高低频重复经颅磁交替刺激治疗卒中后认知障碍患者临床疗效观察

Clinical Observation of High and Low Frequency Repetitive Transcranial Magnetic Stimulation in Patients with Cognitive Impairment After Stroke

目的观察高低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)交替治疗卒中后认知障碍(post-stroke cognitive impairment,PSCI)患者的临床疗效。方法选取2017年3月—2022年3月在江苏民政康复医院和南京医科大学第二附属医院住院治疗的PSCI患者60例为研究对象,按照随机数表法分为治疗组和对照组,每组30例。对照组给予口服盐酸美金刚片和常规康复治疗,治疗组在对照组基础上给予高低频rTMS交替治疗。治疗前后给予两组患者简明精神状态量表(MMSE)、蒙特利尔认知测试(MoCA)、改良Barthel指数(MBI)评价,记录整理数据并统计分析。结果治疗后,治疗组患者MMSE评分高于对照组,差异有统计学意义(P<0.05);治疗后,治疗组患者的MoCA评分高于对照组,差异有统计学意义(P<0.05);治疗后,治疗组患者的MBI评分高于对照组,差异有统计学意义(P<0.05)。结论高低频rTMS交替治疗可以更快改善PSCI患者的认知功能,提高其日常生活能力,值得临床应用。

Objective To observe the clinical effect of high and low frequency repetitive transcranial magnetic stimulation(rTMS)on patients with post stroke cognitive impairment(PSCI).Methods 60 PSCI patients hospitalized in Jiangsu Civil Affairs Rehabilitation Hospital and the Second Affiliated Hospital of Nanjing Medical University from March 2017 to March 2022 were selected and divided into treatment group and control group according to random number table.There were 30 patients in each group.The control group was treated with oral memantine hydrochloride tablets and conventional rehabilitation therapy.The treatment group was treated with high and low frequency rTMS on the basis of the control group.Before and after treatment,the patients were evaluated with Mini mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),and modifi ed Barthel index(MBI),and the data were recorded and analyzed statistically.Results After treatment,the MMSE scores of patients in the treatment group were higher than those in the control group,with a statistically significant difference(P<0.05);after treatment,the Moca score of patients in the treatment group was higher than that in the control group,with a statistically significant difference(P<0.05);after treatment,the MBI score of the treatment group was higher than that of the control group,with a statistically significant difference(P<0.05).Conclusion High and low frequency rTMS alternative treatment can improve the cognitive function of PSCI patients more quickly and improve the ability of daily living,which is worthy of further clinical application.