摘要目的 比较高频、低频重复经颅磁刺激(rTMS)在脑梗死患者运动功能康复中的作用. 方法 选取自2010年10月至2011年6月在珠江医院康复医学科治疗的60例脑梗死患者,按随机数字表法分成高频rTMS组(20例)、低频rTMS组(20例)和假刺激组(20例).在常规药物治疗及功能训练治疗相同的情况下,高频rTMS组、低频rTMS组给予每天1次、每次10 min的高频(3 Hz)或低频(1 Hz)rTMS治疗,连续14d;假刺激组给予假刺激.比较3组患者治疗前后的简易Fugl-Meyer(FMA)运动功能评分、Barthel指数、运动诱发电位(MEP)潜伏期及中枢运动传导时间(CMCT). 结果 治疗前,3组患者间FMA评分、Barthel指数、MEP潜伏期及CMCT比较差异无统计学意义(P＞0.05).治疗后,3组患者FMA评分、Barthel指数、MEP潜伏期及CMCT均较治疗前差异有统计学意义(P＜0.05)；高频rTMS组、低频rTMS组的运动功能恢复明显优于假刺激组,FMA评分、Barthel指数、MEP潜伏期及CMCT与假刺激组比较差异均有统计学意义(P＜0.05),高频rTMS组与低频rTMS组间FMA评分、Barthel指数、MEP潜伏期及CMCT比较差异无统计学意义(P＞0.05). 结论 高频及低频rTMS均有利于脑梗死患者运动功能的康复,且两者间疗效无明显差异.

abstractsObjective To compare the effects of high and low frequencies of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation of motor function in patients with cerebral infarction. Methods From October 2010 to June 2011,60 patients with cerebral infarction undergoing treatment in our department were randomly assigned into 3 even groups. In addition to conventional medication and functional training for all patients,group A were given high frequency (3 Hz) rTMS once per day and 10 minutes per time for 14 days,group B low frequency (1 Hz) rTMS and group C sham stimulation in the same manner. The 3 groups were compared before and after stimulation in terms of motor function scores of Fugl-Meyer assessment (FMA),the Barthel index (BI),motion evoked potential (MEP) and central motion conduction time (CMCT). Results Before stimulation,there were no significant differences between the 3 groups in FMA,BI,MEP and CMCT (P ＞0.05),but significant significances were observed between the 3 groups after stimulation (P＜0.05) indicating that the motor functional recovery in groups A and B was significantly better than in group C. But there were no statistically significant differences between group A and group B in FMA,BI,MEP and CMCT (P＞0.05).Significant improvements were achieved in all 3 groups after rehabilitative treatment in FMA,BI,MEP and CMCT (P＜0.05). Conclusion Both high frequency rTMS and low frequency rTMS can promote motor functional recovery for patients with cerebral infarction, and their effects are not significantly different.