中医针灸联合经颅磁刺激治疗脑胶质瘤术后偏瘫的临床研究  

Clinical research on TCM combining acupuncture and moxibustion combined with transcranial magnetic stimulation on cerebral glioma postoperative hemiplegia

作　　者：方伟 赵阳 FANG Wei;ZHAO Yang

机构地区：[1]南阳市中心医院神经外科三病区,473005 [2]南阳市中心医院中医科,473005

出　　处：《中国疗养医学》2023年第4期406-409,共4页Chinese Journal of Convalescent Medicine

基　　金：河南省医学科技攻关项目(2021001651),加速康复外科理念在治疗神经外科脑肿瘤患者术后康复中的价值应用研究。

摘　　要：目的观察中医针灸联合经颅磁刺激技术(TMS)对改善脑胶质瘤术后偏瘫患者认知功能、肢体功能的效果。方法选择2021年1月至2022年1月南阳市中心医院收治的82例脑胶质瘤术后偏瘫患者为研究对象,采用抽签法将其均分为联合组和对照组,每组41例,两组患者均接受常规治疗+经颅磁刺激治疗,联合组采用中医针灸配合治疗,比较两组患者的脑神经功能、脑血液流变学、认知功能、肢体功能及治疗后不良事件发生情况。结果治疗前,两组患者的脑神经功能、脑血液流变学、认知及肢体功能差异无统计学意义(P>0.05);治疗7 d、14 d、30 d后,联合组的脑源性神经营养因子(BDNF)水平均高于对照组;治疗后,联合组的脑组织血浆黏度(PSV)、全血高切黏度(HSV)、全血低切黏度(LSV)低于对照组,简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分高于对照组,Fugl-Meyer运动功能评分量表(FMA)上肢、下肢功能评分高于对照组,不良事件发生率7.32%(3/41)低于对照组24.39%(10/41),P<0.05。结论采用中医针灸联合TMS技术治疗脑胶质瘤术后偏瘫可显著改善患者脑神经功能及脑血流动力学,对促进其认知功能、肢体功能恢复并降低不良事件发生风险均有积极意义。Objective To observe the effects of Tradition Chinese Medicine(TCM)therapy acupuncture combined with transcranial magnetic stimulation(TMS)on cognitive function and limb function of postoperative hemiplegia in glioma patients.Methods Totally 82 glioma patients with postoperative hemiplegia treated in Nanyang Central Hospital from January 2021 to January 2022 were taken as study subjects.The patients were equally assigned to receive conventional treatment+TMS(the control group)or conventional treatment+TCM acupuncture+TMS(the combination group).The cerebral nerve function,cerebral hemorheology,cognitive function,limb function and adverse events of patients were included as comparison.Results Differences in cerebral nerve function,cerebral hemorheology,cognition and limb function of patients in the two groups after treatment weren't statistically significant(P>0.05).On days 7,14 and 30,the level of brain derived neurotrophic factor(BDNF)in the combination group was higher than that in the control group.The plasma viscosity of brain tissue(PSV),whole blood high shear viscosity(HSV)of whole blood and low shear viscosity(LSV)in brain tissue in the combination group after treatment were lower than those in the control group.Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)scores were higher than those in the control group,and upper limb and lower limb function scores of Fugl-Meyer Assessment(FMA),motor function scores were higher than those in the control group,and the incidence of adverse events was significantly lower in the the combination group than in the control group 7.32%(3/41)VS 24.39%(10/41),P<0.05,respectively.Conclusion For glioma patients with postoperative hemiplegia,TCM acupuncture with TMS supports significantly improving the patients'cerebral nerve function and cerebral hemodynamics,delivering active significance in promoting the recovery of their cognitive function and limb function and reducing the risk of adverse events.

关 键 词：脑胶质瘤 术后偏瘫 中医针灸 经颅磁刺激技术 功能改善 

分 类 号：R246.5[医药卫生—针灸推拿学]