经外耳皮肤电刺激迷走神经对脑梗死偏瘫患者上肢运动功能恢复的影响

关键词：脑梗死  偏瘫  上肢运动功能  经外耳皮肤电刺激迷走神经

Keywords:cerebral infarction  hemiplegia  upper extremity motor function  transcutaneous vagus nerve stimulation

摘要：

      摘要 目的：探讨经外耳皮肤电刺激迷走神经（transcutaneous vagus nerve stimulation, t-VNS）对脑梗死偏瘫患者上肢运动功能的影响。 方法：将确定入组的42例脑梗死患者随机分配至试验组（t-VNS+常规治疗）及对照组（sham-t-VNS+常规治疗）。入组0天进行基线评定，入组后21天进行治疗后的评价。评定内容包括上肢Fugl-Meyer评分（Fugl-Meyer assessment, FMA）、Wolf运动功能测试（Wolf motor function test，WMFT）、功能独立性评定（functional independence measurement，FIM）。同时治疗过程中及治疗后观察可能出现的副作用。 结果：治疗前两组患者的上肢FMA、WMFT、FIM评分均无显著性差异（P＞0.05）。治疗21天后，两组上肢FMA、WMFT、FIM评分均较治疗前提高（P＜0.05），并且试验组指标优于对照组（P＜0.05）。治疗过程中及治疗后未出现明显的不良反应。 结论：t-VNS对脑梗死偏瘫患者上肢运动功能恢复的具有促进作用，并且无明显副作用。

Abstract:

      Abstract Objective: To investigate the effects of transcutaneous vagus nerve stimulation (t-VNS) on upper limb motor function in patients with ischemic stroke. Method: Forty-two patients with cerebral infarction were randomly assigned to the experimental group (t-VNS + conventional treatment) and the control group (sham-t-VNS + conventional treatment) according to the random number table method. The test was conducted. Baseline assessment was performed on the day enrollment, and post-treatment evaluation was performed 21 days after enrollment. The assessment included the upper limb Fugl-Meyer assessment (FMA), Wolf motor function test (WMFT), and functional independence measurement (FIM). At the same time, adverse effects were quested through out the treatment. Result: There were no significant differences in the upper limb FMA, WMFT, and FIM scores between the two groups before treatment (P>0.05). After 21 days of treatment, the FMA, WMFT, and FIM scores of the upper limbs were higher than those before treatment (P<0.05), and the experimental group was superior to the control group (P<0.05). No obvious adverse effects occurred during and after treatment. Conclusion: t-VNS has a promoting effect on the recovery of upper limb motor function in patients with hemiplegia due to cerebral infarction, and has no obvious adverse effects.