摘要
目的探讨经颅直流电刺激(tDCS)对脑卒中后肌张力增高康复疗效及脑网络机制研究。方法选取40例脑卒中偏瘫患者作为本次研究对象,按照随机数字表法分为研究组(n=20)和对照组(n=20),对照组给予常规康复治疗,研究组给予常规康复治疗+tDCS治疗,治疗4周后对比两组治疗效果,根据改良Ashworth痉挛量表(MAS)、Fugl-Meyer运动功能评分量表(FMA)、日常生活能力表Barthel指数(BI)、功能性磁共振成像(fMRI)检查评估患者治疗情况并分析该治疗方案对患者脑网络机制的治疗情况。结果研究组总有效率优于对照组(χ^(2)=5.63,P<0.05)。治疗前两组患者上肢和下肢FMA评分、BI评分比较,差异均无统计学意义(t分别=0.70、1.13、0.12,P均>0.05),治疗4周后,研究组患者上肢和下肢FMA评分、BI评分高于对照组,差异均有统计学意义(t分别=11.38、35.46、2.73,P均<0.05)。结论脑卒中后肌张力增高患者行tDCS能明显降低患者肢体肌张力,改善运动功能,提高日常生活能力,还可改善脑卒中后肌张力增高的部分脑网络机制。
Objective To investigate the rehabilitation effect of transcranial direct current stimulation(tDCS)on in⁃creased muscle tone after stroke and the mechanism of brain network.Methods Totally 40 stroke hemiplegic patients were selected as the research objects.They were randomly divided into research group(n=20)and control group(n=20).The control group was received routine rehabilitation treatment,and the research group was received routine rehabilitation and tDCS treatment.After 4 weeks of treatement,the treatement effects of the two groups were compared.The clinical ef⁃fect of patients was evaluated according to the modified Ashworth spasm scale(MAS),Fugl Meyer assessment(FMA),Barthel index(BI)and fMRI,and the intervention of the treatment scheme on the mechanism of brain network was ana⁃lyzed.Results The total effective rate of the research group was better than that of the control group(χ^(2)=5.63,P<0.05).There was no significant difference in FMA scores of upper and lower limbs and BI score between the two groups before the treatement(t=0.70,1.13,0.12,P>0.05).After 4 weeks of treatement,the FMA scale and BI score of the patients in the research group were higher than those in the control group,and the difference was statistically significant(t=11.38,35.46,2.73,P<0.05).Conclusion tDCS in patients with increased muscle tone after stroke can significantly reduce the limb muscle tone,improve motor function and improve the ability of daily living.In addition,it can also im⁃prove some brain network mechanisms of increased muscle tone after stroke,which has positive significance in clinical treatment.
作者
赵娇阳
施鸣飞
范文天
陈碧华
金丽丽
ZHAO Jiaoyang;SHI Mingfei;FAN Wentian(Department of Rehabilitation Medicine,People's Hospital of Tiantai County,Zhejiang Province,Tiantai 317200,China)
出处
《全科医学临床与教育》
2023年第5期407-409,F0002,共4页
Clinical Education of General Practice
基金
浙江省医药卫生科技计划项目(2019KY796)。
关键词
经颅直流电刺激
脑卒中
肌张力增高
康复疗效
脑网络
机制
transcranial direct current stimulation
stroke
increased muscle tone
rehabilitation effect
brain network
mechanism
