| 浦创,梁凡,杨小玥,徐亚,钱虹.不同频率和刺激部位的重复经颅磁刺激治疗脑卒中后运动性失语的临床研究[J].中国康复,2025,40(7):412-417 |
| 不同频率和刺激部位的重复经颅磁刺激治疗脑卒中后运动性失语的临床研究 |
| Clinical study on the treatment of post-stroke motor aphasia with different frequency repetitive transcranial magnetic stimulation |
| |
| DOI：10.3870/zgkf.2025.07.006 |
| 中文关键词: 频率 刺激 重复经颅磁刺激 脑卒中 运动性失语 |
| 英文关键词: frequency stimulation repetitive transcranial magnetic stimulation stroke motor aphasia |
| 基金项目:四川省卫生健康科研课题（19SYJS02） |
|
| 摘要点击次数: 99 |
| 全文下载次数: 56 |
| 中文摘要: |
| 目的：观察不同频率和刺激部位的重复经颅磁刺激（rTMS）治疗脑卒中后运动性失语（PSBA）的疗效。方法：选择本院收治的轻、中度PSBA患者99例为研究对象，随机分为高频组、低频组和双刺激组。高频组采用10Hz的rTMS刺激左侧Broca区，低频组采用1Hz的rTMS刺激右侧Broca镜像区，双刺激组先采用1Hz低频刺激右侧Broca镜像区，间隔20min后再使用10Hz高频rTMS刺激左侧Broca区，3组均干预8周。干预前后分别采用波士顿诊断性失语症测评分级（BDAE）、中国功能性语言沟通能力检査法评分（CFCP）、嗓音障碍指数（VHI）、脑卒中和失语症生活质量量表(SAQOL-39)对患者进行评估，采集外周血以酶联免疫吸附试验(ELISA）检测神经元特异性烯醇化酶（NSE）、脑源性神经营养因子（BDNF）水平，并评估临床疗效。结果：干预8周后，3组BDAE分级均优于干预前（P＜0.05），双刺激组优于高频组和低频组（P＜0.05）；3组CFCP评分均高于干预前（P＜0.05），双刺激组CFCP评分高于其余2组（P＜0.05），VHI均低于干预前（P＜0.05），双刺激组低于低频组（P＜0.05）；在SAQOL-39评分方面，心理维度仅双刺激组评分高于干预前（P＜0.05），沟通维度和生理维度评分3组均高于干预前（P＜0.05），且双刺激组在沟通维度和生理维度均高于其余2组（P＜0.05）；双刺激组和高频组外周血BDNF高于干预前（P＜0.05），双刺激组高于低频组（P＜0.05）；3组外周血NSE水平均低于干预前（P＜0.05），双刺激组NSE水平低于其余2组（P＜0.05）；在临床疗效方面，双刺激组总有效率高于高频组和低频组（P<0.05）。结论：就轻、中度PSBA而言，高频rTMS刺激左侧与低频rTMS刺激右侧的效果相当，而两者联合干预能够起到增强疗效的作用。 |
| 英文摘要: |
| Objective: To observe the differences in the treatment of post-stroke motor aphasia with repeated transcranial magnetic stimulation (rTMS) at different frequencies and stimulation sites. Methods: A total of 99 patients with post-stroke motor aphasia admitted to our hospital were selected as the research subjects and randomly divided into high-frequency group, low-frequency group, and dual stimulation group,with 33 patients in each group. The high-frequency group was stimulated with 10 Hz rTMS to stimulate the left Broca area, and the low-frequency group was stimulated with 1Hz rTMS to stimulate the right Broca mirror area. The dual stimulation group was first given 1 Hz low-frequency stimulation to stimulate the right Broca mirror area, and then received 10 Hz high-frequency stimulation to stimulate the left Broca area every 20 min. All three groups were intervened for 8 weeks. The Boston diagnostic aphasia rating scale (BDAE), Chinese functional communicative competence test (CFCP) score, voice disorder index (VHI), stroke and aphasia quality of life scale (SAQOL-39), as well as the levels of neuron specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) were observed before and after treatment, and the clinical efficacy was evaluated. Results: After 8 weeks of intervention, the BDAE grading of all three groups was better than before intervention (P<0.05). The dual stimulation group was superior to both the high-frequency and low-frequency groups (P<0.05). After 8 weeks of intervention, the CFCP in all three groups was higher than before stimulation (P<0.05), and the VHI was lower than before stimulation (P<0.05). The dual stimulation group had a higher CFCP than the other two groups (P<0.05). The VHI score in the double stimulation group was lower than in the low-frequency group (P<0.05). After 8 weeks of intervention, except for the low-frequency group, the remaining groups had higher levels of BDNF and lower levels of NSE than before stimula-tion (P<0.05). The double stimulation group had lower NSE levels than the other two groups (P<0.05). The level of BDNF in the dual stimulation group was higher than the low-frequency group (P<0.05). After 8 weeks of intervention, except for the psychological dimensions of the low-frequency and high-frequency groups, the scores of the other three groups in all three dimensions of SAQOL-39 were higher than before stimulation (P<0.05). Inter group comparison showed that the dual stimulation group had higher communication and physiological dimensions than the other two groups (P<0.05). In terms of clinical efficacy, the total effective rate of the dual stimulation group was 96.97%, which was significantly higher than the high frequency group and the low frequency group (P<0.05). Conclusion: By comparing the intervention of rTMS on mild and moderate post-stroke motor aphasia with different frequencies and stimulation sites, it was found that the effect of high-frequency rTMS on the left side was equivalent to that of low-frequency rTMS on the right side, and the combined stimulation of the two could enhance the therapeutic effect. |
|
查看全文
下载PDF阅读器 HTML全文 |
| 关闭 |
|
|
|
