经颅超声刺激联合低频神经肌肉电刺激对脑卒中患者认知和运动功能的改善作用  

The improvement effect of transcranial ultrasound stimulation combined with low-frequency neuromuscular electrical stimulation on cognitive and motor function in patients with stroke

作　　者：赵焕 殷其勇 陈和木[2] 鲍文 Zhao Huan;Yin Qiyong;Chen Hemu;Bao Wen(Department of Rehabilitation,the Third Affiliated Hospital of Anhui Medical University(Hefei First People's Hospital),Hefei 230000,China;Department of Rehabilitation,the First Affiliated Hospital of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第三附属医院(合肥市第一人民医院)康复科,合肥230000 [2]安徽医科大学第一附属医院康复科,合肥230000

出　　处：《中华行为医学与脑科学杂志》2025年第1期36-42,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：安徽省高等学校科学研究项目(2022AH051160)。

摘　　要：目的探讨经颅超声刺激联合低频神经肌肉电刺激治疗脑卒中患者认知和运动功能缺损的临床疗效。方法选择2023年7月—2024年7月康复医学科收治的90例脑卒中患者,随机分为对照组(n=44)和观察组(n=46)。对照组采取常规模式和低频神经肌肉电刺激康复治疗,观察组在对照组治疗基础上给予经颅超声刺激治疗。采用简易精神状态检查量表(MMSE)、简化的Fugl-Meyer运动量表(SFMA)、改良Barthel指数(MBI)及Brunnstromm分期评价两组患者脑卒中认知和运动功能康复治疗效果。使用SPSS 26.0统计软件对数据进行配对t检验、独立样本t检验和Mann-WhitneyU检验。结果治疗后两组患者MMSE评分[观察组(26.12±2.24)分,对照组(23.08±1.56)分]、SFMA评分[观察组(24.83±9.02)分,对照组(17.24±9.51)分]和MBI指数[观察组(68.00±7.03)分),对照组(49.66±7.98)分]均高于治疗前[MMSE:观察组(21.32±2.11)分,对照组(21.56±1.96)分;SFMA:观察组(10.43±8.05)分,对照组(10.56±7.63)分;MBI:观察组(32.34±7.65)分,对照组(32.00±9.73)分],均差异有统计学意义(t=-18.13~-2.31,均P<0.05);治疗后,观察组MMSE评分、SFMA评分和MBI指数均高于对照组,均差异有统计学意义(t=-4.45,-4.51,-5.59,均P<0.05)。治疗后观察组患侧上肢(Z=-6.236,P=0.045)及下肢(Z=-6.589,P=0.036)Brunnstrom分期为Ⅳ期及以上的患者均多于对照组,且两组患者患侧下肢达到Ⅳ级及以上者多于患侧上肢,差异有统计学意义(P<0.05)。结论经颅超声刺激治疗联合低频神经肌肉电刺激可明显改善脑卒中患者认知和运动功能可用于脑卒中患者认知和运动功能缺损的康复治疗。ObjectiveTo explore the clinical efficacy of transcranial ultrasound stimulation combined with low-frequency neuromuscular electrical stimulation on the treatment of cognitive and motor function deficits in stroke patients.MethodsNinety patients with cerebral hemorrhage in the rehabilitation department from July 2023 to July 2024 were selected and divided into control group(n=44)and observation group(n=46)randomly.The control group received conventional rehabilitation methods and low-frequency neuromuscular electrical stimulation rehabilitation treatment,while the observation group received transcranial ultrasound treatment in addition.Mini-mental state examination(MMSE),simplified Fugl-Meyer assessment(SFMA),modified Barthel index(MBI)and Brunnstrom movement therapy phase were used to evaluate the effectiveness of cognitive and motor rehabilitation treatment for all stroke patients.The data were analyzed by paired t-test,independent sample t-test,and Mann-Whitney U test using SPSS 26.0 software.ResultsAfter treatment,the scores of MMSE(observation group:26.12±2.24,control group:23.08±1.56),SFMA(observation group:24.83±9.02,control group:17.24±9.51),and MBI(observation group:68.00±7.03,control group:49.66±7.98)of both groups were significantly higher than those before treatment(MMSE(observation group:21.32±2.11,control group:21.56±1.96),SFMA(observation group:10.43±8.05,control group:10.56±7.63),MBI(observation group:32.34±7.65,control group:32.00±9.73)),and the differences were all statistically significant(t=-18.13--2.31,all P<0.05).The scores of MMSE,SFMA,and MBI in observation group were all higher than those of the control group,with statistically significant differences(t=-4.45,-4.51,-5.59,all P<0.05).After treatment,the observation group had more patients with Brunstrom stageⅣor above in the affected upper limb(Z=-6.236,P=0.045)and lower limb(Z=-6.589,P=0.036)compared to the control group.There were more patients in both two groups with gradeⅣor above in the affected lower limb than in the

关 键 词：经颅超声刺激 低频神经肌肉电刺激 脑-肢协同治疗 脑卒中 

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]