重复经颅磁刺激对脊髓损伤后神经性疼痛及大脑皮质兴奋性的影响

发布时间：2018-03-22 17:21

本文选题：重复经颅磁刺激　切入点：脊髓损伤　出处：《中国康复医学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的:观察重复经颅磁刺激(rTMS)对脊髓损伤后神经性疼痛(NP)的治疗效果及其对脊髓损伤后大脑皮质兴奋性的影响。方法:本研究选取在我科住院治疗的不完全性脊髓损伤后神经性疼痛患者共32例,用随机数字表法将32例患者分为实验组和对照组,试验组(n=17)给予常规物理治疗及右侧大脑M1区rTMS治疗,对照组(n=15)给予常规物理治疗及右侧大脑M1区假刺激。两组治疗均为每天1次,每周6天,连续治疗4周。于治疗前、治疗4周后对两组患者进行视觉模拟评分(VAS)测试,并对右侧大脑半球的静息运动阈值(RMT)、运动诱发电位(MEP)进行测试及分析。结果:治疗4周后,试验组VAS评分降低,RMT波幅降低、MEP波幅增高,与对照组比较有显著性差异(P0.05)。结论:rTMS能有效缓解脊髓损伤后神经性疼痛,其机制可能与大脑皮质兴奋性改变相关。
[Abstract]:Objective: to observe the therapeutic effect of repetitive transcranial magnetic stimulation (RTMS) on neuropathic pain after spinal cord injury (NPN) and its effect on the excitability of cerebral cortex after spinal cord injury. There were 32 cases of neuropathic pain after medullary injury. 32 patients were randomly divided into experimental group and control group. The experimental group was treated with routine physical therapy and the right M1 region of the brain was treated with rTMS. The control group was treated with routine physical therapy and false stimulation in M1 region of the right brain. The two groups were treated once a day, 6 days a week for 4 weeks. Before and after 4 weeks of treatment, the visual analogue scores (VASs) were measured in both groups. The resting exercise threshold (RMT) and motor evoked potential (MEP) of the right hemisphere were measured and analyzed. Results: after 4 weeks of treatment, the VAS score decreased and the amplitude of VAS decreased and the amplitude of MEP increased in the experimental group. Compared with the control group, there was a significant difference between the two groups (P0.050.Conclusion: RTMS can effectively relieve the neuralgia after spinal cord injury, and its mechanism may be related to the changes of cerebral cortex excitability.
【作者单位】：第四军医大学西京医院康复理疗科;南方医科大学深圳医院康复医学科;
【基金】：陕西省国际科技合作与交流计划项目(2015KW-035) 国家国际合作项目(2013DFA32610)
【分类号】：R651.2

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