低频重复经颅磁刺激治疗卒中后非流畅性失语的系统评价  

Low-frequency repetitive transcranial magnetic stimulation for non-fluenct aphasia after stroke:a systematic review

作　　者：郑怡 刘晶 王洋洋 邢津骁 顾莹 汤继芹[3] Zheng Yi;Liu Jing;Wang Yangyang(School of Rehabilitation Medicine,Weifang Medical University,Weifang 261053,China)

机构地区：[1]潍坊医学院康复医学院,山东潍坊261053 [2]山东中医药大学中医学院,济南250355 [3]山东中医药大学康复医学院,济南250355 [4]山东省立第三医院康复医学部,济南250031

出　　处：《中国康复》2021年第6期365-371,共7页Chinese Journal of Rehabilitation

基　　金：山东省中医药科技发展计划项目(2017-011);山东省高等学校科技计划项目(J14LK08);山东中医药大学经方治疗重大疾病作用机理与疗效评价科研创新团队基金资助项目(220316)。

摘　　要：目的:系统评价低频重复经颅磁刺激(rTMS)治疗卒中后非流畅性失语症患者的疗效。方法:检索PubMed、EMbase、Cochrane Library、中国知网、万方、维普和中国生物医学文献数据库,搜集rTMS治疗卒中后失语症患者的随机对照试验(RCT),检索时段为建库至2020年6月。筛选文献后,对能够进行效应量合并的研究采用RevMan 5.3软件进行Meta分析;其余研究采用描述性分析。结果:纳入10个随机对照试验。6篇文献以西部失语症检查的失语商(WAB-AQ)为结局指标,Meta分析结果显示:接受低频重复经颅磁刺激后,干预组的WAB-AQ评分优于对照组[SMD=1.27,95%CI(0.71,1.82),P<0.01]。2篇文献采用了汉语失语成套测验(ABC)评分为结局指标,Meta分析结果显示:2组得分差异无统计学意义[MD=6.07,95%CI(-6.92,19.05),P=0.36]。结论:低频重复经颅磁刺激能有效改善卒中后非流畅性失语患者的言语功能,但上述结论仍需更多大样本或统一评价量表的临床试验予以验证。Objective:To systematically evaluate the efficacy of low-frequency repetitive transcranial magnetic stimulation(rTMS)in the treatment of non-fluenct aphasia after stroke.Methods:The PubMed,EMbase,Cochrane Library,CNKI,WanFang data,VIP and CBM databases were searched,and randomized controlled trials(RCT)of rTMS in the treatment of post-stroke aphasia were collected.The search period was from the establishment of the database to June 2020.After screening the literature,a meta-analysis of mergeable studies was performed using RevMan 5.3 software for the studies with an effect size.The rest studies were given the descriptive analysis.Results:Totally,10 RCTs were included.Six trials used The Western Aphasia Battery-AQ(WAB-AQ)as the result indicator.The results of the meta-analysis showed that after low-frequency rTMS,the WAB-AQ score in the treatment group was higher than that in the control group[SMD=1.27,95%CI(0.71,1.82),P<0.01].Two trials used Aphasia Battery of Chinese(ABC)scores as outcome indicators.There was no significant difference between the two groups[MD=6.07,95%CI(-6.92,19.05),P=0.36].Conclusion:Low-frequency rTMS can effectively improve the speech function of patients with non-fluenct aphasia after stroke.However,the above conclusions still need to be verified by clinical trials with a larger number of samples or a unified evaluation scale.

关 键 词：重复经颅磁刺激 失语症 脑卒中 系统评价 Meta分析 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]