1Hz低频重复经颅磁刺激联合外源性神经生长因子对脑卒中后肢体运动功能障碍的影响  

Effects of 1 Hz low-frequency Repetitive Transcranial Magnetic Stimulation Combined with Exogenous Nerve Growth Factor Therapy on Limbs Dyskinesia in Stroke Patients

作　　者：梁军军 李婷婷 王玉琴 刘双洁 吕铭新 LIANG Junjun;LI Tingting;WANG Yuqin;LIU Shuangjie;LV Mingxin(Intensive Care Unit,Fourth People’s Hospital of Langfang City,Langfang,Hebei 065700;Department of Internal Neurology,Fourth People’s Hospital of Langfang City,Langfang,Hebei 065700)

机构地区：[1]廊坊市第四人民医院ICU,河北廊坊065700 [2]廊坊市第四人民医院神经内科,河北廊坊065700

出　　处：《智慧健康》2023年第15期141-144,148,共5页Smart Healthcare

基　　金：廊坊市科学技术研究与发展计划《重复经颅磁刺激在脑卒中后康复中的临床应用研究》(项目编号:2019013099)。

摘　　要：目的 探讨1Hz低频重复经颅磁刺激(rTMS)联合外源性神经生长因子(NGF)对脑卒中后肢体运动功能障碍的影响。方法 将128例脑卒中后肢体功能障碍患者随机分为对照组和联合组,每组64例。所有患者均接受外源性NGF治疗,在此基础上联合组给予健侧皮层1Hz低频rTMS,对照组给予假刺激。对比分析两组运动诱发电位潜伏期(MEP-CL)、中枢运动传导时间(CMCT)、上下肢改良Ashworth痉挛评定量表(MAS)分级、上下肢Fugl-Meyer (FMA)评分、功能独立性量表(FIM)评分、Berg平衡量表评分的差异。结果 治疗后,两组MEP-CL及CMCT均缩短(P <0.05),但联合组变化程度优于对照组(P<0.05)。治疗后两组上下肢MAS分级均有改善,且联合组改善程度优于对照组(P<0.05)。治疗后,两组上下肢FMA、FIM及Berg评分均有提高,但联合组上升更多(P<0.05)。结论 1Hz低频rTMS联合外源性NGF治疗脑卒中后肢体功能障碍的疗效优于NGF单用,表现在提高皮质兴奋性以及改善肢体痉挛症状、运动功能、功能独立性、平衡能力等方面。Objective To explore the effects of 1 Hz low-frequency repetitive transcranial magnetic stimulation combined with exogenous nerve growth factor therapy on limbs dyskinesia in stroke patients.Methods One hundred and twenty-eight stroke patients with limbs dyskinesia were randomly divided into control group and combination group,with sixty-four patients in each group.All patients received exogenous NGF treatment,and on this basis,the combination group was given 1 Hz low-frequency rTMS in the healthy side cortex,the control group was given false stimulation.The differences between the two groups in motor evoked potential cortical latency(MEP-CL),central motor conduction time(CMCT),upper and lower limb Modified Ashworth Scale(MAS),upper and lower limb Fugl-Meyer Assessment(FMA),functional independence measure(FIM)and Berg balance scale were compared.Results After treatment,MEP-CL and CMCT were shortened in both groups(P<0.05),but the changes in the combined group were better than those in the control group(P<0.05).After treatment,both groups showed improvement in MAS classification of upper and lower limbs,and the improvement degree of the combination group was better than that of the control group(P<0.05).After treatment,FMA scores of the upper and lower limbs,FIM and Berg scores in both groups were improved,but those in the combination group increased mor e(P<0.05).Conclusion The effects of 1 Hz low-frequency rTMS combined with exogenous NGF on stroke are superior to NGF alone in terms of improving cortical excitability,limb spasm symptoms,motor function,functional independence and balance ability.

关 键 词：脑卒中 肢体运动功能障碍 重复经颅磁刺激 1Hz低频 外源性神经生长因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]