重复经颅磁刺激对脑卒中后血管性痴呆患者认知功能的疗效研究  

Effects of Repeated Transcranial Magnetic Stimulation on Cognitive Function in Patients with Vascular Dementia after Stroke

作　　者：周甜甜 苏文杰 连松勇 林友聪 ZHOU Tiantian;SU Wenjie;LIAN Songyong;LIN Youcong(Quanzhou Medical College,Quanzhou,Fujian 362100;The 910th Hospital of the People's Liberation Army Logistics Support Force,Fuzhou,Fujian 362000)

机构地区：[1]泉州医学高等专科学校,福建泉州362100 [2]中国人民解放军联勤保障部队第九一〇医院,福建泉州362000

出　　处：《中医康复》2025年第4期66-71,共6页Traditional Chinese Medicine Rehabilitation

基　　金：泉州市医疗卫生领域指导性科技计划项目(2023N010S)。

摘　　要：目的:探究重复经颅磁刺激对血管性痴呆患者认知功能的作用及机制。方法:选择2021年4月~2024年6月中国人民解放军联勤保障部队第九一〇医院中医康复科收治的符合纳入标准的血管性痴呆患者60例,采用计算机随机分为常规治疗组(CT组)和重复经颅磁刺激组(rTMS组)各30例。两组患者均接受常规康复训练,包括运动功能训练、日常生活活动训练和认知功能训练,rTMS组在此基础上接受rTMS干预,每天一次,每周5天,持续4周。治疗前和治疗后分别对患者的认知功能(简易精神状态量表MMSE、蒙特利尔认知评估量表MoCA)、日常生活活动能力(改良巴氏指数MBI)和生活质量(卒中专用生活质量量表SS-QOL)进行评定,并且记录两组患者事件相关电位P300的波幅和潜伏期。结果:治疗前,两组患者MMSE、MoCA、MBI和SS-QOL评分以及P300潜伏期和波幅等数据差异无统计学意义(P>0.05)。治疗后,两组患者MMSE、MoCA、MBI、SS-QOL及P300波幅均显著提高(P<0.05),而P300潜伏期缩短(P<0.05),且rTMS组的MMSE、MoCA、MBI、SS-QOL评分、P300波幅均高于CT组(P<0.05),但P300潜伏期短于CT组(P<0.05)。结论:重复经颅磁刺激能显著改善血管性痴呆患者认知功能、日常生活活动能力和生活质量,这可能与P300潜伏期缩短和波幅增高有关。Objective:To investigate the effect and mechanism of repeated transcranial magnetic stimulation(rTMS)on cognitive function in patients with vascular dementia.Methods:60 patients with vascular dementia were randomly divided into conventional treatment group(CT group,n=30)and repeated transcranial magnetic stimulation group(rTMS group,n=30)by computer.Patients in both groups received routine rehabilitation training,including motor function training,daily living activities training and cognitive function training.Patients in the rTMS group also received rTMS intervention once a day,5 days a week for 4 weeks.The cognitive function(MMSE and MoCA),activities of daily living(MBI)and quality of life(SS-QOL)of patients were assessed before and after treatment,and the amplitude and latency of event-related potential P300 were recorded in two groups.Results:There were no significant differences in MMSE,MoCA,MBI,SS-QOL score,P300 latency and amplitude between the two groups before treatment(P>0.05).After treatment,the cognitive function,the ability of daily living,the quality of life and the amplitude of P300 were significantly improved(P<0.05),while the latency of P300 was shortened(P<0.05).Besides,MMSE,MoCA,MBI,SS-QOL score and P300 amplitude in rTMS group were higher than those in CT group(P<0.05),but P300 latency was shorter than that in CT group,the differences were statistically significant(P<0.05).Conclusion:rTMS can significantly improve cognitive function,daily living ability and quality of life in patients with vascular dementia,which may be related to the shortened latency and increased amplitude of P300.

关 键 词：血管性痴呆 重复经颅磁刺激 认知功能 MMSE MOCA P300 波幅 潜伏期 

分 类 号：R749.16[医药卫生—神经病学与精神病学]