摘要
目的系统评价重复经颅磁刺激(rTMS)治疗脑卒中后认知功能障碍(PSCI)的有效性及安全性。方法计算机检索中国知网数据库(CNKI)、万方数据库(WanFang Data)、中国生物医学文献数据库(CBM)、维普中文期刊全文数据库(VIP)、PubMed等数据库,收集rTMS治疗PSCI的随机对照试验(RCTs)。检索时间为建库至2020年10月30日,从研究中提取资料,并对文献进行质量评价。采用RevMan 5.3软件进行Meta分析。结果共纳入18篇文献,涉及1235例PSCI病人。Meta分析结果显示:试验组蒙特利尔认知评估量表(MoCA)评分[MD=3.16,95%CI(2.79,3.53),Z=16.85,P<0.00001]、改良Barthel指数量表(MBI)评分[MD=7.79,95%CI(5.01,10.56),Z=5.50,P<0.00001]、P300波幅[MD=0.86,95%CI(0.60,1.12),Z=6.54,P<0.00001]高于对照组,试验组P300潜伏期低于对照组[MD=-16.33,95%CI(-19.24,-13.41),Z=10.98,P<0.00001]。结论现有证据表明:rTMS可有效改善PSCI病人认知功能障碍,提高日常生活活动能力。
Objective To systematically evaluate the efficacy and safety of repetitive transcranial magnetic stimulation(rTMS)in the treatment of post-stroke cognitive impairment(PSCI).Methods CNKI,WanFang,Chinese Bio Medical Literature Database,VIP,and PubMed databases were searched to collect randomized controlled trials(RCTs)of rTMS in the treatment of PSCI from the establishment of the database to October 30,2020.Data were extracted from the studies and the quality of the literatures was evaluated.Meta-analysis was performed using RevMan 5.3 software.Results A total of 18 literatures were included,involving 1235 patients.The results of Meta-analysis showed that Montreal Cognitive Assessment Scale(MoCA)score in the experimental group[MD=3.16,95%CI(2.79,3.53),Z=16.85,P<0.00001],modified Barthel Index Rating Scale(MBI)score[MD=7.79,95%CI(5.01,10.56),Z=5.50,P<0.00001],the amplitude of P300[MD=0.86,95%CI(0.60,1.12),Z=6.54,P<0.00001]were higher than those in the control group.The P300 latent period of experimental group[MD=-16.33,95%CI(-19.24,-13.41),Z=10.98,P<0.00001]was lower than that of control group.Conclusion Current evidence showed that rTMS in the treatment of PSCI could effectively improve the cognitive impairment and enhance the activities of daily living.
作者
王若兰
韩祖成
WANG Ruolan;HAN Zucheng(Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi,China)
出处
《中西医结合心脑血管病杂志》
2022年第8期1379-1386,共8页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
陕西省中医药管理局项目,编号:陕中医药发〔2018〕40号
陕西省中医药管理局项目(No.2019-GJ-QT006)。
关键词
脑卒中后认知功能障碍
重复经颅磁刺激
系统评价
META分析
post-stroke cognitive impairment
repetitive transcranial magnetic stimulation
systematic review
Meta-analysis
