【摘要】 目的探索成对关联刺激(PAS)与重复经颅磁刺激技术(rTMS)治疗脑卒中患者的效果及对肢体功能、运动诱发电位的影响。方法选取2018-03—2019-06于焦作市人民医院神经内科治疗的脑卒中患者60例进行研究,按照单双号法随机分为对照组和研究组,每组30例。在常规治疗的实施下,对照组采用rTMS,研究组采用成对关联刺激,比较2组患者临床疗效、肢体功能评分及运动诱发电位变化。结果治疗4周后,研究组治疗有效率为90.00%,高于对照组80.00%,但2组对比差异无统计学意义(P>0.05);2组患者治疗2、4周后的NIHSS评分均显著降低(P<0.05),且治疗后同时间节点研究组与对照组差异显著(P<0.05);研究组治疗2周、4周后上肢功能评分(FM)显著高于对照组(P<0.05),下肢功能FM评分仅治疗4周后显著高于对照组(P<0.05);治疗4周后,研究组基本生活能力评分(MBI)显著高于对照组(P<0.05);治疗4周后,2组患者MEP潜伏期、中枢运动传导时间较治疗前明显降低而MEP波幅明显升高(P<0.05),且研究组治疗后的MEP潜伏期显著小于对照组而MEP波幅显著大于对照组(P<0.05)。结论成对关联刺激与rTMS治疗脑卒中均能达到一定的临床疗效,其中成对关联刺激疗法治疗有效率较高,能明显改善患者肢体功能和运动诱发电位,值得推广应用。更多还原

【Abstract】 Objective To explore the effects of pairedassociativestimulation(PAS) and repetitive transcranial magnetic stimulation(rTMS) in the treatment of stroke patients and their influence on limb function and motor evoked potentials.Methods Sixty patients with stroke who were treated in our hospital from March 2018 to June 2019 were enrolled in the study.They were randomly divided into control group and study group according to the single and double numbers method,with 30 cases in each group.Under the implementation of conventional treatment,control group was treated with rTMS,and study group was treated with paired associative stimulation.The clinical efficacy,limb function score and motor evoked potentials were compared between the two groups.Results The effective rate of treatment in study group was higher than that in control group(P>0.05)(90.00% vs 80.00%).The NIHSS scores in the two groups were significantly decreased after 2 and 4 weeks of treatment(P<0.05),and there was a significant difference at the same time point after treatment between study group and control group(P<0.05).The upper limb function score(FM) in study group was significantly higher than that in control group after 2 weeks and 4 weeks of treatment(P<0.05),and the lower limb function FM score was only significantly higher than that in control group after 4 weeks of treatment(P<0.05).After 4 weeks of treatment,the basic living ability score(MBI) in study group was significantly higher than that in control group(P<0.05).After 4 weeks of treatment,the motor evoked potential latency and central motor conduction time in the two groups were significantly decreased compared with those before treatment while the amplitude was significantly increased(P<0.05),and the latency in study group after treatment was significantly lower than that in control group while the amplitude was significantly higher than that in control group(P<0.05).Conclusion Paired associative stimulation and rTMS can achieve certain clinical efficacy in the treatment of stroke.Paired associative stimulation therapy has high effective rate of treatment,and can significantly improve the limb function and motor evoked potentials of patients,thus it is worthy of popularization and application.更多还原