重复经颅磁刺激联合头针疗法对脑卒中后手功能障碍的疗效观察

Observing the Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation Combined with Scalp Acupuncture Therapy on Hand Dysfunction after Stroke

摘要: 目的：探讨对脑卒中后手功能障碍患者予以重复经颅磁刺激联合头针疗法的效果。方法：研究对象均选自日照市中心医院收治的60例脑卒中后手功能障碍患者，对其进行随机对照研究。分为三组：20例使用常规康复治疗的命名为对照组；20例使用常规康复治疗联合重复经颅磁刺激治疗的命名为经颅磁刺激组；20例使用常规康复搭配重复经颅磁刺激治疗，并施以头针疗法的命名为联合治疗组，研究组间对比效果。结果：在组间治疗前后FMA运动功能评分及MBI改良指数评分变化方面，重复经颅磁刺激组及联合治疗组的这两项评分指标在治疗前后变化明显，但联合治疗组更为显著，改善情况组间比较有统计学意义(P < 0.05)；在治疗前后三组的重复经颅磁刺激运动诱发电位(rTMS-MEP)的潜伏期和波幅变化情况上，联合治疗组改善更为明显，组间比较指标水平差异显著(P < 0.05)。结论：对脑卒中后手功能障碍患者行重复经颅磁刺激治疗基础上联合头针疗法的疗效可观，可有效改善手功能障碍，提高患者的日常生活能力，临床应用前景良好。

Abstract: Objective: To explore the effect of repeated transcranial magnetic stimulation combined with scalp acupuncture therapy on patients with hand dysfunction after stroke. Method: The research subjects were selected from a randomized controlled study of 60 patients with post-stroke hand dysfunction admitted to Rizhao Central Hospital. They were divided into three groups: 20 patients receiving conventional rehabilitation treatment as the control group, 20 patients receiving conventional rehabilitation treatment combined with repetitive transcranial magnetic stimulation treatment as the transcranial magnetic stimulation group, and 20 patients receiving conventional rehabilitation combined with repetitive transcranial magnetic stimulation treatment and scalp acupuncture therapy as the combined treatment group, and the effects among the study groups were compared. Result: Compared with the changes in FMA motor function score and MBI improvement index score before and after treatment, the repeated transcranial magnetic stimulation group and the combination therapy group showed significant changes in both score indicators before and after treatment, with the combination therapy group showing more significant changes. The improvement between the groups was statistically significant (P < 0.05). The changes in latency and amplitude of repetitive transcranial magnetic stimulation motor evoked potentials (rTMS-MEP) in the three groups before and after treatment were more significantly improved in the combined treatment group, and there was a significant difference in the level of comparison indicators between the groups (P < 0.05). Conclusion: The combination of repetitive transcranial magnetic stimulation therapy and scalp acupuncture therapy has a significant therapeutic effect on hand dysfunction patients after stroke, which can effectively improve hand dysfunction and enhance patients’ daily living abilities. The clinical application prospects are promising.