重复经颅磁联合针刺对中风后手功能康复的研究

Research on the Repetitive Transcranial Magnetic Stimulation Combined with Acupuncture on Rehabilitation of Hand Function after Stroke

目的观察低频重复经颅磁刺激联合针刺对脑卒中患者手功能康复的临床疗效。方法选取符合纳入标准的脑卒中患者60例,随机分为3组,每组20例。对照组1给予常规康复训练,对照组2给予常规康复训练联合针刺治疗,观察组在康复训练和针刺基础上给予低频重复经颅磁刺激。3组均每天治疗1次,6 d作为一个疗程,连续4个疗程。比较3组治疗前后的Fugl-Meyer量表(手指部分,FMA)评估手功能,改良Barthel指数(MBI)评估患者日常生活活动能。结果治疗后,3组的FMA评分和MBI评分均高于治疗前,差异有统计学意义(P <0. 05);其中观察组的FMA评分和MBI评分明显高于2组对照组,差异有统计学意义(P <0. 05);对照组2的FMA评分显示手功能恢复优于对照组1(P <0. 05);但是对照组2的MBI评分相对于对照组1无明显优势(P> 0. 05)。结论低频重复经颅磁刺激联合针刺对脑卒中患者手功能康复,提高患者生活质量有显著的疗效,值得临床推广。

Objective To observe the clinical effect of low frequency repetitive transcranial magnetic stimulation combined with acupuncture on hand function rehabilitation in stroke patients.Methods Sixty patients with stroke who met the inclusion criteria were randomly divided into 3 groups,with 20 in each group.The control group one was given routine rehabilitation training,the control group two was given conventional rehabilitation training combined with acupuncture treatment,and the observation group was given low frequency repetitive transcranial magnetic stimulation on the basis of the rehabilitation training and acupuncture.All the 3 groups were treated once a day,6 days as a course of treatment,and 4 courses in succession.The Fugl-Meyer scale(finger part,FMA)before and after treatment was compared,the hand function,and the Barthel index(MBI)was used to evaluate the daily activities of the patient.Results After treatment,the FMA score and MBI score of the three groups were higher than those before treatment(P<0.05).The FMA score and MBI score of the observation group were significantly higher than that of the two control groups(P<0.05).FMA score of control group two showed that hand function recovery was better than control group one(P<0.05).However,MBI score of control group two had no significant advantage compared with control group one(P>0.05).Conclusion Low-frequency repetitive transcranial magnetic stimulation combined with acupuncture has significant curative effect on the rehabilitation of hand function in patients with stroke and improve the quality of life of patients.It is worthy of clinical promotion.