针灸联合重复经颅磁刺激治疗脑卒中后运动功能障碍患者的临床效果  

Clinical efficacy of acupuncture combined with repetitive transcranial magnetic stimulation in the treatment of post-stroke motor dysfunction

作　　者：李雪梅[1] 石晶晶 刘霞[1] 张皓 肖王静 任金来[4] LI Xuemei;SHI Jingjing;LIU Xia;ZHANG Hao;XIAO Wangjing;REN Jinlai(Rehabilitation Medicine,Binzhou Medical University Hospital,Shandong,Binzhou 256603,China;Rehabilitation Medicine,Shandong Provincial Third Hospital,Shandong,Jinan 250031,China;Rehabilitation Medicine,Affiliated Hospital of Jiangnan University,Jiangsu,Wuxi 214122,China;Clinical laboratory,Binzhou Medical University Hospital,Shandong,Binzhou 256603,China)

机构地区：[1]滨州医学院附属医院康复医学科,山东滨州256603 [2]山东省立第三医院康复医学科,山东济南250031 [3]江南大学附属医院康复医学科,江苏无锡214122 [4]滨州医学院附属医院检验科,山东滨州256603

出　　处：《中国医药科学》2025年第7期86-91,共6页China Medicine And Pharmacy

基　　金：山东省中医药科技项目(2021M159)。

摘　　要：目的探讨针灸联合重复经颅磁刺激(rTMS)治疗脑卒中后运动功能障碍患者的运动及平衡功能的改善情况,以及针灸联合rTMS治疗后功能性近红外光谱(fNIRS)检测比较。方法纳入2022年8月至2023年8月就诊于滨州医学院附属医院康复医学科的脑卒中患者28例,采用随机数表法将患者分为针灸组及针灸+rTMS组。针灸组采用针灸治疗,针灸+rTMS组采用针灸联合rTMS治疗。两组在治疗前、治疗4周后均进行运动、平衡功能评定及脑功能监测。结果治疗前,两组各项评分的比较,差异无统计学意义(P>0.05)。经治疗后,针灸+rTMS组的步行能力、平衡能力、运动评分高于针灸组,差异有统计学意义(P<0.05)。治疗后,针灸+rTMS组在额叶、顶叶的平均激活程度高于针灸组,在枕叶的平均激活程度低于针灸组(P<0.05)。结论针灸+rTMS治疗在脑卒中后运动功能障碍患者的治疗过程中可能产生协同作用,能更大程度促进患者的功能恢复,同时影响部分脑区的激活程度。Objective To investigate the effects of acupuncture combined with repetitive transcranial magnetic stimulation(rTMS)on motor and balance function in patients with post-stroke motor dysfunction,as well as to compare functional near-infrared spectroscopy(fNIRS)findings before and after treatment.Methods A total of 28 stroke patients admitted to the Department of Rehabilitation Medicine,Binzhou Medical University Hospital from August 2022 to August 2023 were included.The patients were divided into acupuncture group and acupuncture+rTMS group by random number table method.The acupuncture group was treated with acupuncture,and the acupuncture+rTMS group was treated with acupuncture combined with transcranial magnetic therapy.Motor function,balance function,and brain activity were assessed before and after 4 weeks of treatment.Results Before treatment,there was no significant difference in scores between the two groups(P>0.05).After treatment,the walking ability,balance ability and exercise score of acupuncture and moxibustion combined with transcranial magnetic field group were higher than those of acupuncture and moxibustion group,and the differences were statistically significant(P<0.05).After treatment,the average activation degree of acupuncture combined with acupuncture+rTMS group in frontal and parietal lobes was higher than that of acupuncture group,and the average activation degree of occipital lobe was lower than that of acupuncture group(P<0.05).Conclusion The combination of acupuncture and rTMS may have a synergistic effect in the treatment of post-stroke motor dysfunction,promoting greater functional recovery and influencing activation levels in specific brain regions.

关 键 词：脑卒中 针灸 功能性近红外光谱 重复经颅磁刺激 

分 类 号：R743.3[医药卫生—神经病学与精神病学]