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目的：探讨间歇θ脉冲刺激（iTBS）及高频重复经颅磁刺激（rTMS）对脑卒中后执行功能障碍（PSEI）的临床疗效。方法：选取2021年4月～2022年6月在徐州市中心医院康复科及徐州市康复医院住院治疗的的PSEI患者90例，随机分入iTBS组、高频组、对照组。3组患者均给予常规康复训练，并分别予iTBS、10Hz rTMS、伪刺激治疗，共4周。治疗前后分别对患者进行蒙特利尔认知评估量表（MoCA）、额叶功能评定量表（FAB）、Stroop色词测验（SCWT）、形状连线测验（STT）、数字广度测验（DST）、事件相关电位P300评定。结果：治疗后3组患者的MoCA、FAB、SCWT、STT、DST评分、P300潜伏期及波幅均明显优于治疗前（P<0.05）;iTBS组及高频组的MoCA、FAB、SCWT、STT-B、DST评分、P300潜伏期、波幅均优于对照组，有显著差异（P<0.05）,iTBS组与高频组之间无明显差异（P>0.05）。结论：iTBS可以改善PSEI，疗效与10Hz rTMS相当，iTBS耗时更短、效率更高，值得在临床中推广应用。
Abstract：Objective: To investigate the clinical efficacy of intermittent theta burst stimulation(iTBS) and high frequency repetitive transcranial magnetic stimulation(rTMS) on post-stroke executive impairment(PSEI). Methods: Ninety patients with PSEI who were hospitalized in the rehabilitation department of Xuzhou Central Hospital and Xuzhou Rehabilitation Hospital from April 2021 to June 2022 were selected and divided into iTBS group, high-frequency group and control group. All three groups of patients received routine rehabilitation training, given rTMS treatment with iTBS, 10 Hz and shame stimulation for 4 weeks. Before and after treatment, all the patients were evaluated with the Montreal cognitive assessment(MoCA), the frontal assessment battery(FAB), troop color-word test(SCWT), shape trails test(STT), digit span test(DST) and event related potential P300. Results: After treatment, MoCA, FAB, SCWT, STT, DST scores, P300 latency and amplitude were significantly better in the three groups than before treatment(P<0.05). MoCA, FAB, SCWT, STT-B, DST scores, P300 latency and amplitude in the iTBS group and high-frequency group were better than in the control group, with significant differences(P<0.05).The difference between iTBS group and high-frequency group was not statistically significant(P>0.05). Conclusion: iTBS can improve PSEI, and the efficacy is comparable to 10Hz rTMS. iTBS takes less time with better efficiency, and it is worth popularizing and applying in clinic.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20230420.002
中图分类号:R743.3
引用信息:
[1]田耕润,王世雁,毕迎立,等.不同模式重复经颅磁刺激治疗脑卒中后执行功能障碍的临床研究[J].海南医学院学报,2023,29(12):916-921.DOI:10.13210/j.cnki.jhmu.20230420.002.
基金信息:
江苏省卫生健康委员会科研项目（K2019012）; 徐州市科技局计划项目（KC19156）~~
2023-04-21
2023-04-21
2023-04-21