重复经颅磁刺激联合镜像疗法对脑卒中患者手功能康复的效果  

The Effect of Repetitive Transcranial Magnetic Stimulation Combined with Mirror Therapy on Hand Function Rehabilitation in Stroke Patients

作　　者：陈世振 李玉花 姜艳菊 李安婷 王博禹 CHEN Shizhen;LI Yuhua;JIANG Yanju(Department of Rehabilitation Medicine,Shanghai Zhongye Hospital,Shanghai 200941)

机构地区：[1]上海中冶医院康复医学科,上海200941

出　　处：《医学临床研究》2025年第1期12-15,19,共5页Journal of Clinical Research

基　　金：环球医疗科研基金(编号:UM0223013);上海市宝山区科学技术委员会科技创新专项资金项目-区级医学卫生项目(编号:21-E-70)。

摘　　要：【目的】探讨重复经颅磁刺激(rTMS)联合镜像疗法(MT)对脑卒中患者手功能康复的效果。【方法】80例脑卒中恢复期患者,随机分为对照组和观察组,每组40例。对照组接受常规手功能康复训练,观察组接受rTMS联合MT。治疗1个月后,比较两组患者的脑电图指标[δ/α值(DAR)、脑对称指数(BSI)]、上肢运动功能(fugl-meyer评估量表,FMA)评分、手功能评分(采用Brunnstrom评定量表、改良Ashworth痉挛评定量表评估)、日常生活能力(改良Barthel指数)和生活质量评分。【结果】观察组治疗后的DAR、BSI显著低于对照组(P<0.05);两组治疗后的Brunnstrom评定分期、Ashworth痉挛评定分级比较,差异有统计学意义(P<0.05);观察组患者腕部、手以及上肢的FMA总分、治疗后的改良Barthel指数评分和各项生活质量评分均高于对照组(P<0.05)。【结论】rTMS联合MT能够显著改善脑卒中患者的脑电图指标,促进其手功能康复,提高其日常生活能力和生活质量。【Objective】To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)combined with mirror therapy(MT)on hand function rehabilitation in stroke patients.【Methods】Eighty stroke patients in the recovery period were randomly divided into a control group and an observation group,with 40 patients in each group.The control group received conventional hand function rehabilitation training,while the observation group received rTMS combined with MT mirror therapy.After one month of treatment,the electroencephalogram(EEG)indices[δ/αvalue(DAR),brain symmetry index(BSI)],upper limb motor function scores(Fugl-Meyer,FMA),hand function scores(using the Brunnstrom evaluation scale and the Modified Ashworth Spasticity Scale),daily living abilities(Modified Barthel Index),and quality of life were compared between the two groups.【Results】The levels of DAR and BSI in the observation group were significantly lower than those in the control group after treatment(P<0.05).The differences in Brunnstrom evaluation stages and Ashworth spasticity grades between the two groups after treatment were statistically significant(P<0.05).The total FMA scores for the wrist,hand,and upper limbs,as well as the Barthel scores and various quality of life scores after treatment,were higher in the observation group than in the control group(P<0.05).【Conclusion】The rTMS combined with MT can significantly improve EEG indices in stroke patients,promote hand function rehabilitation,and enhance daily living abilities and quality of life.

关 键 词：卒中 经颅磁刺激 神经康复 中风康复 治疗结果 

分 类 号：R743[医药卫生—神经病学与精神病学]