重复经颅磁刺激联合电针对脑卒中偏瘫恢复期患者上肢运动功能及血清BDNF、NGF的影响  

The effect of repetitive transcranial magnetic stimulation combined with electroacupuncture on upper limb motor function and serum BDNF,NGF in patients with stroke hemiplegia during recovery period

作　　者：刘盛冬 叶涛 申建权[2] 杨继 陈春艳 LIU Sheng-Dong;YE Tao;SHEN Jian-Quan(The First Affiliated Hospital of Guizhou University of Chinese Medicine,Guiyang 550001,Guizhou,China)

机构地区：[1]贵州中医药大学第一附属医院,贵州贵阳550001 [2]黔南民族医学高等专科学校

出　　处：《中国老年学杂志》2023年第11期2578-2581,共4页Chinese Journal of Gerontology

基　　金：国家自然科学基金地区科学基金项目(82060896);贵州省科技计划基础研究(科学技术基金)项目(黔科合基础-ZK[2021]一般505);贵州省教育厅青年科技人才成长项目(黔教合KY字[2021]210);贵州省中医药管理局中医药、民族医药科学技术研究课题(QZYY-2021-015);贵州省卫生健康委科学技术基金项目(gzwkj2021-072)。

摘　　要：目的分析重复经颅磁刺激联合电针对脑卒中偏瘫恢复期患者上肢运动功能及血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)的影响。方法纳入脑卒中偏瘫恢复期患者100例,依据随机数表法分为对照组和观察组各50例。对照组采用电针治疗,观察组采用重复经颅磁刺激联合电针治疗。比较两组细胞因子含量表达、大脑血流速度、上肢痉挛程度评分、Fugl-Meyer运动功能评定量表(FMA)评分,并比较两组临床疗效。结果两组治疗前血清BDNF、NGF表达,大脑前动脉、中动脉、后动脉血流速度,改良版Ashworth量表(MAS)评分,FMA评分无明显差异(P>0.05),治疗后观察组细胞因子含量表达、大脑血流速度、上肢痉挛程度评分、FMA评分显著优于对照组,MAS评分显著低于对照组(P<0.001)。治疗后观察组临床总有效率明显高于对照组(P<0.05)。结论重复经颅磁刺激联合电针能够改善脑卒中偏瘫恢复期患者血清BDNF、NGF表达,达到增加大脑血流速度,缓解上肢痉挛,改善上肢运动功能和临床疗效。Objective To analyze the effect of repetitive transcranial magnetic stimulation combined with electroacupuncture on upper limb motor function and serum brain-derived neurotrophin factor(BDNF)and nerve growth factor(NGF)in patients with stroke hemiplegia during recovery period.Methods 100 patients with stroke hemiplegia during recovery period were included,they were divided into control group and observation group based on a random number table method,with 50 patients in each group.The control group received electroacupuncture treatment,the observation group received repetitive transcranial magnetic stimulation combined with electroacupuncture treatment.The expression of cytokines content,cerebral blood flow velocity,upper limb spasticity score,Fugl-Meyer motor function assessment scale(FMA)score of two groups were analyzed and compared,and the clinical efficacy of the two groups was compared.Results There was no significant difference between the two groups in serum BDNF,NGF expression,blood flow velocity of anterior,middle and posterior cerebral arteries,modified Ashworth scale(MAS)score and FMA score before treatment(P>0.05).After treatment,the expressions of cytokines content,cerebral blood flow velocity,upper limb spasticity score and FMA score in the observation group were significantly better than those in the control group,and the MAS score in the observation group was significantly lower than that in the control group(P<0.001).The total clinical effective rate of the observation group after treatment was significantly higher than that in the control group(P<0.05).Conclusions Repetitive transcranial magnetic stimulation combined with electroacupuncture could improve the expressions of serum BDNF and NGF,increase cerebral blood flow velocity,alleviate upper limb spasms,improve upper limb motor function and clinical efficacy in patients with stroke hemiplegia during recovery period.

关 键 词：脑卒中 偏瘫 恢复期 重复经颅磁刺激 电针 脑源性神经营养因子 神经生长因子 

分 类 号：R742[医药卫生—神经病学与精神病学]