低频重复经颅磁刺激联合益生菌对脑卒中后抑郁患者认知和运动功能及肠道菌群的影响

Effects of low frequency repetitive transcranial magnetic stimulation combined with probiotics on cognition,motor function and intestinal flora in patients with post-stroke depression

目的分析低频重复经颅磁刺激联合益生菌对脑卒中后抑郁患者认知、运动功能及肠道菌群的影响。方法选取我院2016年12月至2019年2月收治的110例脑卒中后抑郁患者进行研究,按随机数字表法分为观察组与对照组,各55例。两组患者均给予低频重复经颅磁刺激治疗,观察组患者进一步联合益生菌治疗。治疗4周后比较两组患者抑郁、认知功能、运动功能、肠道菌群及不良反应发生情况。结果治疗后观察组患者肠道双歧杆菌数量[(9.59±0.73)lg copies/g vs(7.56±0.54)lg copies/g]和乳杆菌数量[(9.53±0.68)lg copies/g vs(7.84±0.56)lg copies/g]高于对照组,而肠球菌数量[(7.86±0.63)lg copies/g vs(9.81±0.52)lg copies/g]与大肠埃希菌数量[(7.64±0.37)lg copies/g vs(9.16±0.48)lg copies/g]低于对照组,差异有统计学意义(均P<0.05)。治疗后两组患者MMSE评分及HAMD评分较治疗前明显改善,其中观察组患者MMSE评分[(24.71±6.89)分vs(18.16±5.92)分]和HAMD评分[(7.84±4.19)分vs(14.06±7.23)分]均优于对照组(均P<0.05)。治疗后两组患者上肢和下肢FMA评分与治疗前相比明显增高,其中观察组患者上下肢FMA评分[(39.57±9.11)分vs(33.08±9.43)分]、[(37.65±10.25)分vs(32.17±12.06)分]均高于对照组(均P<0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05)。结论低频重复经颅磁刺激联合益生菌治疗可有效改善脑卒中后抑郁患者认知、运动功能及其肠道菌群和抑郁状态,安全性较高。

Objective To analyze the effects of low frequency repetitive transcranial magnetic stimulation(LFRTMS)combined with probiotics on cognition,motor function and intestinal flora in patients with post-stroke depression.Methods A total of 110 patients with post-stroke depression treated in our hospital from December 2016 to February 2019 were randomly divided into observation group or control group,55 cases in each group.Both groups were treated with LFRTMS.The observation group was additionally given probiotic treatment.After 4 weeks of treatment,the depression,cognitive function,motor function,intestinal flora and adverse reactions were compared between the two groups.Results After treatment,the numbers of Bifidobacteria[(9.59±0.73)lg copies/g vs(7.56±0.54)lg copies/g]and Lactobacillus[(9.53±0.68)lg copies/g vs(7.84±0.56)lg copies/g]in the observation group were higher than those in the control group,while the numbers of Enterococci[(7.86±0.63)lg copies/g vs(9.81±0.52)lg copies/g]and Escherichia coli[(7.64±0.37)lg copies/g vs(9.16±0.48)lg copies/g]in the observation group were lower than those in the control group(all P<0.05).After treatment,the MMSE score and HAMD score of the two groups were significantly improved compared with those before treatment,with the MMSE score[(24.71±6.89)vs(18.16±5.92)]and HAMD score[(7.84±4.19)vs(14.06±7.23)]of the observation group better than those of the control group(all P<0.05);the FMA scores of upper and lower limbs in the two groups were significantly higher than those before treatment,with the FMA scores of upper[(39.57±9.11)vs(33.08±9.43)]and lower limbs[(37.65±10.25)vs(32.17±12.06)]in the observation group higher than those in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Low frequency repetitive transcranial magnetic stimulation combined with probiotics can effectively improve the cognition,motor function,intestinal flora and depression in patients with post-stroke depression.