谢浩源,陈军.外周与中枢重复经颅磁刺激治疗功能性便秘的疗效对比[J].中华物理医学与康复杂志,2025,47(2):123-126
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| 外周与中枢重复经颅磁刺激治疗功能性便秘的疗效对比 |
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| DOI：10.3760/cma.j.cn421666-20240417-00286 |
| 中文关键词: 功能性便秘 重复经颅磁刺激 乳果糖 |
| 英文关键词: Constipation Transcranial magnetic stimulation Peripheral magnetic stimulation Lactulose |
| 基金项目:陕西省自然科学基础研究计划项目（2023-JC-YB-663）；陕西省教育厅重点科研计划项目（21JS018） |
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| 中文摘要: |
| 目的 观察外周与中枢重复经颅磁刺激（rTMS）治疗功能性便秘的疗效。 方法 采用随机数字表法将60例功能性便秘患者分为对照组、外周组和中枢组，每组20例。对照组患者给予乳果糖药物口服，外周组患者在此基础上辅以骶部（S2～4）高频rTMS治疗，中枢组患者在对照组基础上辅以右侧前额叶背外侧皮质区低频rTMS治疗。治疗前和治疗3周后（治疗后），采用平均每周自发完全排便（SCBM）次数、便秘主要症状评分、便秘患者症状自评量表（PAC-SYM）对3组患者开展评估。治疗后，对3组患者的临床疗效进行比较。 结果 与组内治疗前比较，3组患者治疗后平均每周SCBM次数、便秘主要症状评分、PAC-SYM评分均有所改善（P＜0.05）。与对照组比较，外周组治疗后平均每周SCBM次数［（3.27±0.28）次］较多、便秘主要症状评分［（2.54±0.26）分］较低、PAC-SYM评分［（10.78±1.14）分］较低（P＜0.05），中枢组治疗后平均每周SCBM次数［（3.45±0.25）次］亦较多、便秘主要症状评分［（2.32±0.35）分］较低、PAC-SYM评分［（10.56±1.42）分］较低（P＜0.05）。外周组和中枢组治疗后上述指标比较，差异均无统计学意义（P＞0.05）。治疗后，外周组和中枢组的治疗总有效率分别为90.00%和95.00%，临床疗效较对照组好（P＜0.05）。 结论 外周高频rTMS与中枢低频rTMS均能有效改善功能性便秘患者的便秘症状，其疗效较单一的乳果糖药物治疗效果好。 |
| 英文摘要: |
| Objective To compare the efficacy of peripheral and central transcranial magnetic stimulation (rTMS) in the treatment of functional constipation. Methods Sixty patients with functional constipation were randomly divided into a control group, a peripheral group and a central group, each of 20. All were given oral lactulose medication, while the peripheral groups was additionally provided with high-frequency repetitive magnetic stimulation (rMS) treatment in the sacral region (S2-4) and the central group received low-frequency rTMS treatment in the right dorsal prefrontal cortex. Before and after 3 weeks of treatment, all were evaluated in terms of the average weekly frequency of spontaneous complete bowel movements (SCBM), major constipation symptom scoring, and using the Constipation Patient Symptom Self Rating Scale (PAC-SYM). Results After the treatment, all of the indicators had improved significantly in all three groups, but all were better in the peripheral and central groups than in the control group, on average. The peripheral group and the central group averages were not significantly different after the treatment. The total effectiveness rates in the peripheral and central groups both exceeded 90%, significantly better than among the control group. Conclusions Both peripheral high-frequency rTMS and central low-frequency rTMS can effectively supplement lactulose drug treatment in relieving the symptoms of constipation. |
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