脑卒中致下肢运动功能障碍患者应用持续重复经颅磁刺激联合头针的疗效观察

Observation on the therapeutic effect of continuous repetitive transcranial magnetic stimulation (rTMS) combined with scalp acupuncture in patients with lower extremity motor dysfunction caused by stroke

摘要:

目的 分析脑卒中致下肢运动功能障碍患者应用持续重复经颅磁刺激（rTMS）联合头针的疗效。方法 选取2022年11月—2024年8月马鞍山十七冶医院康复科收治的79例脑卒中致下肢运动功能障碍患者，按治疗方法不同分为对照组（38例）与观察组（41例），患者均予以降压、降脂、降糖、营养脑细胞、改善微循环等对症治疗及运动康复训练。在该基础上，对照组采取rTMS治疗，观察组采取rTMS联合头针治疗。两组均治疗4周后，比较治疗效果。结果 观察组的有效率高于对照组（P <0.05）。观察组治疗前后Berg平衡量表评分、计时起立-行走测试评分差值均大于对照组（P <0.05）。观察组治疗前后Fugl-Meyer下肢运动功能评定量表评分差值大于对照组（P <0.05）。观察组治疗前后10 m行走时间差值、脑卒中专用生活质量量表评分差值均大于对照组（P <0.05）。观察组与对照组治疗不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 脑卒中致下肢运动功能障碍患者采取rTMS联合头针疗效显著，可有效提高患者平衡能力，提高下肢运动功能，增加行走时间，促进患者神经功能恢复，不增加不良反应。

Abstract:

Objective To analyze the therapeutic effect of continuous repetitive transcranial magnetic stimulation (rTMS) combined with scalp acupuncture in patients with lower extremity motor dysfunction caused by stroke.Methods A total of 79 patients with lower extremity motor dysfunction caused by stroke admitted to the Department of Rehabilitation, Maanshan 17th Metallurgical Hospital from November 2022 to August 2024 were selected and divided into a control group (38 cases) and an observation group (41 cases) according to different treatment methods. Both groups were given symptomatic treatments such as lowering blood pressure, lipid-lowering, hypoglycemic, nourishing brain cells, improving microcirculation, and exercise rehabilitation training. On this basis, the control group was treated with rTMS, and the observation group was treated with rTMS combined with scalp acupuncture. Both groups were treated for 4 weeks, and the therapeutic effects of the two groups were compared.Results The effective rate of the observation group was higher than that of the control group (P < 0.05). The differences in Berg Balance Scale (BBS) scores and Timed Up and Go Test (TUGT) scores before and after treatment in the observation group were both larger than those in the control group (P < 0.05). The difference in Fugl-Meyer Assessment (FMA) Lower Extremity Motor Function Scale scores before and after treatment in the observation group was larger than that in the control group (P < 0.05). The differences in 10-meter walking time and Stroke-Specific Quality of Life Scale (SS-QOL) scores before and after treatment in the observation group were both larger than those in the control group (P < 0.05). There was no statistically significant difference in the total incidence of adverse reactions during treatment between the observation group and the control group (P > 0.05).Conclusion For patients with lower extremity motor dysfunction caused by stroke, rTMS combined with scalp acupuncture has a significant therapeutic effect. It can effectively improve the patients' balance ability, enhance lower extremity motor function, increase walking time, promote the recovery of patients' neurological function, and does not increase adverse reactions.