取2015年1月~2018年1月郑州大学附属儿童医院收治的ASD患儿110例,按照随机数字表法,分为对照组(n=55)和观察组(n=55)。两组均接受传统康复治疗,对照组采用经颅重复高频磁刺激左侧Broca区,观察组采用经颅重复高频磁刺激左侧背外侧前额叶区,比较两组治疗后的孤独症行为量表(ABC)评分、儿童孤独症评定量表(CARS)评分。结果对照组治疗后ABC量表中的交往、语言评分和CARS量表评分均低于治疗前,差异均具有统计学意义(P<0.05);治疗后观察组ABC量表中的躯体运动、生活自理评分和CARS量表评分均低于治疗前,差异均具有统计学意义(P<0.05);治疗后观察组的躯体运动评分低于对照组,交往、语言和CARS量表评分高于对照组,差异均具有统计学意义(P<0.05)。结论经颅重复高频磁刺激Broca区以及背外侧前额叶可有效改善ASD,同时刺激Broca区对于患者交往和言语恢复效果更为显著,刺激背外侧前额叶对于患者躯体运动恢复效果更为显著,临床上需参照患者的具体情况来对刺激部位进行合理选择。

Objective To explore the therapeutic effect of transcranial magnetic stimulation on ASD in different parts.Methods 110 cases of ASD children admitted to the children’s hospital affiliated to zhengzhou university from January 2015 to January 2018 were selected and divided into the control group(n=55)and the observation group(n=55)according to the random number table method.Both groups received traditional rehabilitation therapy.The control group was used transcranial repeated high frequency magnetic stimulation at the left Broca area,while the observation group was used transcranial repeated highfrequency magnetic stimulation on the left lateral prefrontal cortex.After treatment,compared autism behavior scale(ABC)score and childhood autism rating scale(CARS)score of the two groups.Results In the control group,the communication,language score of the ABC scale and CARS scale score were lower than those before treatment,and the differences were statistically significant(P<0.05).After the treatment,the physical activity,the life self-care score of the ABC scale and the CARS scale score were all lower than those before the treatment,and the differences were statistically significant(P<0.05).After treatment,the physical activity of the observation group was lower than that of the control group,and the score of communication,language and CARS was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Transcranial repeated high frequency magnetic stimulation at Broca area and dorsolateral prefrontal can effectively improve the ASD,at the same time stimulation on the Broca area has a more significant effect on patient communication and speech recovery,and stimulation at the dorsolateral prefrontal can improve somatic motor recovery.Doctor needs to change the exciting place according to patients’situation on the clinic.