重复经颅磁刺激技术联合多奈哌齐治疗脑梗死后认知功能障碍的效果观察

Effect of repetitive transcranial magnetic stimulation technique combined with donepezil in treating cognitive impairment after cerebral infarction

目的观察重复经颅磁刺激(rTMS)技术联合多奈哌齐治疗脑梗死后认知功能障碍患者的临床效果。方法选择脑梗死后认知功能障碍患者100例作为研究对象,根据随机数字表法分为观察组和对照组,每组50例。对照组采用多奈哌齐治疗,观察组采用多奈哌齐联合低频rTMS治疗。比较2组的临床疗效和不良反应发生情况,并比较2组治疗前与治疗4周后的认知功能[蒙特利尔认知评估量表(MoCA)评分和简明精神状态检查表(MMSE)评分]。结果观察组治疗总有效率为94.00%,高于对照组的72.00%,差异有统计学意义(P<0.05)。治疗前,2组MoCA评分和MMSE评分比较,差异无统计学意义(P>0.05);治疗4周后,2组MoCA评分和MMSE评分均高于治疗前,且观察组评分高于对照组,差异有统计学意义(P<0.05)。治疗4周后,2组总不良反应发生率比较,差异无统计学意义(P>0.05)。结论rTMS联合多奈哌齐治疗脑梗死后认知功能障碍疗效显著,可有效改善患者认知功能,促进认知功能恢复。

Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)technique combined with donepezil in treating patients with cognitive impairment after cerebral infarction.Methods A total of 100 patients with cognitive dysfunction after cerebral infarction were divided into observation group and control group according to random number table method,with 50 cases in each group.Donepezil was used in the control group,and low frequency rTMS combined with donepezil was used in the observation group.The clinical efficacy and occurrence of adverse reactions of the two groups were compared.Cognitive function indicators[Montreal Cognitive Assessment Scale(MoCA)score and Concise Mental State Checklist(MMSE)score]were compared between the two groups before treatment and 4 weeks after treatment.Results The total effective rate was 94.00%in the observation group,which was significantly higher than 72.00%in the control group(P<0.05).There were no significant differences in MoCA and MMSE scores pre-treatment between the two groups(P>0.05).The MoCA and MMSE scores were higher in both groups after 4 weeks of treatment than before treatment,and were significantly higher in the observation group than those of the control group(P<0.05).After 4 weeks of treatment,there was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05).Conclusion rTMS combined with donepezil can effectively improve cognitive function and promote recovery of cognitive function of patients with cognitive dysfunction after cerebral infarction so combined application has better efficacy.