针刺结合低频重复经颅磁刺激（LF-rTMS）治疗脑卒中后上肢功能障碍的临床研究

发布时间：2018-01-11 16:13

本文关键词：针刺结合低频重复经颅磁刺激（LF-rTMS）治疗脑卒中后上肢功能障碍的临床研究　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的观察针刺配合低频重复经颅磁刺激(LF-rTMS)对脑卒中后上肢运动功能障碍的影响。方法采用随机数字表法将脑卒中后上肢运动功能障碍的患者分为联合组(n=20)和rTMS组(n=20)以及针刺组(n=20)。针刺组给予针刺配合常规康复治疗,rTMS组给予常规康复和LF-rTMS治疗,联合组在针刺组治疗的基础上辅以LF-rTMS治疗,刺激部位为健侧半球的M1区(大脑运动皮质的上肢运动功能代表区),刺激频率为1.0Hz。于治疗前、治疗4周后采用简易Fugl-Meyer运动功能量表(FMA)(上肢部分)、Wolf运动功能测试量表(WMFT)评分评价疗效。结果rTMS组治疗前后FMA评分和WMFT评分:(4.65±1.66)分、(7.45±2.63)分和(0.85±1.57)分、(10.05±4.02)分,针刺组治疗前后FMA评分和WMFT评分:(4.45±0.89)分、(5.80±1.74)分和(0.6±1.23)分、(6.75±2.07)分,联合组治疗前后FMA评分和WMFT评分:(4.60±0.75)分、(13.55±2.56)分和(0.95±2.06)分、(8.95±3.90)分。3组治疗前后FMA评分和WMFT评分均有提高,差异均具有统计学意义(P0.05);组间对比发现,治疗后,rTMS组WMFT评分优于针刺组,FMA评分优于针刺组;rTMS组和联合组Wolf量表评分均明显优于对照组(P0.05),组间差异具均有统计学意义(P0.05)。结论针刺配合1Hz重复经颅磁刺激(rTMS)可显著促进脑卒中后偏瘫上肢运动功能的恢复。
[Abstract]:Objective to observe the combination of acupuncture and low frequency repetitive transcranial magnetic stimulation (LF-rTIMT). Methods the patients with upper limb motor dysfunction after stroke were randomly divided into two groups: combined group (n = 20) and rTMS group (n = 20). The acupuncture group was given acupuncture combined with routine rehabilitation therapy. RTMS group was treated with routine rehabilitation and LF-rTMS, and the combined group was treated with LF-rTMS on the basis of acupuncture group. The stimulation site was M1 in the healthy hemisphere (the motor function of the upper extremity of the motor cortex represented by the region of motor function) and the stimulation frequency was 1.0 Hz before treatment. After 4 weeks of treatment, a simple Fugl-Meyer motor function scale (upper limb part) was used. Results FMA score and WMFT score of rTMS group were 4.65 卤1.66 before and after treatment. 7.45 卤2.63) and 0.85 卤1.57) and 10.05 卤4.02 respectively. Before and after treatment, the FMA score and WMFT score of the acupuncture group were 4.45 卤0.89 and 5.80 卤1.74 and 0.6 卤1.23 respectively. The scores of FMA and WMFT before and after treatment were 6.75 卤2.07 and 4.60 卤0.75 respectively. The scores of FMA and WMFT were improved before and after treatment in group A (13.55 卤2.56) and 0.95 卤2.06 (8.95 卤3.90) before and after treatment. The difference was statistically significant (P 0.05). The comparison between groups showed that the WMFT score of rTMS group was better than that of acupuncture group after treatment. The scores of Wolf in rTMS group and combined group were significantly better than those in control group (P 0.05). Conclusion Acupuncture combined with 1 Hz repetitive transcranial magnetic stimulation can significantly promote the recovery of motor function in the upper limb of hemiplegia after stroke.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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