经颅直流电刺激联合运动康复训练对脑卒中患者下肢运动功能和血清Hcy水平的影响

Effects of transcranial direct current stimulation combined with exercise rehabilitation training on lower limb motor function and serum Hcy level in stroke patients

目的:探讨经颅直流电刺激(tDCS)联合运动康复训练对脑卒中患者下肢运动功能和血清同型半胱氨酸(Hcy)水平的影响。方法:将119例脑卒中患者按治疗方案不同分为对照组(n=59)和试验组(n=60)。试验组予以tDCS刺激;对照组予以tDCS伪刺激,两组均予以运动康复训练,连续治疗4周。对比两组患者治疗前后的血清Hcy水平、膝关节屈曲角度、踝关节背伸角度、Fugl-Meyer下肢运动功能评定量表(FMA-LE)、Berg平衡量表(BBS)、“起立-行走”计时测试(TUGT)、Holden功能性步行分级(FAC)、改良Barthel指数(MBI)和美国国立卫生研究院卒中量表(NHISS)的评估数据。结果:治疗后,相比于对照组,试验组的膝关节屈曲角度、踝关节背伸角度、FMA-LE和BBS评分均更高(P<0.05);TUGT、NHISS评分均更低(P<0.05),FAC分级、MBI评分均更高(P<0.05);血清Hcy水平更低(P<0.05)。结论:tDCS联合运动康复训练能够改善脑卒中患者下肢运动功能和步行能力,降低血清Hcy水平。

Objective:To investigate the effects of transcranial direct current stimulation(tDCS)combined with exercise rehabilitation training on lower limb motor function and serum homocysteine(Hcy)levels in stroke patients.Methods:119 stroke patients were divided into control group(n=59)and experimental group(n=60)according to different treatment methods.Both groups were given exercise rehabilitation training.In addition,the experimental group was given tDCS stimulation,and the control group was given tDCS pseudo stimulation.Both groups were treated continuously for 4 weeks.The evaluation data of knee flexion angle,ankle dorsiflexion angle,Fugl-Meyer lower limb motor function assessment scale(FMA-LE),Berg balance scale(BBS),standing-walking timing test(TUGT),Holden functional walking classification(FAC),modified Barthel index(MBI)and National Institutes of Health Stroke Scale(NHISS)were compared and analyzed before and after treatment,and serum Hcy levels were detected before and after treatment in the two groups.Results:Compared with the control group,the knee flexion angle,ankle dorsiflexion angle,FMA-LE and BBS scores of the experimental group were higher after treatment(P<0.05).The TUGT and NHISS scores of the experimental group were lower than those of the control group(P<0.05),and the FAC grading and MBI scores were higher than those of the control group(P<0.05).The serum Hcy level in the experimental group was lower than that in the control group(P<0.05).Conclusion:tDCS combined with exercise rehabilitation training can improve the lower limb motor function and walking ability of stroke patients,and reduce the serum Hcy level.