经颅直流电刺激联合强制性运动疗法治疗卒中后偏瘫患者的效果  

Effects of transcranial direct current stimulation combined with constraint-induced movement therapy on patients with hemiplegia after stroke

作　　者：林强[1] LIN Qiang(Department of Rehabilitation of the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350000 Fujian,China)

机构地区：[1]福建中医药大学附属第二人民医院康复科,福建福州350000

出　　处：《中国民康医学》2025年第4期74-77,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察经颅直流电刺激(tDCS)联合强制性运动疗法(CIMT)治疗卒中后偏瘫患者的效果。方法:选取2023年5月至2024年5月该院收治的82例卒中后偏瘫患者进行前瞻性研究,按照随机数字表法将其分为对照组与观察组各41例。对照组采用CIMT治疗,观察组在对照组基础上联合tDCS治疗。比较两组治疗前后神经电生理指标[电位皮质潜伏期(CL)、中枢运动传导时间(CMCT)]水平、步态参数(步速、跨步长比率、步频)水平、肢体运动功能[Fugl-Meyer评定量表(FMA)]评分、日常生活能力[改良Barthel指数(MBI)]评分、生命质量[世界卫生组织生活质量-100量表(WHO-QOL-100)]评分。结果:治疗后,两组CL、CMCT均短于治疗前,且观察组短于对照组,差异有统计学意义(P<0.05);治疗后,两组步速均快于治疗前,且观察组快于对照组,两组跨步长比率、步频水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组FMA、MBI评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组生理、心理、独立性、社会关系、精神、环境等WHO-QOL-100评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:tDCS联合CIMT治疗卒中后偏瘫患者可提高步态参数水平、FMA评分、MBI评分和生命质量评分,降低神经电生理指标水平,效果优于单纯CIMT治疗。Objective:To observe effects of transcranial direct current stimulation(TDCS)combined with constraint-induced movement therapy(CIMT)in treatment of patients with hemiplegia after stroke.Methods:A prospective study was conducted on 82 patients with hemiplegia after stroke admitted to this hospital from May 2023 to May 2024.According to the random number table method,they were divided into control group and observation group,41 cases in each group.The control group was treated with CIMT,while the observation group was treated with TDCS on the basis of that of the control group.The levels of neuroelectrophysiological indexes[cortical latency(CL),central motor conduction time(CMCT)]and gait parameters(walking speed,stride length ratio,stride frequency),the limb motor function[Fugl-Meyer assessment scale(FMA)]score,the daily living ability[modified Barthel index(MBI)]score,the quality of life[world health organization quality of life-100 scale(WHOQOL-100)]score were compared between the two groups before and after the treatment.Results:After the treatment,the CL and CMCT of the two groups were shorter than those before the treatment,those in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the walking speed of the two groups was faster than that before the treatment,and that in the observation group was faster than that in the control group;the stride length ratio and stride frequency of the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;and the differences were statistically significant(P<0.05).After the treatment,the FMA and MBI scores of the two groups were higher than those before the treatment,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,after the treatment,the WHOQOL-100 scores of physiology,psychology,independence,social relations,spir

关 键 词：经颅直流电刺激 强制性运动疗法 卒中 偏瘫 运动功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]