低频脉冲电疗联合经颅直流电刺激对老年卒中患者上肢功能障碍的疗效研究  

Therapeutic effect of low-frequency pulse electrotherapy combined with transcranial direct current stimulation on upper limb dysfunction of elderly stroke patients

作　　者：章姣姣 杨玉平 李璐[1] 洪磊[1] ZHANG Jiaojiao;YANG Yuping;LI Lu;HONG Lei(Department of Acupuncture,the Third Affiliated Hospital of Zhejiang Chinese Medical University(Qingchun District),Hangzhou 310016,China)

机构地区：[1]浙江中医药大学附属第三医院(庆春院区)针灸科,杭州310016

出　　处：《心电与循环》2024年第5期454-458,共5页Journal of Electrocardiology and Circulation

基　　金：浙江省中医药科技计划项目(2022ZA090);浙江中医药大学附属第三医院医药卫生科技计划项目(ZS20CA10)。

摘　　要：目的探讨低频脉冲电疗(LFPE)联合经颅直流电刺激(t DCS)对老年卒中患者上肢功能障碍的疗效。方法回顾性选取2021年1月至2023年8月浙江中医药大学附属第三医院(庆春院区)收治的120例卒中导致上肢功能障碍的老年患者为研究对象,采用LFPE、t DCS、LFPE+t DCS治疗各40例,分别为LFPE组、t DCS组、LFPE+t DCS组。观察并比较3组患者治疗前及治疗4周后上肢运动功能[采用简式Fugl-Meyer量表(FMA)评估]、痉挛程度[采用改良Ashworth痉挛评定量表(MAS)评估]、血清指标[包括血清神经元特异性烯醇化酶(NSE)、S-100β蛋白、髓鞘碱性蛋白(MBP)水平]、自理能力[采用改良Barthel指数(MBI)评估]及生活质量[采用脑卒中专用生活质量量表(SS-QOL)评估]等指标。结果与治疗前比较,治疗4周后3组患者上肢FMA评分以及MBI、SS-QOL评分均明显升高(均P<0.01),上肢MAS评分以及血清NSE、S-100β蛋白、MBP水平均明显降低(均P<0.01)。治疗4周后,LFPE+t DCS组FMA评分以及MBI、SS-QOL评分均明显高于LFPE组、t DCS组(均P<0.05),而MAS评分以及血清NSE、S-100β蛋白、MBP水平均低于LFPE组、t DCS组(均P<0.05)。结论LFPE联合t DCS能有效改善老年卒中患者上肢功能障碍,提高患者自理能力和生活质量。Objective To explore the therapeutic effect of low-frequency pulse electrotherapy(LFPE)combined with transcranial direct current stimulation(tDCS)on upper limb dysfunction of elderly stroke patients.Methods A retrospective study was conducted on 120 elderly patients with upper limb dysfunction caused by stroke admitted to the Third Affiliated Hospital of Zhejiang Chinese Medical University(Qingchun District)from January 2021 to August 2023.LFPE,tDCS,and LFPE+tDCS were used to treat 40 patients each,as the LFPE group,tDCS group,and LFPE+tDCS group.Upper limb motor function[evaluated using the simplified Fugl-Meyer Assessment Scale(FMA)],spasticity degree[evaluated using Modified Ashworth Spasticity Assessment Scale(MAS)],serum indicators[including serum neuronspecific enolase(NSE),S-100茁protein,and myelin basic protein(MBP)levels],self-care ability[evaluated using Modified Barthel Index(MBI)],and quality of life[evaluated using Stroke-Specific Quality Of Life Scale(SS-QOL)]in three groups before and after 4 weeks of treatment were observed and compared.Results After 4 weeks of treatment,the upper limb FMA score,MBI,and SS-QOL score of the patients in three groups were all significantly increased(all P<0.01),while the upper limb MAS score,and serum NSE,S-100茁protein,and MBP levels were significantly decreased(all P<0.01)when comparing with those before treatment.The FMA score,MBI,and SS-QOL score in the LFPE+tDCS group after 4 weeks of treatment were significantly higher than those of LFPE and tDCS groups(all P<0.05),while the MAS score,and serum NSE,S-100茁protein,and MBP levels were lower than those of the LFPE and tDCS groups(all P<0.05).Conclusion LFPE combined with tDCS can effectively improve upper limb dysfunction of elderly stroke patients,and enhance their self-care ability and quality of life.

关 键 词：低频脉冲电疗 经颅直流电刺激 老年人 卒中 上肢功能障碍 

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]