摘要
目的探讨重复经颅磁刺激(rTMS)联合注意力训练对脑梗死后认知障碍的治疗效果。方法 128例脑梗死后认知障碍患者作为研究对象,根据治疗方法不同分为常规药物组、rTMS组、注意力训练组、联合组,各32例。四组患者均给予常规药物治疗, rTMS组加用rTMS治疗,注意力训练组加用注意力训练,联合组加用rTMS和注意力训练。比较四组疗效、神经心理评分[Fugl-Meyer运动功能评定量表(FMA)、蒙特利尔认知评估量表(MoCA)、改良Barthel指数评定量表(MBI)评分]、听觉事件相关电位检测结果 (P300潜伏期、P300波幅)。结果治疗后,联合组治疗总有效率96.88%高于r TMS组的75.00%、常规药物组的75.00%、注意力训练组的81.25%,差异具有统计学意义(P<0.05)。治疗后,四组的MoCA、FMA、MBI评分均高于治疗前,差异具有统计学意义(P<0.05);联合组治疗后MoCA、FMA、MBI评分均高于rTMS组、常规药物组、注意力训练组,差异具有统计学意义(P<0.05)。治疗后,四组P300潜伏期低于治疗前, P300波幅高于治疗前,差异具有统计学意义(P<0.05);联合组的P300潜伏期(341.27±28.31)ms低于rTMS组的(362.39±23.26)ms、常规药物组的(361.53±23.25)ms、注意力训练组的(360.98±23.21)ms, P300波幅(8.35±1.21)μV高于rTMS组的(6.49±1.02)μV、常规药物组的(6.57±1.06)μV、注意力训练组的(6.58±1.09)μV,差异具有统计学意义(P<0.05)。结论 rTMS联合注意力训练用于脑梗死后认知障碍患者中能获得良好的治疗效果,有助于改善患者认知功能,值得推广应用。
Objective To discuss the therapeutic effect of repetitive transcranial magnetic stimulation(rTMS)combined with attention training on cognitive impairment after cerebral infarction.Methods A total of 128 patients with cognitive impairment after cerebral infarction as study subjects were divided into conventional medication group,rTMS group,attention training group and combined group,with 32 cases in each group.The four groups were treated with conventional medications,on this basis,rTMS group was treated with rTMS,attention training group was treated with attention training,and combined group was treated with rTMS and attention training.The clinical efficacy,neuropsychological score[Fugl-Meyer assessment scale(FMA),Montreal cognitive assessment(MoCA),modified Barthel index(MBI)score]and auditory event-related potential test results(P300 latency,P300 amplitude)of the four groups were compared.Results After treatment,the total effective rate 96.88%of the combined group was higher than 75.00%of rTMS group,75.00%of conventional medication group,and 81.25%of attention training group.All the difference was statistically significant(P<0.05).After treatment,the MoCA,FMA and MBI score of the four groups were higher than those before treatment,and the difference was statistically significant(P<0.05).After treatment,the MoCA,FMA and MBI score of combined group were higher than those of rTMS group,conventional medication group and attention training group,and the difference was statistically significant(P<0.05).After treatment,the P300 latency of the four groups were lower than those before treatment,and P300 amplitude was higher than those before treatment.All the difference was statistically significant(P<0.05).The P300 latency(341.27±28.31)ms of combined group was lower than(362.39±23.26),(361.53±23.25)and(360.98±23.21)ms of rTMS group,conventional medication and attention training group,and P300 amplitude(8.35±1.21)μV was higher than(6.49±1.02),(6.57±1.06),(6.58±1.09)μV of rTMS group,conventional medication grou
作者
杜凤其
DU Feng-qi(Haizhu District Hospital of Traditional Chinese Medicine,Guangzhou 510220,China)
出处
《中国实用医药》
2021年第13期1-4,共4页
China Practical Medicine
关键词
重复经颅磁刺激
注意力训练
认知障碍
Repetitive transcranial magnetic stimulation
Attension training
Cognitive impairment
