间歇性theta节律刺激联合电针治疗对脑卒中偏瘫患者上肢运动功能恢复的影响  

Efect of intermittent theta rhythm stimulation combined with electroacupuncture therapy on recovery of upper limb motor function in patients with hemiplegia after stroke

作　　者：仰唯栋 谢晶军[1] YANG Weidong;XIE Jingjun(Department of Rehabilitation Medicine,Huzhou First People's Hospital,Huzhou 313000,CHINA)

机构地区：[1]湖州市第一人民医院康复医学科,浙江313000

出　　处：《江苏医药》2024年第11期1107-1110,1115,共5页Jiangsu Medical Journal

基　　金：浙江省中医药科技计划项目(2024ZL1027);湖州市科技计划项目(2022GY16)。

摘　　要：目的 探讨间歇性theta节律刺激(iTBS)联合电针治疗对脑卒中偏瘫患者上肢运动功能恢复的影响。方法 在常规药物治疗和康复训练治疗基础上,脑卒中偏瘫患者79例分为iTBS治疗(A)组20例、电针治疗(B)组19例、iTBS联合电针治疗(D)组20例及对照(C)组20例,治疗4周。采用Fugl-Meyer上肢运动功能评定量表(FMA-UE)、香港版偏瘫上肢功能测试评定量表(FTHUE-HK)及改良Ashworth量表(MAS)评估四组治疗前后患侧上肢运动功能恢复情况。检测四组治疗前后运动诱发电位(MEP)振幅。结果 与治疗前比较,治疗后四组FMA-UE评分、FTHUE-HK评分及MEP振幅均升高,而MAS评分降低(P<0.01)。与C组治疗后比较,A、B、D组治疗后FMA-UE评分、FTHUE-HK评分及MEP振幅均升高,而MAS评分降低(P<0.05),且D组治疗后上述指标优于A、B组(P<0.05)。结论 iTBS联合电针治疗有助于脑卒中偏瘫患者大脑功能重塑,促进患侧上肢运动功能恢复。Objective To observe the effect of intermittent theta rhythm stimulation(iTBS)combined with electroacupuncture therapy on the recovery of upper limb motor function in the patients with hemiplegia after stroke.Methods On the basis of routine medical medication and rehabilitation training,79 stroke patients with hemiplegia were divided into four groups of A(treated with iTBS,20 cases),B(treated with electroacupuncture,19 cases),D(treated with iTBS and electroacupuncture,20 cases)and C(the controls,20 cases).The treatment lasted for 4 weeks.Fugl-Meyer Assessment of upper extremity scale(FMA-UE),Hong Kong version of functional test for hemiplegic upper extremity(FTHUE-HK)and Modified Ashworth Scale(MAS)were used to evaluate the recovery of affected upper limb motor function before and after treatment in four groups.The amplitude of motor evoked potential(MEP)before and after treatment was detected in the four groups.Results Compared with before treatment,FMA-UE score,FTHUE-HK score and MEP amplitude were all increased,while MAS score was decreased in the four groups after treatment(P<0.O1).Compared with group C after treatment,FMA-UE score,FTHUE-HK score and MEP amplitude were increased,while MAS score was decreased in groups of A,B and D after treatment(P<0.05),which after treatment were better in group D than those in groups of A and B(P<0.05).Conclusion In the patients with hemiplegia after stroke,iTBS combined with electroacupuncture therapy can help to reshape the brain function and promote the recovery of motor function of affected upper limb.

关 键 词：间歇性theta节律刺激 电针 脑卒中 偏瘫 上肢运动功能 

分 类 号：R743[医药卫生—神经病学与精神病学]