中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2015年
5期
361-364
,共4页
重复经颅磁刺激%脑卒中后抑郁%睡眠障碍%日常生活活动能力
重複經顱磁刺激%腦卒中後抑鬱%睡眠障礙%日常生活活動能力
중복경로자자격%뇌졸중후억욱%수면장애%일상생활활동능력
Repetitive transcranial magnetic stimulation%Post-stroke depression%Sleep disorder%Activities of daily living
目的 探讨重复经颅磁刺激(rTMS)对脑卒中后抑郁(PSD)患者抑郁情绪、睡眠障碍及日常生活活动(ADL)能力的影响.方法 选取PSD患者90例,按随机数字表法将其分为对照组、治疗组和联合治疗组,每组30例.3组患者均给予基础治疗及综合康复训练,对照组在此基础上给予艾司西酞普兰治疗,治疗组给予rTMS治疗,联合治疗组在对照组基础上辅以rTMS治疗,疗程8周.治疗前及治疗8周后(治疗后),采用汉密尔顿抑郁量表(HAMD)、匹斯堡睡眠质量指数量表(PSQI)、中国脑卒中量表(CSS)及改良Barthel指数(MBI)对患者的抑郁情绪、睡眠质量、神经功能缺损情况及ADL能力进行评定.结果 治疗前,3组患者HAMD、CSS、PSQI、MBI评分之间比较.差异无统计学意义(P＞0.05).治疗8周后(治疗后),3组患者HAMD评分、PSQI评分、CSS评分均较治疗前明显下降(P＜0.05),MBI评分较治疗前明显增高(P＜0.05).与对照组治疗后比较,治疗组及联合治疗组治疗后HAMD、CSS、PSQI、MBI评分均无显著变化,差异无统计学意义(P＞0.05).与联合治疗组治疗后比较,治疗组治疗后HAMD[(9.76±4.59)分]、CSS[(7.65±2.35)分]、PSQI[(16.13 ±4.12)分]、MBI评分[(52.6l±9.26)分]无显著变化,差异无统计学意义(P＞0.05).结论 rTMS可显著改善PSD患者的抑郁症状、睡眠障碍及神经功能缺损状况,有效提高其ADL能力.
目的 探討重複經顱磁刺激(rTMS)對腦卒中後抑鬱(PSD)患者抑鬱情緒、睡眠障礙及日常生活活動(ADL)能力的影響.方法 選取PSD患者90例,按隨機數字錶法將其分為對照組、治療組和聯閤治療組,每組30例.3組患者均給予基礎治療及綜閤康複訓練,對照組在此基礎上給予艾司西酞普蘭治療,治療組給予rTMS治療,聯閤治療組在對照組基礎上輔以rTMS治療,療程8週.治療前及治療8週後(治療後),採用漢密爾頓抑鬱量錶(HAMD)、匹斯堡睡眠質量指數量錶(PSQI)、中國腦卒中量錶(CSS)及改良Barthel指數(MBI)對患者的抑鬱情緒、睡眠質量、神經功能缺損情況及ADL能力進行評定.結果 治療前,3組患者HAMD、CSS、PSQI、MBI評分之間比較.差異無統計學意義(P＞0.05).治療8週後(治療後),3組患者HAMD評分、PSQI評分、CSS評分均較治療前明顯下降(P＜0.05),MBI評分較治療前明顯增高(P＜0.05).與對照組治療後比較,治療組及聯閤治療組治療後HAMD、CSS、PSQI、MBI評分均無顯著變化,差異無統計學意義(P＞0.05).與聯閤治療組治療後比較,治療組治療後HAMD[(9.76±4.59)分]、CSS[(7.65±2.35)分]、PSQI[(16.13 ±4.12)分]、MBI評分[(52.6l±9.26)分]無顯著變化,差異無統計學意義(P＞0.05).結論 rTMS可顯著改善PSD患者的抑鬱癥狀、睡眠障礙及神經功能缺損狀況,有效提高其ADL能力.
목적 탐토중복경로자자격(rTMS)대뇌졸중후억욱(PSD)환자억욱정서、수면장애급일상생활활동(ADL)능력적영향.방법 선취PSD환자90례,안수궤수자표법장기분위대조조、치료조화연합치료조,매조30례.3조환자균급여기출치료급종합강복훈련,대조조재차기출상급여애사서태보란치료,치료조급여rTMS치료,연합치료조재대조조기출상보이rTMS치료,료정8주.치료전급치료8주후(치료후),채용한밀이돈억욱량표(HAMD)、필사보수면질량지수량표(PSQI)、중국뇌졸중량표(CSS)급개량Barthel지수(MBI)대환자적억욱정서、수면질량、신경공능결손정황급ADL능력진행평정.결과 치료전,3조환자HAMD、CSS、PSQI、MBI평분지간비교.차이무통계학의의(P＞0.05).치료8주후(치료후),3조환자HAMD평분、PSQI평분、CSS평분균교치료전명현하강(P＜0.05),MBI평분교치료전명현증고(P＜0.05).여대조조치료후비교,치료조급연합치료조치료후HAMD、CSS、PSQI、MBI평분균무현저변화,차이무통계학의의(P＞0.05).여연합치료조치료후비교,치료조치료후HAMD[(9.76±4.59)분]、CSS[(7.65±2.35)분]、PSQI[(16.13 ±4.12)분]、MBI평분[(52.6l±9.26)분]무현저변화,차이무통계학의의(P＞0.05).결론 rTMS가현저개선PSD환자적억욱증상、수면장애급신경공능결손상황,유효제고기ADL능력.
Objective To explore the effects of repetitive transcraninal magnetic stimulation (rTMS) on depression,sleep disorder and activities of daily life (ADL) in post-stroke depression (PSD) patients.Methods A total of 90 PSD patients were divided into a control group,a treatment group and a combined treatment group according to a random number table,30 cases in each group.All patients were given basic treatment and comprehensive rehabilitation training.Moreover,the control group was additionally received escitalopram treatment,the treatment group rTMS treatment,the combined treatment group the above both,lasting 8 weeks.Before and after the treatment,the Hamilton depression (HAMD) scale,the Pittsburgh sleep quality index (PQSI),the Chinese stroke scale (CSS) and the modified Barthel index (MBI) were employed to evaluate depression,quality of sleep,neurological impairment and the activities of daily living (ADL) of patients in three groups.Results Before treatment,there was no significant difference in the HAMD,CSS,PSQI and MBI score among the 3 groups.After 8 weeks' treatment,the HAMD,PSQI and CSS scores of three groups had significantly decreased,but their MBI scores had significantly increased.Compared with the control group,no significant differences were observed in HAMD,CSS,PSQI and MBI scores of the treatment group and the combined treatment group (P ＞ 0.05).After treatment,there was no significant difference in the above four values between the combined treatment group,and the treatment group.Conclusion The rTMS can significantly improve PSD patient's depressive symptoms,relieve sleep disorders and neurological deficit situation,and effectively improve their ADL.
