重复经颅磁刺激联合针刺治疗意识障碍的临床研究

Clinical Study on Repetitive Transcranial Magnetic Stimulation Combined with Acupuncture for the Treatment of Consciousness Disorders

目的:探讨重复经颅磁刺激(rTMS)对意识障碍(DOC)患者的促醒疗效。方法:将在郑州大学第五附属医院康复医学科治疗的58例意识障碍患者,根据随机数字表分为对照组和治疗组,各29例。对照组采用针刺治疗,治疗组予以rTMS治疗联合针刺治疗。比较治疗前后两组患者Glasgow昏迷评定量表评分、脑电图Synek分级、脑干听觉诱发电位(BAEP)分级以及治疗期间的不良反应情况。结果:治疗后,两组Glasgow昏迷评定量表评分均有改善,且治疗组评分等级优于对照组(P<0.05);治疗组脑电图Synek分级较治疗前降低,且降低幅度高于对照组(P<0.05);治疗组BAEP分级治疗后优于治疗前,且明显优于对照组。结论:rTMS联合针刺治疗可促进意识恢复,提高皮质兴奋性,改善神经缺损,安全有效,值得临床推广。

To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)on disorders of consciousness(DOC).Methods:58 patients with consciousness disorder who were treated in the Department of Rehabilitation Medicine of the Fifth Affiliated Hospital of Zhengzhou University were divided into the control group and the treatment group according to the random number table,29 patients in each group.The control group was treated with acupuncture,and the treatment group was treated with rTMS combined with acupuncture.The Glasgow coma rating scale score,EEG Synek rating,brainstem auditory evoked potential(BAEP)rating and adverse reactions during treatment were compared between the two groups before and after treatment.Results:After treatment,the scores of Glasgow coma rating scale in both groups were improved,and the scores in the treatment group were better than those in the control group(P<0.05);The Synek grade of EEG in the treatment group was lower than that before treatment,and the reduction extent was higher than that in the control group(P<0.05);The BAEP grading of the treatment group after treatment was better than before treatment and significantly better than that of the control group.Conclusion:rTMS combined with acupuncture can promote the recovery of consciousness,increase cortical excitability,improve nerve defect,which is safe and effective,and is worthy of clinical promotion.