摘要
目的研究重复经颅磁刺激(r TMS)辅助常规康复疗法对外伤性脊髓损伤患者的影响。方法采用前瞻性研究方法,选取2015年1月至2017年12月上海市第一康复医院收治的外伤性脊髓损伤患者120例,按照随机数字表法将患者分为对照组和观察组,每组各60例。对照组患者给予常规康复治疗,观察组患者在对照组的基础上加用r TMS。比较两组患者的疼痛水平、负面情绪、生活质量和运动功能。结果观察组患者的疼痛评级指数总分(PRI-T)、疼痛评级指数感觉类(PRI-S)、疼痛评级指数情感类(PRI-A)和视觉模拟评分(VAS)分别为(18.23±4.06)分、(13.48±3.35)分、(4.75±1.21)分和(4.87±0.93)分,均低于对照组,差异具有统计学意义(P<0.05)。观察组患者的汉密尔顿焦虑量表(HAMA)评分和汉密顿抑郁量表(HAMD)评分分别为(10.52±3.75)分和(8.94±3.27)分,低于对照组,WHO生活质量测定简表(WHOQOL-BREF)前28项评分为(48.61±9.35)分,WHOQOL-BREF自身评分为(51.79±9.83)分,高于对照组,差异具有统计学意义(P<0.05)。观察组患者的ASIA下肢运动评分(LEMS)、10 m步行速度(10MWT)和脊髓损伤步行指数Ⅱ(WISCIⅡ)分别为(34.97±4.38)分、(0.49±0.13)m/s和(13.48±3.27),均高于对照组,改良Ashworth量表(MAS)评分为(0.62±0.09)分,低于对照组,差异具有统计学意义(P<0.05)。结论r TMS辅助常规康复疗法可以明显降低外伤性脊髓损伤患者的疼痛水平,改善负面情绪,提高患者的运动功能和生活质量,值得临床推广应用。
Objective To study the effect of repetitive transcranial magnetic stimulation(r TMS)combined with routine rehabilitation therapy on patients with traumatic spinal cord injury.Methods A prospective study was conducted,selecting 120 patients with traumatic spinal cord injury admitted to Shanghai First Rehabilitation Hospital from January 2015 to December 2017.According to the random number table method,the patients were divided into the control group and the observation group,60 cases in each group.Patients in the control group were given conventional rehabilitation treatment;patients in the observation group were given r TMS on the basis of conventional rehabilitation treatment.Pain levels,negative emotions,quality of life and motor function were compared between the two groups.Results The pain rating index-total(PRI-T),pain rating index-sensory(PRI-S),pain rating index-affective(PRI-A)and visual analogue score(VAS)of the observation group were(18.23±4.06),(13.48±3.35),(4.75±1.21)and(4.87±0.93)respectively,lower than those of the control group,and the differences were statistically significant(P<0.05).The hamilton anxiety scale(HAMA)score and hamilton depression scale(HAMD)score of the observation group were(10.52±3.75)and(8.94±3.27),lower than those of the control group;the score of the first 28 items of the brief version of WHO quality of life(WHOQOL-BREF)of the observation group was(48.61±9.35),WHOQOL-BREF self score was(51.79±9.83),higher than that of the control group,and the differences were statistically significant(P<0.05).The ASIA lower extremity motor score(LEMS),10 m walking test(10 MWT)and walking index of spinal cord injuryⅡ(WISCIⅡ)of the observation group were(34.97±4.38),(0.49±0.13)m/s and(13.48±3.27)respectively,higher than those of the control group;the modified Ashworth scale(MAS)was(0.62±0.09),lower than that of the control group,and the differences were statistically significant(P<0.05).Conclusion r TMS assisted conventional rehabilitation therapy can significantly reduce the pa
作者
张弛
张海林
陶艳
谢伟
陆阳洋
李波
ZHANG Chi;ZHANG Hai-lin;TAO Yan(Department of Orthopaedics,The First Rehabilitation Hospital of Shanghai,Shanghai 200090,China;Yinhang Street Community Health Center,Yangpu District,Shanghai,Shanghai 200438,China)
出处
《临床和实验医学杂志》
2020年第5期528-531,共4页
Journal of Clinical and Experimental Medicine
基金
上海市卫健委资助项目(编号:201640255).
关键词
外伤性脊髓损伤
重复经颅磁刺激
疼痛
负面情绪
生活质量
Traumatic spinal cord injury
Repetitive transcranial magnetic stimulation
Pain
Negative emotions
Quality of life
