阴极经颅直流电刺激对卒中患者上肢运动功能的影响  

Effect of cathodal transcranial direct current stimulation on upper limb motor function in patients with stroke

作　　者：曲斯伟[1] 宋为群[1] 

机构地区：[1]首都医科大学宣武医院康复医学科,北京100053

出　　处：《中国脑血管病杂志》2017年第12期622-627,共6页Chinese Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金面上项目(81371194)

摘　　要：目的探讨阴极经颅直流电刺激(ct DCS)对卒中患者上肢运动功能的影响。方法前瞻性纳入2016年7月至2017年2月在首都医科大学宣武医院接受康复治疗的初发卒中后偏瘫患者45例,病程为1~6个月。按随机数字表法分为ct DCS 1.0 mA、2.0 mA和对照组各15例。3组患者均接受传统康复训练,2次/d,45 min/次,5 d/周,持续2周。1.0 mA组和2.0 mA组在此基础上,周期给予1.0 mA或2.0 mA的ct DCS治疗,1次/d,20 min/次,5 d/周,对照组仅接受假刺激。于治疗前及治疗后2周进行上肢功能评定。采用简式Fugl-Meyer运动功能评分(FMA)和手臂动作调查测试量表(ARAT)评价上肢运动功能。组内治疗前后比较采用配对t检验,组间比较采用单因素方差分析。结果 (1)治疗前3组患者上肢FMA评分、ARAT评分和MBI评分,差异均无统计学意义(均P>0.05);治疗后2周,3组患者的上肢FMA评分、ARAT评分和MBI评分均与同组治疗前比较明显提高,1.0 mA组差值分别为(12±3)、(10±2)、(22±9)分;2.0 mA组差值分别为(12±3)、(10±3)、(20±6)分,对照组差值分别为(9±3)、(7±3)、(18±7)分,差异均有统计学意义(均P<0.01)。(2)治疗后2周1.0 mA组和2.0 mA组的上肢FMA评分和ARAT评分均优于对照组,两组FMA评分比较均P<0.01,ARAT评分比较均P<0.05;而1.0 mA组和2.0 mA组间评分比较差异无统计学意义(P>0.05)。结论 ct DCS有改善卒中患者上肢运动功能的趋势,但ct DCS强度1.0 mA与2.0 mA的治疗效果无明显差异。Objective To investigate the effect of cathodal transcranial direct current stimulation（ ct DCS） on upper limb motor function in patients with stroke. Methods From July 2016 to February2017,45 patients with first-ever stroke hemiplegia treated with rehabilitation at the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were enrolled prospectively. Their course of disease was 1-6 months. They were randomly divided into a 1. 0 mA group,a 2. 0 mA group,and a control group（ n = 15 in each group） according to the random number table. The 3 groups of patients received traditional rehabilitation training,2 times a day,once for 45 min,5 days a week for 2 weeks. On this basis,the 1. 0 mA group and 2. 0 mA group were treated with 1. 0 mA and 2. 0 mA ct DCS for two weeks,once a day,once for 20 min,5 days a week at the same time,while the control group was only treated with sham stimulation.The upper limb function was evaluated before treatment and 2 weeks after treatment. Fugl-Meyer Assessment（ FMA） score and Action Research Arm Test（ ARAT） were used to assess the upper limb motor function.The modified Barthel index（ MBI） was used to evaluate the activities of daily living. Paired t test was used to compare before and after treatment in the groups. Single factor analysis of variance was used to compare between the groups. Results（ 1） There were no significant differences in the upper limb FMA score,ARAT score,and MBI score before treatment among the three groups of patients（ all P〈0. 05）. Two weeks after treatment,the upper limb FMA score,ARAT score,and MBI score of the patients in the 3 groups were significantly improved compared with those in the same groups before treatment. The differences in the1. 0 mA group were 12 ± 3,10 ± 2,and 22 ± 9,respectively,those in the 2. 0 mA group were 12 ± 3,10 ± 3,and 20 ± 6,respectively,and those in the control group were 9 ± 3,7 ± 3,and 18 ± 7,respectively in control group（ all P〈0. 01）.（ 2） Two weeks after

关 键 词：卒中 上肢功能障碍 经颅直流电刺激 康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]