重复经颅磁刺激联合沙盘游戏疗法对智力低下儿童智力改善及认知发育的影响  

Effect of repetitive transcranial magnetic stimulation combined with sandplay therapy on mental improvement and cognitive development of children with mental retardation

作　　者：莫丽华[1] 陈盈 杨幸 MO Li-hua;CHEN Ying;YANG Xing(Department of Rehabilitation Medicine,Second Affiliated Hospital of Guangxi Medical University,Nanning Guangxi 530007,China;Department of Child Rehabilitation,Maternity and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning Guangxi 530000,China)

机构地区：[1]广西医科大学第二附属医院康复医学科,广西南宁530007 [2]广西壮族自治区妇幼保健院儿童康复科,广西南宁530000

出　　处：《临床和实验医学杂志》2021年第14期1557-1560,共4页Journal of Clinical and Experimental Medicine

基　　金：广西壮族自治区康复临床重点专科建设项目经费资助[桂卫医发(2018)6号]。

摘　　要：目的探讨重复经颅磁刺激(rTMS)联合沙盘游戏疗法对智力低下(MR)儿童智力改善及认知发育的影响。方法前瞻性选取2018年1月至2020年12月广西医科大学第二附属医院收治的MR儿童48例为研究对象,采用随机数字表法分为观察组(n=25)与对照组(n=23)。2组患儿均给予常规康复治疗,对照组在此基础上给予沙盘游戏疗法,5次/周,持续训练3个月。观察组在常规治疗基础上给予rTMS联合沙盘游戏。观察2组患儿临床疗效、智力情况[发育商(DQ)评分量表]、认知发育情况[蒙特利尔认识评估量表(MoCA)]及运动能力情况[88项粗大功能测试量表(GMFM-88)]和精细运动能力测试量表(FMEM)。结果观察组患儿治疗总有效率为92.00%(23/25),高于对照组的65.21%(15/23),差异有统计学意义(P<0.05)。治疗3个月后,2组患儿DQ评分均较治疗前升高,且观察组[(43.25±4.82)分]高于对照组[(30.28±2.14)分],差异均有统计学意义(P<0.05)。治疗3个月后,2组患儿MoCA评分均较治疗前升高,且观察组[(26.14±4.33)分]高于对照组[(22.83±2.38)分],差异均有统计学意义(P<0.05)。观察组GMFM-88和FMEM运动功能均高于对照组,差异均有统计学意义(P<0.05)。结论对MR患儿采取重复经颅磁刺激联合沙盘游戏疗效确切,可显著改善患儿智力,认知功能及运动功能,促进患儿康复和正常发育,治疗效果较好。Objective To explore the effect of repeated transcranial magnetic stimulation(rTMS)combined with sandpla therapy on mental improvement and cognitive development in children with mental retardationmental retardation(MR).Methods Fourty-eight children with MR admitted to Second Affiliated Hospital of Guangxi Medical University from January 2018 to December 2020 were prospectively selected and divided into the observation group(n=25)and the control group(n=23)according to the random number table method.Both groups of children were given conventional rehabilitation treatment,and the control group was given sandplay therapy on this basis,5 times a week,and continued training for 3 months.The observation group was given rTMS combined with sandplay therapy on the basis of conventional treatment.Clinical efficacy,intelligence[Developmental Quotient(DQ)score scale],cognitive development[Montreal Cognitive Assessment(MoCA)]and exercise ability[Gross Function Test Scale(GMFM-88)]and the Fine Motor Function Measur(FMEM)were observed.Results The total effective treatment of children in the observation group was 92.00%(23/25),which was higher than 65.21%(15/23)in the control group,and the difference was statistically significant(P<0.05).After 3 months of treatment,the DQ scores in the two groups were higher than before treatment,and the observation group[(43.25±4.82)points]were higher than those in the control group[(30.28±2.14)points],the differences were statistically significant(P<0.05).After 3 months of treatment,the MoCA scores in the two groups were higher than before treatment,and the observation group[(26.14±4.33)points]were higher than those in the control group[(22.83±2.38)points],the differences were statistically significant(P<0.05).The motor functions of GMFM-88 and FMEM in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion Repetitive transcranial magnetic stimulation combined with sandplay therapy for children with mental retardat

关 键 词：智力低下儿童 经颅磁刺激 沙盘游戏疗法 智力改善 认知发育 

分 类 号：R748[医药卫生—神经病学与精神病学]