生物波早期综合康复疗法联合不同频率重复经颅磁刺激治疗重型颅脑损伤昏迷患者的临床研究  

Clinical Study on the Biological Wave Early Comprehensive Rehabilitation Therapy Combined with Different Frequencies Repetitive Transcranial Magnetic Stimulation in the Treatment of Coma Patients with Severe Craniocerebral Injury

作　　者：倪小能 路伟 卢英云 孙梁 丁晓彤 NI Xiao-neng;LU Wei;LU Ying-yun;SUN Liang;DING Xiao-tong(Department of Rehabilitation Medicine,Shandong Provincial Third Hospital,Ji'nan,Shandong,250031,China)

机构地区：[1]山东省立第三医院康复医学科,山东济南250031

出　　处：《现代生物医学进展》2024年第11期2155-2158,2181,共5页Progress in Modern Biomedicine

基　　金：山东省中医药科技项目(Q-2022100)。

摘　　要：目的:观察生物波早期综合康复疗法联合不同频率重复经颅磁刺激(r TMS)治疗重型颅脑损伤昏迷患者的临床研究。方法:2022年1月至2023年4月期间,选取山东省立第三医院收治的重型颅脑损伤昏迷患者90例。根据随机数字表法,将患者分为A、B两组,均为45例,所有患者均给予生物波早期综合康复疗法联合r TMS治疗,A组给予低频率r TMS,B组给予高频率r TMS。对比两组治疗前后残疾程度(DRS)评分、格拉斯哥昏迷量表(GCS)评分、脑血流动力学指标[平均血流速度(Vm)、大脑中动脉收缩期峰流速(Vs)、搏动指数(PI)]、神经细胞因子[脑源性神经营养因子(BDNF)、胶质纤维酸性蛋白(GFAP)、S100-β、神经元特异性烯醇化酶(NSE)]和不良反应。结果:治疗后,B组GCS评分高于A组,DRS评分低于A组(P<0.05)。治疗后,B组Vm、Vs高于A组,PI低于A组(P<0.05)。治疗后,B组BDNF高于A组,GFAP、S100-β、NSE低于A组(P<0.05)。B组的不良反应发生率高于A组(P<0.05)。结论:生物波早期综合康复疗法联合r TMS治疗重型颅脑损伤昏迷患者,具有一定的促醒效果,其中以高频的促醒效果更佳,可有效调节神经细胞因子水平,改善机体脑血流动力学,改善GCS、DRS评分。但高频r TMS治疗不良反应较低频r TMS更大,值得引起临床重视。Objective:To observe the clinical study of biological wave early comprehensive rehabilitation therapy combined with different frequencies repetitive transcranial magnetic stimulation(rTMS)in the treatment of coma patients with severe craniocerebral injury.Methods:From January 2022 to April 2023,90 coma patients with severe craniocerebral injury in the Third Hospital of Shandong Province were selected.According to the random number table method,patients were divided into group A and group B,45 cases in each group,all patients were treated with biological wave early comprehensive rehabilitation therapy combine with rTMS,group A was given low frequency rTMS,and group B was given high frequency rTMS.The Disability Rating Scale(DRS)score,Glasgow Coma Scale(GCS)score,cerebral hemodynamic indexes[blood flow velocity(Vm),middle cerebral artery systolic peak velocity(Vs),pulsatility index(PI)],nerve cell factors[brain-derived neurotrophic factor(BDNF),glial fibrillary acidic protein(GFAP),S100-β,neuron-specific enolase(NSE)]and adverse reactions were compared in two groups before and after treatment.Results:After treatment,the GCS score in group B was higher than that in group A,and the DRS score was lower than that in group A(P<0.05).After treatment,the Vm and Vs in group B were higher than those in group A,and the PI was lower than that in group A(P<0.05).After treatment,BDNF in group B was higher than that in group A,and GFAP,S100-βand NSE were lower than those in group A(P<0.05).The incidence of adverse reactions in group B was higher than that in group A(P<0.05).Conclusion:Biological wave early comprehensive rehabilitation therapy combined with rTMS in the treatment of coma patients with severe craniocerebral injury has a certain wake-up effect,among which high frequency wake-up effect is better,and it can effectively regulate the level of nerve cell factors,improve the body's cerebral hemodynamics,and improve GCS and DRS scores.But the adverse reactions of high-frequency rTMS treatment are greater than those of lo

关 键 词：生物波早期综合康复疗法 不同频率 重复经颅磁刺激 重型颅脑损伤 昏迷 临床研究 

分 类 号：Q64[生物学—生物物理学] R651.1[医药卫生—外科学]