重复经颅磁刺激结合百会长留针治疗脑卒中后认知功能障碍的临床疗效观察

Clinical observation of repetitive transcranial magnetic stimulation combined with long-time needle retaining at Baihui in the treatment of cognitive dysfunction after stroke

目的观察重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)结合百会长留针治疗脑卒中后认知功能障碍(post-stroke cognitive impairment,PSCI)的疗效。方法将符合纳入标准的50例PSCI患者采用随机数字表法分为对照组25例和观察组25例,对照组采用神经内科常规治疗、西医康复治疗及百会长留针,观察组在对照组治疗的基础上加用rTMS。治疗4周后,观察简易精神状态检查量表(mini-mental state examination,MMSE)、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、改良Barthel指数量表(modified barthel index,MBI)评分的变化。结果治疗4周后,两组MMSE、MoCA、MBI评分均较同组治疗前提高(P<0.01),且观察组优于对照组(P<0.05)。结论重复经颅磁刺激结合百会长留针治疗PSCI疗效显著,安全性好,值得临床推广应用。

Objective To observe the effect of repetitive transcranial magnetic stimulation combined with long-time needle retaining at baihui in the treatment of cognitive dysfunction after stroke.Methods All of 50 patients with cognitive dysfunction after stroke who met the inclusion criteria were randomly divided into the control group(n=25)and the observation group(n=25).The control group received routine treatment of neurology department,western medicine rehabilitation treatment and baihui long-time needle retaining.The observation group received repetitive transcranial magnetic stimulation(rTMS)in addition to the same treatment as the control group.After 4 weeks of treatment,the changes of mini-mental state examination(MMSE),montreal cognitive assessment(MoCA)and modified Barthel index(MBI)were observed.Results After 4 weeks of treatment,the MMSE,MoCA and MBI scores of the two groups were higher than those before treatment(P<0.05),and the scores of the observation group were better than those of the control group(P<0.05).Conclusion Repetitive transcranial magnetic stimulation combined with long-time needle retaining at baihui has significant efficacy and high safety in the treatment of cognitive dysfunction after stroke,which is worthy of clinical application.