经颅磁刺激结合蜡疗对脑卒中肢体痉挛患者运动功能的影响

Effect of transcranial magnetic stimulation combined with wax therapy on motor function of stroke patients with limb spasticity

摘要:

目的 探究经颅磁刺激（TMS）结合蜡疗在改善脑卒中后肢体痉挛患者的运动功能的效果。方法 本研究共纳入2021年1月—2024年1月在常州市武进中医医院80例脑卒中后肢体痉挛患者，按随机数字表法随机分为对照组和实验组，每组40例。对照组仅接受常规康复治疗，而实验组在此基础上增加TMS和蜡疗。治疗周期为8周，5次/周。比较两组康复疗效、中医症状评分。通过改良Ashworth痉挛量表（MAS）评定痉挛程度，单腿站立支撑时间（SLWT）评估单腿负重能力，Fugl-Meyer评定量表（FMA）评定肢体功能，美国国立卫生研究院卒中量表（NIHSS）评定神经功能，精细运动功能评估量表（FMFM）评估运动功能。结果 实验组总有效率高于对照组（P <0.05）。实验组干预前后MAS、NIHSS、FMA评分的差值均高于对照组（P <0.05）。实验组干预前后中医症状评分（乏力、麻木、走路不稳）的差值均高于对照组（P <0.05）。实验组干预前后FMFM评分（B区、C区、D区、E区、总分）的差值均高于对照组（P <0.05）。实验组干预前后SLWT、膝关节和髋关节屈曲伸展活动度的差值均高于对照组（P <0.05）。结论 TMS结合蜡疗对脑卒中后肢体痉挛患者的运动功能恢复有显著促进作用，可以作为常规康复治疗的有效补充。

Abstract:

Objective To investigate the effects of transcranial magnetic stimulation (TMS) combined with wax therapy on improving motor function of stroke patients with limb spasticity.Methods This study included 80 cases of patients with limb spasticity following strokes at Wujin Hospital of Traditional Chinese Medicine from January 2021 to January 2024. They were randomly divided into the control group and the experimental group by the random number table method, each with 40 participants. The control group received standard rehabilitation treatments, while the experimental group additionally received TMS and wax therapy. Treatments were administered five times a week over a period of eight weeks. The rehabilitation effect and traditional Chinese medicine symptom scores were compared between the two groups. The spasticity was assessed via the modified Ashworth scale (MAS), the single-leg weight-bearing capacity via single-leg weight-bearing time (SLWT), the limb function via Fugl-Meyer Assessment (FMA), the neurological function via National Institutes of Health Stroke Scale (NIHSS), and the motor function via Fine Motor Function Measure (FMFM).Results The overall effective rate of the experimental group was higher than that of the control group (P < 0.05). The differences in MAS, NIHSS and FMA scores before and after intervention in the experimental group were greater than those in the control group (P < 0.05). The differences in traditional Chinese medicine symptom scores (fatigue, numbness, and unsteady walking) before and after intervention in the experimental group were greater than those in the control group (P < 0.05). The differences in FMFM scores (B, C, D, E subitem scores and total scores) before and after intervention in the experimental group were higher than those in the control group (P < 0.05). The differences in SLWT and the range of motion for flexion and extension of the knee joint and the hip joint before and after intervention in the experimental group were higher than those in the control group (P < 0.05).Conclusions Combining TMS with wax therapy significantly enhances the recovery of motor function in stroke patients with limb spasticity, and can serve as an effective complement to conventional rehabilitation treatment.