神经损伤与功能重建
神經損傷與功能重建
신경손상여공능중건
Neural Injury and Functional Reconstruction
2015年
5期
411-413
,共3页
低频%重复经颅磁刺激%卒中后抑郁%认知功能%生活能力
低頻%重複經顱磁刺激%卒中後抑鬱%認知功能%生活能力
저빈%중복경로자자격%졸중후억욱%인지공능%생활능력
low frequency%repetitive transcranial magnetic stimulation%post stroke depression%cognitive func-tion%life ability
目的：探讨低频重复经颅磁刺激（rTMS）治疗对卒中后抑郁（PSD）患者认知和日常生活能力的影响。方法：PSD 伴轻度认知障碍患者128例随机分为对照组和 r-TMS 组，各64例。对照组给予常规药物治疗及早期肢体功能康复、心理疏导和抗抑郁治疗；r-TMS 组在对照组治疗基础上加用低频 r-TMS 治疗。疗程均为8周。分别于治疗前和治疗后4、8周，采用汉密顿抑郁量表（HAMD）-17评定患者抑郁程度，简易精神状态检查量表（MMSE）评定患者认知功能，巴塞尔指数（BI）评定患者的日常生活能力。结果：治疗前2组患者 HAMD、MMSE 评分及 BI 差异无统计学差异（P＞0.05）；治疗后2组 HAMD 评分均低于治疗前，MMSE 评分及 BI 指数高于治疗前（P＜0.05），r-TMS 组改善程度优于对照组（P＜0.05或0.01）。r-TMS 组未发生严重不良反应。结论：低频 r-TMS 治疗 PSD 患者的抑郁症状的效果明显，能够提高患者的认知功能及日常生活能力，且不良反应少。
目的：探討低頻重複經顱磁刺激（rTMS）治療對卒中後抑鬱（PSD）患者認知和日常生活能力的影響。方法：PSD 伴輕度認知障礙患者128例隨機分為對照組和 r-TMS 組，各64例。對照組給予常規藥物治療及早期肢體功能康複、心理疏導和抗抑鬱治療；r-TMS 組在對照組治療基礎上加用低頻 r-TMS 治療。療程均為8週。分彆于治療前和治療後4、8週，採用漢密頓抑鬱量錶（HAMD）-17評定患者抑鬱程度，簡易精神狀態檢查量錶（MMSE）評定患者認知功能，巴塞爾指數（BI）評定患者的日常生活能力。結果：治療前2組患者 HAMD、MMSE 評分及 BI 差異無統計學差異（P＞0.05）；治療後2組 HAMD 評分均低于治療前，MMSE 評分及 BI 指數高于治療前（P＜0.05），r-TMS 組改善程度優于對照組（P＜0.05或0.01）。r-TMS 組未髮生嚴重不良反應。結論：低頻 r-TMS 治療 PSD 患者的抑鬱癥狀的效果明顯，能夠提高患者的認知功能及日常生活能力，且不良反應少。
목적：탐토저빈중복경로자자격（rTMS）치료대졸중후억욱（PSD）환자인지화일상생활능력적영향。방법：PSD 반경도인지장애환자128례수궤분위대조조화 r-TMS 조，각64례。대조조급여상규약물치료급조기지체공능강복、심리소도화항억욱치료；r-TMS 조재대조조치료기출상가용저빈 r-TMS 치료。료정균위8주。분별우치료전화치료후4、8주，채용한밀돈억욱량표（HAMD）-17평정환자억욱정도，간역정신상태검사량표（MMSE）평정환자인지공능，파새이지수（BI）평정환자적일상생활능력。결과：치료전2조환자 HAMD、MMSE 평분급 BI 차이무통계학차이（P＞0.05）；치료후2조 HAMD 평분균저우치료전，MMSE 평분급 BI 지수고우치료전（P＜0.05），r-TMS 조개선정도우우대조조（P＜0.05혹0.01）。r-TMS 조미발생엄중불량반응。결론：저빈 r-TMS 치료 PSD 환자적억욱증상적효과명현，능구제고환자적인지공능급일상생활능력，차불량반응소。
Objective: To explore the effects of low-frequency repetitive transcranial magnetic stimulation (r-TMS) on cognitive function and daily life ability of patients with post stroke depression (PSD). Methods: One-hundred and twenty-eight patients with PSD and mild cognitive impairment were enrolled and randomly divided into control group and r-TMS group with 64 cases in each group. Foundation treatment such as nerve nutrition, dilate blood ves-sels, early limb function rehabilitation, psychological counseling and antidepressant treatment were implemented in the control group. Cases in r-TMS group were treated with low-frequency r-TMS on the basis of foundation treat-ment for 8 weeks. The degree of depression were evaluated by using Hamilton depression scale (HAMD)-17; the cognitive function were evaluated by using mini-mental state examination (MMSE), and daily life ability were eval-uated by using Barthel index (BI) before and 4 and 8 weeks after treatment in two groups. Results: There were no difference in HAMD and MMSE scores and BI between two the groups (P>0.05) before treatment. After treatment, both groups showed lower HAMD scores as well as higher MMSE scores and BI than those before treatment (P<0.05). The scores of HAMD, MMSE and BI were improved more significantly in r-TMS group than those in control group (P<0.05 or 0.01). No serious adverse event was found in r-TMS group. Conclusion: Low-frequency r-TMS is an effective and safe therapy for patients with PSD, which can relieve depression and improve the cognitive func-tion and daily life ability.
