重复经颅磁刺激对后循环老年卒中后患者平衡功能障碍及认知功能影响  

Effect of repetitive transcranial magnetic stimulation on balance dysfunction and cognitive function in post-circulation elderly stroke patients

作　　者：陈悦霞[1] 胡美娇[1] 朱青[1] 李芳琴[1] CHEN Yuexia;HU Meijiao;ZHU Qing;LI Fangqin(Department of Geriatrics, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310007, China)

机构地区：[1]杭州市中医院老年病科,浙江杭州310007

出　　处：《中国现代医生》2019年第8期88-91,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2016ZB091)

摘　　要：目的观察重复经颅磁刺激对后循环老年卒中后患者平衡功能及认知功能改善情况,为临床提供更好的治疗方案。方法选取2015年10月～2018年1月在本院老年病科治疗的132例缺血性脑卒中患者随机分为两组,均伴有平衡功能及认知功能障碍,对照组66例采用常规平衡障碍康复训练及吡拉西坦药物治疗,观察组66例在对照组治疗基础上加用重复经颅磁刺激,对比分析对照组及观察组治疗后血清中星形胶质源性蛋白(S100B)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)、胶质纤维酸性蛋白(Glial fibrillary acidic protein,GFAP)水平变化及Berg平衡量表(Berg Balance Scale,BBS)、Tinetti量表(Tinetti Balance and Gait Analysis)、蒙特利尔认知评估(MoCA)量表评分改变。结果两组治疗前血清S100B、NSE和GFAP水平比较,差异无统计学意义(P>0.05),治疗后均较治疗前好转,观察组较对照组好转明显,差异有统计学意义(P<0.05)。治疗前两组BBS评分、Tinetti量表评分比较,差异无统计学意义(P>0.05),治疗后均较治疗前增加,观察组较对照组明显增加,差异有统计学意义(P<0.05)。治疗前两组MoCA量表评分比较,差异无统计学意义(P>0.05),治疗后均较治疗前增加,观察组较对照组明显增加,差异有统计学意义(P<0.05)。结论重复经颅磁刺激对后循环老年卒中后患者平衡功能及认知功能具有改善作用,可以很大程度提高患者生活质量。Objective To observe the improvement effect of repetitive transcranial magnetic stimulation on balance function and cognitive function in post-circulation elderly stroke patients, and to provide a better treatment plan for the clinic. Methods A total of 132 patients with ischemic stroke who were treated in the Department of Geriatrics in our hospital from October 2015 to January 2018 were randomly divided into two groups, all with balance dysfunction and cognitive dysfunction. 66 patients in the control group were treated with rehabilitation training for routine balance disorder and piracetam drug treatment. 66 patients in the observation group were treated with repeated transcranial magnetic stimulation based on the treatment of the control group. The changes of serum astrocyte-derived protein(S100B), neuron-specific enolase(NSE), Glial fibrillary acidic protein(GFAP), Berg Balance Scale(BBS), Tinetti Table(Tinetti Balance and Gait Analysis), Montreal Cognitive Assessment(MoCA) scale in the control group and the observation group were comparatively analyzed. Results There were no significant differences in serum S100B, NSE and GFAP levels between the two groups before treatment(P>0.05). After treatment, the serum S100B, NSE and GFAP levels were better than those before treatment. The observation group improved significantly compared with the control group, and the difference was statistically significant(P<0.05). There was no significant difference in the BBS score and Tinetti score between the two groups before treatment(P>0.05). BBS score and Tinetti score after treatment increased compared with those before treatment, and the observation group improved significantly compared with the control group, and the difference was statistically significant(P<0.05). There was no significant difference in the scores of MoCA scales between the two groups before treatment(P>0.05). The scores of MoCA scales after treatment were increased compared with those before treatment. The observation group was significantly increased

关 键 词：重复经颅磁刺激 老年卒中 平衡功能障碍 认知功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]