重复经颅磁刺激对脑卒中患者运动功能障碍的影响

关键词：脑卒中  重复经颅磁刺激  运动障碍

Keywords:stroke  transcranial magnetic stimulation  dyskinesia

摘要：

      摘要 目的：观察低频rTMS治疗对于卒中后运动功能障碍恢复的作用，同时观察脑出血患者低频rTMS治疗的安全性。 方法：选取75例患者，采用随机数字表法随机分组：对照组（n=39），治疗组（n=36）。2组患者均予常规康复训练，治疗组除常规康复治疗外，予健侧M1区低频rTMS治疗，每日1次，共20天。治疗前后分别对各组患者进行Fugl-Meyer评分（包括上肢及下肢评分）、FIM、Berg评分。 结果：①Fugl-Meyer评分：治疗后2组患者Fugl-Meyer评分均升高，与对照组相比，治疗组评分（特别是上肢评分）升高更明显(P<0.05)。②Berg评分：2组患者在治疗后Berg评分较治疗前均有升高，且治疗组明显高于对照组(P<0.05)。③FIM评分：2组患者在治疗后FIM评分较治疗前均有升高，但是2组未显示显著性差异(P>0.05)。④安全性：治疗过程中所有观察对象均未出现不良反应，安全性较好。 结论：健侧M1区低频rTMS能明显提高卒中后患者偏瘫肢体的运动功能及平衡功能，对上肢功能作用更显著，且治疗安全性好。

Abstract:

      Abstract Objective: To study the effect of low frequency repetitive transcranial magnetic stimulation (rTMS) on dyskinesia in stroke patients, and its safety for patients with cerebral hemorrhage. Method: Seventy-five stroke patients were randomly assigned to treatment group（n=36）and control group（n=39）.Both groups received conventional rehabilitation, and the treatment group received rTMS in M1 region，once a day, a total of 20 days. Both groups were assessed with Fugl-Meyer Assessment (FMA),Functional Independence Measure(FIM)and Berg before and after treatment. Result: ①Fugl-Meyer Assessment：Fugl-Meyer scores of the 2 groups were both elevated after treatment. Compared with the control group，the treatment group score for the upper limb increased more significantly (P<0.05). ②Berg scale：The scores of Berg scale in 2 groups were higher than those before treatment，and the treatment group was significantly higher than the control group(P<0.05). ③FIM: The post treatment scores of FIM in 2 groups were higher than those before treatment, however, no significant difference was found between the 2 groups(P>0.05). ④Safety: No side-effects were observed during treatment, and the safety is good. Conclusion: rTMS is safe and can improve motor function (especially for upper limb) and balance function significantly for stroke patients.