标题：经颅磁刺激联合功能训练对脑卒中患者神经功能及肢体功能的影响

      作者：刘家峰 1，王虹 2，许海莺 1，张民英 1    1.西安市第九医院中医康复科，陕西 西安 710054；2.中国人民解放军空军军医大学第一附属医院康复医学科，陕西 西安 710032

      卷次： 2020年31卷15期

      【摘要】 目的 研究经颅磁刺激(TMS)联合功能训练对脑卒中患者神经功能及肢体功能的影响。方法 选取2018年 1月至 2019年 3月西安市第九医院收治的脑卒中患者 88例，按照随机数表法分为观察组和对照组各 44例。观察组采用TMS联合功能训练，对照组采用常规功能训练，均连续训练4周，比较两组患者训练4周后的疗效，于治疗前、治疗4周后采用美国国立卫生院卒中量表(NIHSS)评价神经功能、Fugl-Meyer运动功能评定量表(FMA)评价肢体功能、改良Barthel指数(MBI)和日常生活能力评分量表(ADL)评价日常生活能力，同时比较两组患者治疗4周后的肌力水平。结果 治疗4周后，观察组患者的临床治疗显效率为61.36%，明显高于对照组的31.82%，差异有统计学意义(P<0.05)；治疗4周后，两组患者的NIHSS、ADL评分均较治疗前明显下降，且观察组患者的NIHSS、ADL评分分别为(13.43±3.83)分和(16.53±3.81)分，明显低于对照组的(18.71±3.88)分和(19.87±4.29)分，差异均有统计学意义(P<0.05)；治疗4周后，两组患者 FMA、MBI评分均较治疗前明显上升，且观察组患者的FMA、MBI评分分别为(46.53±7.50)分和(63.91±7.03)分，明显高于对照组的(42.26±6.64)分和(56.68±7.12)分，差异均有统计学意义(P<0.05)；治疗4周后，观察组患者的上肢肌力水平优良率为68.18%，明显高于对照组的45.45%，差异有统计学意义(P<0.05)。结论 经颅磁刺激联合功能训练能够有效改善脑卒中患者神经功能及肢体功能、提升日常生活能力及上肢肌力。
      【关键词】 经颅磁刺激；功能训练；脑卒中；神经功能；肢体功能
      【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1003—6350（2020）15—1926—04

Effects of transcranial magnetic stimulation combined with functional training on neurological function and limbfunction in patients with stroke.
LIU Jia-feng 1, WANG Hong 2, XU Hai-ying 1, ZHANG Min-ying 1. 1. Department ofTraditional Chinese Medicine Rehabilitation, the Ninth Hospital of Xi'an, Xi'an 710054, Shaanxi, CHINA. 2. Department ofRehabilitation Medicine, the First Affiliated Hospital of Air Force Medical University of PLA, Xi'an 710032, Shaanxi, CHINA
【Abstract】 Objective To study the effects of transcranial magnetic stimulation (TMS) combined with function-al training on neurological function and limb function in patients with stroke. Methods Eighty-eight stroke patientswho were treated in Ninth Hospital of Xi'an from January 2018 to March 2019 were selected and divided into the obser-vation group and control group according to random number table method, with 44 patients in each group. The observa-tion group was given TMS combined with functional training, and the control group was given routine functional train-ing, continuously for 4 weeks. The efficacy after 4 weeks of training was compared between the two groups. Before treat-ment and after 4 weeks of treatment, the neurological function was evaluated by National Institutes of Health StrokeScale (NIHSS), the limb function was assessed by Fugl-Meyer Motor Function Assessment (FMA), and the daily livingability was evaluated by Modified Barthel Index (MBI) and Ability of Daily Living Scale (ADL). The muscle strengthwas compared between the two groups after 4 weeks of treatment. Results After 4 weeks of treatment, the marked ef-fective rate of clinical treatment in the observation group was significantly higher than that in the control group