郑婵娟,夏文广,段璨,等.重复经颅磁刺激联合多奈哌齐治疗卒中后认知功能障碍的疗效观察[J].中华物理医学与康复杂志,2020,42(1):32-36
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| 重复经颅磁刺激联合多奈哌齐治疗卒中后认知功能障碍的疗效观察 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2020.01.008 |
| 中文关键词: 卒中后认知障碍 重复经颅磁刺激 多奈哌齐 |
| 英文关键词: Stroke Cognitive impairment Transcranial magnetic stimulation Donepezil |
| 基金项目:重大疑难疾病中西医临床协作试点项目（SATCM-20180339）；湖北省卫健委面上项目（WJ2019M245） |
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| 中文摘要: |
| 目的 探讨重复经颅磁刺激（rTMS）联合多奈哌齐对卒中后认知障碍（PSCI）患者认知功能及日常生活活动（ADL）能力的影响。 方法 采用随机数字表法将106例PSCI患者分为观察组及对照组，观察组患者给予rTMS+多奈哌齐治疗，对照组患者给予假磁刺激+多奈哌齐治疗，每天治疗1次，每周治疗5 d，连续治疗4周。于治疗前、治疗4周后分别采用蒙特利尔认知评估量表（MoCA）、行为记忆量表（RBMT）及改良Barthel指数（MBI）量表对2组患者认知功能、记忆能力及ADL能力进行评定，同时采用肌电诱发电位仪检测2组患者听觉事件诱发电位P300潜伏期及波幅。 结果 治疗后2组患者MoCA、RBMT、MBI评分、P300潜伏期及波幅均较治疗前有不同程度改善（P<0.01）；通过进一步组间比较发现，治疗后观察组MoCA总分［（23.13±3.23）分］、RBMT评分［（17.15±3.08）分］、MBI评分［（72.3±13.6）分］及P300潜伏期［（346.60±14.54）ms］、波幅［（7.19±0.53）μV］均显著优于对照组水平，组间差异均具有统计学意义（P＜0.05）。 结论 rTMS联合多奈哌齐能进一步改善PSCI患者认知功能及ADL能力，该联合疗法值得临床推广、应用。 |
| 英文摘要: |
| Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) combined with donepezil on the cognition of persons with post-stroke cognitive impairment (PSCI) and their ability to perform activities of daily living (ADL). Methods A total of 106 PSCI patients were randomly divided into an observation group and a control group using a random number table. Those in the observation group received 10Hz rTMS (5 seconds on and 25 seconds off for 20 minutes daily) and donepezil daily, 5 days per week for 4 weeks, while those in the control group were provided with donepezil but only sham rTMS on the same schedule. Before and after 4 weeks of treatment, the Montreal cognitive assessment scale (MoCA), the Rivermead behavior memory test (RBMT) and the modified Barthel index (MBI) were used to evaluate the subjects′ cognitive functioning, memory capacity and ADL ability. The latency and amplitude of auditory event-related potential P300 were also assessed using a myoelectric evoked potential apparatus. Results After the treatment, improvement was observed in all the measurements of both groups. After the treatment, the average MoCA, RBMT and MBI scores, as well as the latency and amplitude of P300 in the observation group were all significantly better than among the control group. Conclusions rTMS can supplement donepezil′s ability to improve the cognition and ADL ability of persons with PSCI. Such therapy is worthy of clinical promotion and application. |
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