脊激肌技术联合重复经颅磁刺激治疗脑卒中后睡眠与心理障碍的疗效观察  

Effects of spine nerves muscle stimulation combined with repetitive transcranial magnetic stimulation on sleep disorder and psychology after stroke

作　　者：蒋敏静 陈伟青 王婷婷 王际媚 都斌 Jiang Minjing;Chen Weiqing;Wang Tingting(Xianju People’s Hospital,Zhejiang Southeast Campus of Zhejiang Provincial People’s Hospital,Affiliated Xianju Hospital,Hangzhou Medical College,Xianju,Zhejiang 317300,China)

机构地区：[1]仙居县人民医院(浙江省人民医院浙东南院区/杭州医学院附属仙居医院),浙江仙居317300

出　　处：《中国康复》2025年第4期202-206,共5页Chinese Journal of Rehabilitation

基　　金：浙江省中医药项目(2022ZA186)。

摘　　要：目的:观察脊激肌技术联合重复经颅磁刺激(rTMS)治疗对脑卒中后睡眠障碍(SD)及心理障碍的疗效。方法:选取2023年5月~2024年3月我院收治的90例脑卒中后SD患者,随机分为手法组、rTMS组、联合组3组,每组30例。3组分别脱落2例、1例、1例,最终分别为28例、29例、29例。3组均采用常规治疗,在此基础上,手法组予以脊激肌技术治疗,30min/d,6d/周,共4周;rTMS组予以rTMS治疗,20min/d,6d/周,共4周;联合组予以rTMS+脊激肌技术治疗,50min/d,6d/周,共4周。分别评估3组患者治疗前后的匹兹堡睡眠质量指数(PSQI)评分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分以及多导睡眠监测参数(觉醒次数、睡眠效率、睡眠潜伏期、睡眠总时间)并进行比较。结果:治疗前,3组上述各项结果比较无统计学差异。经过4周治疗后,3组患者PSQI、HAMD、HAMA评分、觉醒次数、睡眠潜伏期均较治疗前降低(P<0.05);睡眠效率、睡眠总时间均较治疗前升高(P<0.05);联合组PSQI、HAMD、HAMA评分、觉醒次数、睡眠潜伏期低于手法组、rTMS组(P<0.05);联合组睡眠效率、睡眠总时间高于手法组、rTMS组(P<0.05);rTMS组与手法组PSQI、IHAMD、HAMA评分及多导睡眠监测参数比较差异无统计学意义。结论:脊激肌技术、rTMS联合治疗较单用脊激肌技术、rTMS治疗可更有效地改善脑卒中患者的SD,缓解患者的抑郁和焦虑。Objective:To observe the impact of spine nerves muscle stimulation combined with repetitive transcranial magnetic stimulation(rTMS)on post-stroke sleep disorders(SD)and psychological status.Methods:From May 2023 to March 2024,90 patients with post-stroke SD admitted to our hospital were selected and randomly divided into three groups:manual therapy group,rTMS group,and combined group,with 30 patients in each group.However,2 patients dropped out from the manual therapy group,1 from the rTMS group,and 1 from the combined group,leaving 28,29,and 29 patients in each group respectively.All groups received conventional treatment.Additionally,the manual therapy group received spine nerves muscle stimulation for 30 min/day,6 days/week for 4 weeks;the rTMS group received rTMS for 20 min/day,6 days/week for 4 weeks;and the combined group received both rTMS and spine nerves muscle stimulation for 50 min/day,6 days/week for 4 weeks.The Pittsburgh sleep quality index(PSQI),Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),and polysomnography parameters(arousal index,sleep efficiency,sleep latency,and total sleep time)were evaluated and compared before and after treatment in all groups.Results:Before treatment,there were no statistically significant differences in the aforementioned outcomes among the three groups.After 4 weeks of treatment,the PSQI,HAMD,HAMA scores,arousal index,and sleep latency decreased in all groups compared to baseline(P<0.05),while sleep efficiency and total sleep time increased(P<0.05).The PSQI,HAMD,HAMA scores,arousal index,and sleep latency were lower in the combined group than in the manual therapy and rTMS groups(P<0.05).Additionally,the sleep efficiency and total sleep time parameters were higher in the combined group than in the manual therapy and rTMS groups(P<0.05).There were no statistically significant differences in PSQI,HAMD,HAMA scores,or polysomnography parameters between the rTMS group and the manual therapy group.Conclusion:Compared with spine nerves muscle stimulation or rTM

关 键 词：脊激肌技术 重复经颅磁刺激 脑卒中 睡眠障碍 心理障碍 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]