间歇性θ爆发式刺激在脑卒中后上肢运动功能恢复中的有效性研究:一项随机对照试验  

The effectiveness of intermittent theta bust stimulation for upper limb motor recovery after stroke:A randomized controlled trial

作　　者：陈松斌 黎晓彤 杨文清 陈文瑜 李海 Chen Songbin;Li Xiaotong;Yang Wenqi;Chen Wenyu;Li Hai(Department of Rehabilitation Medicine,Shenzhen Hospital,Southern Medical University,Shenzhen 518110,China;Department of Rehabilitation Medicine,Guangzhou First People’s Hospital,Guangzhou 510180,China)

机构地区：[1]南方医科大学深圳医院康复医学科,深圳518110 [2]广州市第一人民医院康复医学科,广州510180

出　　处：《现代仪器与医疗》2025年第1期16-21,共6页Modern Instruments & Medical Treatment

基　　金：深圳市科技计划(JCYJ20210324134401004);深圳市医学研究专项资金(C2401028);广东省医学科研基金(A2023367);广州市卫生健康科技一般引导项目(20251A011002)。

摘　　要：目的探讨间歇性θ爆发式刺激(Intermittent Theta-Burst Stimulation,iTBS)对亚急性期脑梗死患者上肢运动功能的具体影响。方法本研究为一项随机对照试验,在2023年1月—2024年7月期间,从广州市第一人民医院康复医学科筛选并纳入了50例亚急性期脑梗死患者作为研究对象,随机分配至iTBS组(n=25)或假刺激组(n=25),iTBS组进行10次iTBS刺激,假刺激组进行10次假刺激干预,两组均接受常规康复治疗。在治疗前后进行Fugl-Meyer上肢运动功能评估量表(Fugl-Meyer Assessment of Upper Extremity,FMA-UE)、上肢动作研究量表(Action Research Arm Test,ARAT)、Wolf运动功能测试评分(Wolf Motor Function Test,WMFT)、改良Barthel指数(Modified Barthel Index,MBI)、上肢躯体运动诱发电位(Motor Evoked Potential,MEP)的测量,并对测量结果进行对比分析。结果治疗前后,两组FMA-UE评分比较,差异均无统计学意义(P>0.05)。治疗后,两组FMA-UE评分与本组治疗前比较,差异均有统计学意义(P<0.05)。治疗前后,两组动作评分比较,差异均无统计学意义(P>0.05)。治疗后,iTBS组的ARAT评分高于本组治疗前(P<0.05),而假刺激组与本组治疗前比较,差异无统计学意义(P>0.05)。治疗前后,两组WMFT评分比较,差异无统计学意义(P>0.05)。治疗后,iTBS组WMFT评分高于本组治疗前,差异有统计学意义(P<0.001),而假刺激组与本组治疗前比较,差异无统计学意义(P=0.532)。治疗前,两组患者MBI比较,差异无统计学意义(P>0.05)。治疗后,iTBS组MBI高于本组治疗前和同期假刺激组,差异有统计学意义(P=0.008)。治疗前后,在潜伏期和波幅方面,两组比较,差异无统计学意义(P>0.05)。治疗后,iTBS组的MEP潜伏期和波幅低于本组治疗前(P<0.05)。结论iTBS刺激能有效提升亚急性期脑卒中患者的上肢运动功能并促进功能独立性。这为将iTBS作为脑卒中患者标准康复方案中的有效辅助手段提供了有力的证据支持。Objective The aim of this study is to explore the impact of intermittent theta burst stimulation(iTBS)on upper limb motor function in subacute cerebral infarction patients.Methods This study is a randomized controlled trial conducted from January 2023 to July 2024 at the Department of Rehabilitation Medicine,Guangzhou First People's Hospital.A total of 50 individuals were recruited for the study.Participants were randomly assigned to either the iTBS group(n=25)or sham stimulation group(n=25),each receiving 10 sessions of intervention,along with conventional rehabilitation therapy.The Fugl-Meyer Assessment of Upper Extremity(FMA-UE),Action Research Arm Test(ARAT),Wolf Motor Function Test(WMFT),Modified Barthel Index(MBI),and Motor Evoked Potential(MEP)were measured,and the results of these assessments were compared.Results Before and after treatment,there was no significant difference in FMA-UE scores between the two groups(P>0.05).After treatment,the FMA-UE score of the two groups was significantly different from that of the group before treatment(P<0.05).Before and after treatment,there was no significant difference in movement scores between the two groups(P>0.05).After treatment,the ARAT score of iTBS group was higher than that before treatment(P<0.05),but there was no significant difference between false stimulation group and before treatment(P>0.05).Before and after treatment,there was no significant difference in WMFT scores between the two groups(P>0.05).After treatment,WMFT score in iTBS group was higher than that before treatment,the difference was statistically significant(P<0.001),while there was no statistically significant difference between false stimulation group and before treatment(P>0.05).Before treatment,there was no significant difference in MBI between the two groups(P>0.05).After treatment,the MBI in iTBS group was higher than that before treatment and in spurious stimulation group at the same time,and the difference was statistically significant(P<0.05).Before and after treatment,there was

关 键 词：间歇性θ爆发式刺激 中风 运动功能 功能独立性 缺血性1 

分 类 号：TH77[机械工程—仪器科学与技术] R743.3[机械工程—精密仪器及机械]