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薛翠萍,郄淑燕,李 伟,张黎明,赵茹莲,张巧荣.经颅直流电刺激联合认知训练对脑损伤患者执行功能康复疗效的研究[J].中国康复医学杂志,2021,(2):149~154
经颅直流电刺激联合认知训练对脑损伤患者执行功能康复疗效的研究    点此下载全文
薛翠萍  郄淑燕  李 伟  张黎明  赵茹莲  张巧荣
首都医科大学附属北京康复医院,北京市,100144
基金项目:首都医科大学附属北京康复医院培养项目(2018-021)
DOI:10.3969/j.issn.1001-1242.2021.02.004
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摘要:
      摘要 目的:探讨经颅直流电刺激联合认知训练对脑损伤患者执行功能障碍的疗效。 方法:选取脑损伤后执行功能障碍患者26例,采用随机数字表法将患者随机分为对照组(n=13)和试验组(n=13)。试验组患者在采用“认知康复工作站”进行常规认知康复训练的基础上,同时结合经颅直流电刺激仪器进行20min/次,1次/天,5天/周,持续6周的治疗。对照组患者进行常规的认知康复训练及假经颅直流电刺激治疗。对两组患者采用威斯康星卡片分类测验、Stroop测验、汉诺塔测验、数字倒背、额叶功能评定量表进行康复效果评定,分别在治疗前、治疗6周后及治疗结束后4周进行测试。 结果:治疗前两组患者各项测试得分的差异无显著性意义(P>0.05)。对照组威斯康星卡片分类测验、汉诺塔测验、数字倒背及额叶功能评定量表的得分在治疗6周后较治疗前具有明显的提高,差异有显著性意义(P<0.05),但治疗结束后4周的测试结果较治疗前相比差异无显著性意义(P>0.05),说明治疗效果不能持续4周;试验组在治疗6周后除Stroop测验外其他测试均较治疗前成绩显著提高(P<0.01),且治疗结束后4周再次测试结果较治疗前仍具有显著性差异(P<0.01),说明经颅直流电刺激对执行功能障碍的改善效应至少可以持续4周。 结论:经颅直流电刺激联合认知训练可以改善脑损伤患者执行功能,特别是在中远期的疗效方面更是优于传统的治疗方法。经颅直流电刺激作用持续,治疗过程安全、高效,在临床工作中具有广阔的应用前景。
关键词:经颅直流电刺激  脑损伤  执行功能障碍
Effects of transcranial direct current stimulation combined with cognitive training on rehabilitation of executive dysfunctions in patients with brain injury    Download Fulltext
Beijing Rehabilitation Hospital Affiliated to Capital Medical University Beijing City,100144
Fund Project:
Abstract:
      Abstract Objective: To investigate the effect of transcranial direct current stimulation on the executive dysfunctions in patients with brain injury. Method: Twenty-six patients with executive dysfunction after brain injury were randomly divided into control group (n=13) and experimental group (n=13). On the basis of conventional cognitive rehabilitation training with "cognitive rehabilitation workstation", the experimental group was treated with transcranial direct current stimulation instrument for 20 minutes/time, 1 time/day, 5 days/week for 6 weeks. The patients in the control group only received conventional cognitive rehabilitation training and sham transcranial direct current stimulation. Two groups of patients were assessed by Wisconsin card classification test, stroop test, hannotta test, numerical inversion and frontal lobe function assessment scale. The rehabilitation effects were tested before training, after 6 weeks training and 4 weeks after training. Result: There were no significant difference in the scores of each test between the two groups before treatment (P>0.05). The wisconsin card classification test, hanoi tower test, numerical inversion and frontal lobe function assessment scale in the control group were significantly improved after 6 weeks treatment compared with those before training (P<0.05), but there was no statistical difference in the results of 4 weeks after training compared with those before training (P>0.05). These indicated that the training results could not last for 4 weeks after training. For the experimental group after 6 weeks treatment, the results of other tests, except stroop test, were significantly higher than those before training (P<0.01), and still a statistical difference 4 weeks after training(P<0.01). These indicated that the improvement of executive dysfunction by transcranial direct current stimulation could last at least 4 weeks. Conclusion: Transcranial direct current stimulation combined with cognitive training can improve executive dysfunction in patients with brain injury, especially in the medium and long term effect is better than the traditional treatment. Transcranial direct current stimulation is a long last safe and efficient treatment process, and has broad application prospects in clinical works.
Keywords:transcranial direct current stimulation  brain injury  executive dysfunction
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