摘要
目的观察高频重复经颅磁刺激(rTMS)治疗卒中后肩手综合征的临床疗效。方法选取2019年6月至2020年10月在淮安市康复医院康复科病房住院的60例卒中后肩手综合征患者,按照随机数字表法将其分为对照组(30例)和治疗组(30例)。两组患者均接受常规止痛治疗和常规康复治疗。对照组在常规治疗的基础上给予伪rTMS治疗,治疗组在常规治疗的基础上给予5 Hz的rTMS治疗。两组均治疗2周,每周治疗6 d。治疗过程中对照组脱落1例,治疗组脱落2例。两组患者治疗前后均采用视觉模拟评分(VAS)评价疼痛程度,采用Fugl-Meyer运动功能评分量表上肢部分(FMA-UE)评价上肢运动功能,采用排水法评价患侧前臂肿胀程度,采用匹兹堡睡眠质量指数(PSQI)评价睡眠状态。结果经过2周的治疗,两组患者的疼痛程度均缓解,差异有统计学意义(P<0.05);治疗组治疗后的疼痛改善程度优于对照组,差异有统计学意义[(4.30±1.10)分比(4.85±0.86)分,P<0.05]。两组患者治疗后的患肢活动功能均优于治疗前,差异有统计学意义(P<0.05);治疗组患者治疗后的改善程度优于对照组,差异有统计学意义[(31.00±4.00)分比(35.89±4.74)分,P<0.05]。两组患者的患肢肿胀程度较治疗前均有减轻(P<0.05),治疗组患者治疗后的肿胀减轻程度优于对照组,差异有统计学意义[(52.85±12.48)ml比(47.70±11.17)ml,P<0.05]。两组患者的睡眠质量较治疗前均有显著改善,差异有统计学意义(P<0.05);治疗组患者治疗后的睡眠质量与对照组比较,差异无统计学意义[(7.70±2.00)分比(7.37±2.26)分,P>0.05]。结论高频rTMS可以明显改善卒中后肩手综合征患者的疼痛程度和临床症状,2周时间的高频rTMS治疗较常规治疗不能明显改善睡眠质量。
Objective To observe the clinical effect of high frequency repetitive transcranial magnetic stimulation(rTMS)on shoulder-hand syndrome after stroke.Methods A total of 60 patients with shoulder hand syndrome after stroke admitted to Department of Rehabilitation in Huaian Rehabilitation Hospital from June 2019 to October 2020 were divided into control group(30 cases)and treatment group(30 cases)by random number table method.Both groups received routine analgesic treatment and conventional rehabilitation treatment.On the basis of conventional treatment,the control group was given the pseudo rTMS treatment,and the treatment group was given 5 Hz rTMS treatment.The treatment was conducted 6 days a week for 2 weeks.During the treatment,1 case fell off from the control group and 2 fell off from the treatment group.Visual analogue scale(VAS)was used to evaluate the degree of pain.Fugl-Meyer Assessment-Upper Extremity(FAM-UE)was used to evaluate the upper limb motor function.Drainage method was used to evaluate the swelling degree of affected forearm.Pittsburgh Sleep Quality Index(PSQI)was used to evaluate the sleep state.Results After 2 weeks of treatment,the pain were relieved in both groups,and the difference was statistically significant(P<0.05).The pain improvement degree of the treatment group was better than that of the control group,and the difference was statistically significant[VAS=(4.85±0.86)in the control group and(4.30±1.10)in the treatment group,P<0.05].The motor function of affected limb was improved in both groups after treatment,and the differences were statistically significant(P<0.05).The improvement degree of the treatment group was better than that of the control group[FMA-UE=(31.00±4.00)in the control group,FMA-UE=(35.89±4.74)in the treatment group,P<0.05].The degree of swelling of affected limbs in the two groups was significantly lower than that before treatment,and the differences were statistically significant(P<0.05).The degree of swelling reduction in the treatment group was better than tha
作者
田云
耿丹
陈国明
李洪波
Tian Yun;Geng Dan;Chen Guoming;Li Hongbo(Department of Rehabilitation,Huaian Rehabilitation Hospital,Huaian 211600,China)
出处
《神经疾病与精神卫生》
2021年第7期494-498,共5页
Journal of Neuroscience and Mental Health
基金
淮安市自然科学研究计划(指导性)项目(HABZ202011)。
关键词
卒中
重复经颅磁刺激
肩手综合征
疼痛
运动功能
睡眠
Stroke
Repetitive transcranial magnetic stimulation
Shoulder-hand syndrome
Pain
Motor function
Sleep
