摘要
目的:探讨腕踝针电刺激联合重复经颅磁刺激(rTMS)治疗脑卒中后偏身感觉障碍的临床疗效。方法:2021年1月—2022年3月本院脑卒中偏身感觉障碍患者120例,采用随机数字表法分为对照组、rTMS组和联合组。对照组采用常规治疗+假经颅磁刺激;rTMS采用常规治疗+真实经颅磁刺激;联合组在rTMS基础上,加用腕踝针电刺激。3组共干预4周。观察治疗前后的感觉功能(触觉、振动觉和两点辨别觉阈值测定)、Fugl-Meyer感觉障碍评定量表、SF-36量表、体感诱发电位(正中神经和胫神经的波峰振幅值)与临床疗效。结果:在各感觉阈值中,治疗后联合组的触觉阈值低于对照组和rTMS组;两点辨别觉阈值和振动觉阈值仅低于对照组,差异具有统计学意义(P<0.05),与rTMS组比较差异无统计学意义(P>0.05);联合组在体感诱发电位的波峰振幅(正中神经和胫神经)、Fugl-Meyer感觉评分、中医症候积分以及SF-36量表均高于其余两组,差异具有统计学意义(P<0.05);在疗效上,联合组总有效率优于其余两组,差异具有统计学意义(P<0.05)。结论:腕踝针电刺激联合rTMS治疗脑卒中后偏身感觉障碍,能有效改善感觉障碍,提高体感诱发电位和生活质量,疗效显著,值得进一步研究。
Objective:To investigate the clinical efficacy of wrist-ankle electro-acupuncture combined with repetitive transcranial magnetic stimulation(rTMS)in treatment of post-stroke hemidysesthesia.Methods:120 patients with post-stroke hemidysesthesia were randomly divided into the control group,the rTMS group and the combined group.The control group was treated with conventional therapy plus false rTMS;the rTMS group was treated with conventional therapy plus true rTMS;on which basis,the combined group was also treated with wrist-ankle electro-acupuncture.The three groups were intervened for 4 weeks.Sensory function(touch,vibration and two-point discrimination threshold measurement),scores of Fugl Meyer sensory impairment rating scale and SF-36 scale,as well as somatosensory evoked potential(peak amplitude value of median nerve and tibial nerve)were observed before and after the treatment in the three groups.Clinical efficacy was also compared among the three groups.Results:In terms of each sensory threshold,the tactile threshold of the combined group was lower than that of the control group and the rTMS group after the treatment;the thresholds of two-point discrimination and vibration perception were lower in the combined group only than those in the control group(P<0.05),and in which there were no statistical differences between the combined group and the rTMS group(P>0.05);the peak amplitude of somatosensory evoked potential(median nerve and tibial nerve),the scores of Fugl Meyer sensory,TCM symptoms and SF-36 scale were higher in the combined group than those in the other two groups(P<0.05).In terms of curative effect,the total effective rate of the combined group was better than that of the other two groups(P<0.05).Conclusion:Wrist-ankle electro-acupuncture combined with rTMS can effectively improve sensory impairment,somatosensory evoked potential and quality of life after stroke,which is worthy of further study.
作者
刘英
方婷
李艾书
陈杨
尹翎
LIU Ying;FANG Ting;LI Aishu;CHEN Yang;YIN Ling(China MCC5 Group Hospital,Chengdu 610000,China)
出处
《针灸临床杂志》
2023年第5期45-49,共5页
Journal of Clinical Acupuncture and Moxibustion
基金
成都市卫健委科研课题,编号:2020033。
