重复经颅磁刺激对痉挛型脑瘫患儿痉挛及运动功能的影响  

Effect of repetitive transcranial magnetic stimulation on spasticity and motor function of children with spastic cerebral palsy

作　　者：张丽华[1] 郄淑燕[1] 张黎明[1] 王璐怡[1] 马全胜[1] 汪杰[1] 

机构地区：[1]首都医科大学附属北京康复医院康复诊疗中心,北京100144

出　　处：《中国康复》2015年第3期171-173,共3页Chinese Journal of Rehabilitation

摘　　要：目的:本研究拟初步探讨重复经颅磁刺激(rTMS)对痉挛型脑瘫患儿痉挛及运动功能的影响。方法:将痉挛型脑瘫患儿40例随机分为观察组和对照组各20例,2组均接受常规康复治疗,观察组在常规康复治疗的基础上增加rTMS治疗。2组患儿分别在治疗前、治疗2周、4周后进行Ashworth评分、踝关节活动度及粗大运动功能量表(GMFM-88)评定。结果:治疗后,2组患儿小腿三头肌Ashworth分级组内治疗前后及组间比较差异均无统计学意义。治疗2周及4周后,观察组踝关节背屈活动度逐渐提高,且差异有统计学意义(P<0.01),对照组踝关节活动度变化差异无统计学意义,2组治疗2周后差异无统计学意义,到治疗4周后比较差异才有统计学意义(P<0.01)。观察组治疗2周与治疗前比较,GMFM-88评定中D区和E区得分差异无统计学意义,治疗4周与治疗2周后比较明显提高(P<0.05);对照组治疗前后比较差异均无统计学意义,2组治疗2周后,D区和E区得分差异无统计学意义,4周后比较差异有统计学意义(P<0.05)。结论:rTMS结合常规康复治疗可以有效缓解痉挛,提高痉挛型脑瘫患儿的运动功能。Objective：To study the effects of repetitive transcranial magnetic stimulation （rTMS） on spasticity and motor function of children with spastic cerebral palsy .Method：Forty children with spastic cerebral palsy participa‐ted in this study ,and randomly divided into observation group and control group （n=20 each） .All patients received conventional treatment ,and the observation group received rTMS additionally .Two groups were evaluated by Ash‐worth scale ,range of motion of ankle and gross motor function scale before and 2 and 4 weeks after treatment .Re‐sults：The difference in Ashworth scale of triceps between two groups （including comparison between two groups and comparison before and after treatment in two groups） did not reach statistical significance .Two and four weeks after treatment ,the range of motion of ankle dorsiflexion in the observation group was gradually increased ,and the difference was statistically significant （P〈0 .01） ,no significant difference was found in the control group before and after treatment ,and the significant difference was found 4 weeks after treatment between two groups （P〈0 .01） . No significant difference in D and E score of gross motor function scale in the observation group was found before and two weeks after treatment ,and significant difference was found between treatments at 4th week and 2nd week （P〈0 .05）;the difference in control group did not reach statistical significance before and after treatment .There was no significant difference in D and E scores at 2nd week after treatment between two groups ,and significant difference was found between them at 4th week after treatment （P〈0 .05） .Conclusion：rTMS combined with con‐ventional treatment can effectively relieve spasticity and improve the motor function of children with spastic cerebral palsy .

关 键 词：重复经颅磁刺激 痉挛型脑瘫 运动功能 痉挛 

分 类 号：R742.3[医药卫生—神经病学与精神病学]