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黄长耀,窦佳鸣,王丽婷,苏 敏.重复经颅磁刺激对脑卒中患者平衡功能影响的研究[J].中国康复医学杂志,2018,(2):165~169
重复经颅磁刺激对脑卒中患者平衡功能影响的研究    点此下载全文
黄长耀  窦佳鸣  王丽婷  苏 敏
苏州大学附属第一医院康复医学科,苏州,215006
基金项目:国家自然科学基金青年项目(81301059);国家自然科学基金面上项目(81672244)
DOI:
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摘要:
      摘要 目的:观察重复经颅磁刺激(rTMS)对后循环卒中患者平衡功能障碍的评估及治疗效果。 方法:将30例后循环卒中患者随机分成治疗组和假刺激组各15例,两组均进行常规药物治疗及康复训练,治疗组增加健侧初级运动皮质区(M1)1Hz的rTMS刺激,在治疗前、治疗后即时及治疗后2周3个时间点分别采用日本东京大学平衡量表(UTBS),Tetrax平衡测试仪SI及WDI指数以及TMS的MEP阈值对患者平衡功能进行评定。 结果:治疗后即时与治疗前相比,两组患者平衡功能评分均明显高于治疗前(P<0.05),治疗组闭眼状态下Tetrax平衡指数优于假刺激组(P<0.05),同时两组运动皮质MEP阈值有显著性差异(P<0.01);治疗后2周,两组患者平衡功能评分均较治疗前进一步提高(P<0.01),其中治疗组明显高于假刺激组(P<0.05),同时治疗组Tetrax平衡指数显著优于假刺激组(P<0.01),两组MEP阈值有明显差异(P<0.01)。 结论:低频rTMS可抑制大脑皮质中央前回运动区的异常兴奋,提高后循环卒中患者的平衡功能,有康复临床应用价值。
关键词:重复经颅磁刺激  后循环卒中  平衡功能障碍  评估  治疗
Effects of repetitive transcranial magnetic stimulation on balance function in stroke patients    Download Fulltext
The First Affiliated Hospital of Soochow University, Suzhou, 215006
Fund Project:
Abstract:
      Abstract Objective: To observe and evaluate the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) on the balance dysfunction in patients with posterior circulation stroke. Method: Thirty patients with posterior circulation stroke were randomly divided into treatment group and sham stimulation group (15 cases each group). Both groups were given routine drug treatment and rehabilitation training, and additional 1Hz rTMS was applied on the precentral gyrus motor cortex of treatment group. At three time points(before treatment, immediately after treatment and two weeks after treatment), the University of Tokyo balance scale, SI and WDI index of Tetrax balance test, MEP threshold of TMS were used to evaluate the balance function of patients, respectively. Result: Immediately after treatment compared with before treatment, the balance function scores for both groups were significantly higher than those before treatment (P<0.05), and the Tetrax balance index of treatment group with eyes closed was better than that of sham stimulation group (P<0.05). At the same time, there was a significant difference between the two groups in motor cortex MEP threshold (P<0.01). Two weeks after the treatment, the balance function scores of the two groups were improved gradually compared with those before treatment (P<0.01), and the treatment group was significantly higher than sham stimulation group (P<0.05).The Tetrax balance index of the treatment group was significantly better than that of the sham stimulation group (P<0.01), and the MEP threshold of the treatment group was significantly higher than that of the sham stimulation group (P<0.01). Conclusion: Low frequency rTMS can inhibit the abnormal excitability of precentral gyrus motor area, and improve the balance function of patients with posterior circulation stroke, which has clinical value in rehabilitation.
Keywords:repetitive transcranial magnetic stimulation  posterior circulation stroke  balance dysfunction  evaluation  curation
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