摘要
目的 通过探讨不同频率重复经颅磁刺激(rTMS)联合补阳还五汤对气虚血瘀型脑卒中患者运动功能的疗效,希望能够发现一种恢复脑卒中患者肢体运动功能的有效治疗方法。方法 纳入气虚血瘀型脑卒中患者120例,将其分为中药组30例、低频rTMS(1 Hz)+高频rTMS(10 Hz)+中药组30例、高频(10 Hz)+中药30例、低频(1 Hz)+中药组30例,观察并分析以上各组患者治疗后在肢体康复情况、rTMS联合中药治疗取得的临床疗效、日常活动的改善。采用Fugl-Meyer运动评定量表(FMA)评定4组患者治疗前后的肢体运动功能,对4组中医疗效进行对比,采用ADL(改良Barthel指数)评定量表评估治疗前后日常活动的改善。结果 治疗后,4组患者的FMA值、Barthel指数较治疗前改善(P <0.01),其中高频+低频+中药治疗组疗效更为明显(P <0.01)。结论 高频(10 Hz)+低频(1 Hz)rTMS通过双重作用模式,改变以往单纯高频或低频的模式,调节两个半球之间的失衡状态,并联合补阳还五汤治疗,作为治疗脑卒中的一种新型的无痛无创康复治疗手段,改善卒中后偏瘫患者运动功能和日常生活,具有重要的临床应用价值。
Objective This study aims to explore the effect of repetitive transcranial magnetic stimulation(rTMS)with different frequencies combined with Buyang Huanwu Decoction on the motor function of patients with stroke of qi deficiency and blood stasis type,trying to find an effective therapy for restoring the limb motor function of stroke patients.Methods A total of 120 patients with subacute stroke of qi deficiency and blood stasis type were enrolled and divided into Traditional Chinese Medicine(TCM)treatment group(n = 30),low frequency rTMS(1 Hz)+ high frequency r TMS(10 Hz)+ TCM treatment group(n = 30),high frequency(10 Hz)+ TCM treatment group(n = 30),and low frequency(1 Hz)+ TCM treatment group(n = 30).The rehabilitation of limbs,clinical efficacy of rTMS combined with TCM,and the improvement of daily activities were observed and analyzed.The Fugl-Meyer Motor Rating Scale(FMA)was used to evaluate the limb motor function of the patients in the four groups before and after treatment,and the TCM efficacy of the four groups was compared.The ADL(Modified Barthel Index)was used to evaluate the improvement of daily activities before and after treatment.Results After treatment,the FMA value and Barthel index of the four groups were improved compared with those before treatment(all P<0.01).The effect of high frequency(10 Hz)+ low frequency(1 Hz)+ TCM treatment group was more significant compared with other groups(P<0.01).Conclusion rTMS combined with TCM with different frequencies can improve moderate-severe motor function after stroke.High frequency(10 Hz)+ low frequency(1 Hz)rTMS changes the previous simple high frequency or low frequency mode to adjust the imbalance between the two hemispheres through the dual mode of action.Combined with Buyang Huanwu decoction,it is a new painless and non-invasive rehabilitation therapy for stroke patients and it can improve their motor function and daily life.It is of value for clinical application.
作者
黄婷婷
吴海科
练梦结
杨轩
HUANG Tingting;WU Haike;LIAN Mengjie;YANG Xuan(Department of Encephalopathy,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)
出处
《实用医学杂志》
CAS
北大核心
2023年第4期499-504,共6页
The Journal of Practical Medicine
基金
佛山市自筹经费类科技创新项目(医学类科学攻关)(编号:2220001004983)。
关键词
脑卒中
重复经颅磁刺激
运动功能
补阳还五汤
stroke
repetitive transcranial magnetic stimulation
motor function
Buyang Huanwu Decoction
