高频重复经颅磁刺激治疗中风后上肢痉挛的效果研究

Therapeutic Effect of High Frequency rTMS on Upper Limb Spasticity after Stroke

目的:观察高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)作用于患侧初级运动皮层(M1区)对中风患者上肢痉挛的效果。方法:将41例中风后上肢痉挛患者按随机数字表法分为高频rTMS组(n=21)和假刺激组(n=20)。两组均行常规康复治疗,高频rTMS组加以10 Hz rTMS,1次/d,5 d/周,治疗8周。两组患者均在治疗前、后应用改良Ashworth量表(MAS)、Fugl-Meyer上肢运动功能评分量表(FMAUE),以及改良Barthel指数(MBI)进行评估。结果:经8周治疗,两组患者MAS、FMA-UE及MBI评分均有显著改善,与治疗前比较,差异有统计学意义(P<0.05),且高频rTMS组较假刺激组各项评分改善更明显,差异有统计学意义(P<0.05)。结论:高频rTMS可有效改善中风后上肢痉挛,提高患者上肢运动功能和日常生活能力。

Objective:To observe the effect of repetitive transcranial magnetic stimulation(rTMS) on the primary motor cortex(M1) in patients with upper limb spasticity.Method:Forty-one patients with post-stroke upper limb spasticity were randomly divided into the high frequency rTMS group(n=21) and the sham rTMS group(n=20).Both groups received routine rehabilitation.High frequency rTMS group accept 10 Hz rTMS,1 time a day,5 days a week, lasted for 8 weeks.Both groups accepted modified Ashworth scale(MAS),Fugl-Meyer upper limb motor function score scale(FMA-UE),and modified Barthel index (MBI) assessment before and after treatment.Result:After 8 weeks of treatment,the MAS,FMA-UE and MBI scores of both groups were significantly improved(P<0.05),and the high frequency rTMS group improved more significantly than the sham rTMS group.The differences were statistically significant(P<0.05).Conclusion:High-frequency rTMS can effectively improve upper limb spasticity after stroke and improve upper limb motor function and daily living ability.