电头针接力刺法联合低频重复经颅磁刺激对卒中后上肢运动功能障碍及运动诱发电位的影响  

Effect of electric scalp relay acupuncture combined with low frequency repetitive transcranial magnetic stimulation on upper limb motor dysfunction and motor evoked potentials after stroke

作　　者：蔡超群[1] 刘晓瑜[1] 郑庆丹 肖科金 高兆玉 朱胜华 CAI Chaoqun;LIU Xiaoyu;ZHENG Qingdan;XIAO Kejin;GAO Zhaoyu;ZHU Shenghua(Yueyang Hospital of Traditional Chinese Medicine, Yueyang 414000, Hunan, China)

机构地区：[1]湖南省岳阳市中医院,湖南岳阳414000

出　　处：《现代中西医结合杂志》2020年第24期2658-2662,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：湖南省卫生计生委科研计划课题(B2017231)。

摘　　要：目的观察电头针接力刺法联合低频重复经颅磁刺激对卒中后上肢运动功能障碍及运动诱发电位的影响。方法选取2015年1月—2018年12月湖南省岳阳市中医院诊治的120例脑卒中恢复期上肢运动功能障碍患者为研究对象,随机分为颅磁组40例、电针组40例和联合组40例。3组均接受常规药物和康复治疗,颅磁组增加低频重复经颅磁刺激治疗,电针组增加电头针接力刺法治疗,联合组则采取电头针接力刺法联合低频重复经颅磁刺激治疗,3组均治疗2周。检测3组治疗前后拇短展肌运动诱发电位相关指标和评定康复各项评分,并统计3组临床治疗总有效率。结果3组治疗后运动诱发电位皮质潜伏期(MEPL)和中枢运动传导时间(CMCT)较治疗前明显缩短(P均<0.05),运动诱发电位波幅(MEPA)明显增大(P均<0.05);颅磁组和电针组治疗后MEPL、CMCT和MEPA比较差异均无统计学意义(P均>0.05);但联合组治疗后拇短展肌运动诱发电位各项指标均明显优于颅磁组和电针组(P均<0.05)。3组治疗后MI、Fugl-Meyer和Barthel评分均较治疗前明显升高(P均<0.05),颅磁组与电针组治疗后各项评分比较差异均无统计学意义(P均>0.05),但联合组治疗后各项评分均明显高于颅磁组与电针组(P均<0.05)。联合组的临床治疗总有效率明显高于颅磁组和电针组(P均<0.05)。结论电头针接力刺法联合低频重复经颅磁刺激可有效缩短卒中后患者拇短展肌运动诱发电位潜伏期和增大波幅,缩短中枢运动传导时间,改善患者上肢运动功能,可作为一种切实可行的改善上肢运动障碍传统中医和现代技术结合方案应用于临床。Objective It is to observe the effect of electric scalp relay acupuncture combined with low-frequency repetitive transcranial magnetic stimulation on upper limb motor dysfunction and motor evoked potential after stroke.Methods A total of 120 patients with upper limb motor dysfunction in the recovery stage of stroke diagnosed and treated in Yuyang Hospital of Traditional Chinese Medicine from January 2015 to December 2018 were selected as the research objects,and they were randomly divided into transcranial magnetic stimulation group,electroacupuncture group and combination group,40 cases in each group.All the three groups received conventional medicine and rehabilitation.The transcranial magnetic stimulation group received low-frequency repetitive transcranial magnetic stimulation,the electroacupuncture group received electric scalp relay acupuncture,and the combination group received electric scalp acupuncture plus low-frequency repetitive transcranial magnetic stimulation.All groups were treated for 2 weeks.The related indexes of the motor evoked potentials of abductor pollicis brevis and the scores of rehabilitation before and after treatment were observed in the 3 groups,the curative effects were evaluated.Results After treatment,the motor evoked potential cortical latency(MEPL)and central motor conduction time(CMCT)were significantly shorter than those before treatment in the 3 groups(P<0.05),and the motor evoked potential amplitude(MEPA)was significantly increased(P<0.05);there was no significant difference in MEPL,CMCT and MEPA after treatment between the transcranial magnetic stimulation group and the electroacupuncture group(P>0.05),but the indicators of the motor evoked potentials of abductor pollicis brevis in the combination group were significantly better than those of the other two group(P<0.05).After treatment,the scores of MI,Fugl-Meyer and Barthel of the 3 groups were significantly higher than those before treatment(P<0.05).There was no significant difference in the scores between the transcrania

关 键 词：电头针接力刺法 低频重复经颅磁刺激 卒中 上肢运动功能 运动诱发电位 

分 类 号：R743.3[医药卫生—神经病学与精神病学]