摘要
目的观察重复经颅磁刺激(rTMS)联合认知功能训练改善血管性痴呆(VD)患者认知与精神行为症状的效果。方法选取湖州市第三人民医院2020年10月至2022年10月收治的VD患者80例为研究对象,根据治疗方式的不同分为对照组(n=40)与观察组(n=40)。对照组进行rTMS治疗,观察组进行rTMS+认知功能训练,两组持续治疗4周。对两组患者治疗前后简易智力状况量表(MMSE)、AD病理行为评定量表(BE-HAVE-AD)、日常生活能力评定量表(ADL)及匹茨堡睡眠质量指数(PSQI)相关评分进行分析,同时比较两组患者治疗前后的同型半胱氨酸(Hcy)、神经元特异性烯醇化酶(NSE)水平,比较两组临床疗效,并计算总有效率,并对两组治疗期间的不良反应进行统计。结果治疗前对照组、观察组MMSE评分分别为(14.92±2.43)分、(14.83±2.56)分,治疗后分别为(22.81±3.05)分、(25.62±4.07)分;治疗后两组MMSE评分高于同组治疗前,且观察组高于对照组,差异有统计学意义(t=2.25,P<0.05)。治疗前对照组、观察组BE-HAVE-AD评分分别为(45.28±6.27)分、(44.95±6.38)分,治疗后分别为(27.54±2.22)分、(23.07±1.79)分;治疗后,BE-HAVE-AD评分低于同组治疗前,且观察组低于对照组,差异有统计学意义(t=9.56,P<0.05)。治疗前对照组、观察组ADL评分分别为(23.17±1.43)分、(22.83±1.64)分,治疗后分别为(38.27±3.25)分、(41.52±4.26)分;治疗后,两组ADL评分高于治疗前,且观察组高于对照组,差异有统计学意义(t=3.83,P<0.05)。治疗前对照组、观察组PSQI评分分别为(16.423±1.51)分、(15.86±1.49)分,治疗后分别为(9.16±1.12)分、(7.07±1.07)分;治疗后,PSQI评分均低于治疗前,且观察组低于对照组,差异有统计学意义(t=8.53,P<0.05)。治疗前对照组、观察组Hcy、NSE水平分别为(54.27±8.21)ng/L、(55.13±7.64)ng/L和(59.66±9.51)μg/L、(60.97±10.29)μg/L,治疗后分别为(30.63±1.95)ng/L、(25.57±2.06)ng/L和(49.23±6.12)μg/L、(37.21±7.01
Objective To investigate the effect of repetitive transcranial magnetic stimulation combined with cognitive function training on improving cognitive and psychological and behavioral symptoms in patients with vascular dementia.Methods A total of 80 patients with vascular dementia who received treatment at The Third People's Hospital of Huzhou from October 2020 to October 2022 were included in this study.They were divided into a control group and an observation group(n=40 per group)based on different treatment methods.The control group received repetitive transcranial magnetic stimulation,while the observation group received both repetitive transcranial magnetic stimulation and cognitive function training.Both groups were treated continuously for 4 weeks.The scores of The Mini-Mental State Examination(MMSE),the Behavioral Pathology in Alzheimer's Disease Rating Scale(BE-HAVE-AD),Activities of Daily Living(ADL),and Pittsburgh Sleep Quality Index(PSQI)of the two groups were analyzed before and after treatment.Additionally,serum levels of homocysteine and neuron-specific enolase in both groups were compared before and after treatment.The clinical efficacy of the two groups was evaluated,and the total response rate was calculated.Adverse reactions occurring during the treatment period in both groups were also recorded.Results Before treatment,the Mini-Mental State Examination(MMSE)scores for the control and observation groups were(14.92±2.43)points and(14.83±2.56)points,respectively.After treatment,the scores were(22.81±3.05)points for the control group and(25.62±4.07)points for the observation group.After treatment,the MMSE scores in both groups were significantly higher than the respective levels before treatment in the corresponding group,and the observation group had a significantly higher score than the control group(t=2.25,P<0.05).Before treatment,the BE-HAVE-AD scores for the control and observation groups were(45.28±6.27)points and(44.95±6.38)points,respectively.After treatment,the scores were(27.54±2.22
作者
孙枞昊
陈浙丽
金欣
费锦锋
那万秋
Sun Conghao;Chen Zheli;Jin Xin;Fei Jinfeng;Na Wanqiu(Department of Geriatric Psychiatry,The Third People's Hospital of Huzhou,Huzhou 313000,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2024年第9期1288-1294,共7页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省医药卫生科技计划(2020RC036)。
关键词
痴呆
血管性
经颅磁刺激
认知疗法
智力测验
日常生活活动
半胱氨酸
Dementia,vascular
Transcranial magnetic stimulation
Cognitive therapy
Intelligence tests
Activities of daily living
Cysteine
