高频重复经颅磁刺激联合Brunnstrom分期训练对脑卒中恢复期患者康复效果的影响

摘要 目的：探讨高频重复经颅磁刺激（rTMS）联合Brunnstrom分期训练对脑卒中恢复期患者康复效果的影响。方法：根据随机数字表法将新疆医科大学第一附属医院2020年1月~2022年2月期间收治的脑卒中恢复期患者80例分为对照组（40例，Brunnstrom分期训练）和研究组（40例，高频rTMS联合Brunnstrom分期训练）。对比两组疗效、美国国立卫生研究院卒中量表（NIHSS）评分、功能独立性量表（FIM）评分、生活质量评分、血清神经因子指标髓鞘碱性蛋白（MBP）、神经元特异性烯醇化酶（NSE）、神经生长因子-1（NGF-1）]。结果：研究组的临床总有效率（92.50%）明显高于对照组（70.00%）（P<0.05）。治疗4周后，研究组MBP、NSE低于对照组，NGF-1高于对照组（P<0.05）。与对照组比较，治疗4周后，研究组NIHSS评分降低，FIM评分升高（P<0.05）。治疗4周后，研究组心理/躯体/物质/社会功能评分较对照组高（P<0.05）。结论：高频rTMS联合Brunnstrom分期训练有助于提高脑卒中恢复期患者的康复效果，同时还可调节血清神经指标，提高生活质量。

Effect of High Frequency Repetitive Transcranial Magnetic Stimulation Combined with Brunnstrom Staging Training on Rehabilitation Effect of Stroke Patients in Convalescent Stage

ABSTRACT Objective: To investigate the effect of high frequency repetitive transcranial magnetic stimulation (rTMS) combined with Brunnstrom staging training on the rehabilitation effect of stroke patients in convalescent stage. Methods: According to the random number table method, 80 cases of stroke patients in convalescent stage who were admitted to The First Affiliated Hospital of Xinjiang Medical University from January 2020 to February 2022 were divided into control group (40 cases, Brunnstrom staging training) and study group (40 cases, high frequency rTMS combined with Brunnstrom staging training. The efficacy, National Institutes of Health Stroke Scale (NIHSS) score, Functional Independence Scale (FIM) score, quality of life score, serum neurological indexes myelin basic protein (MBP),neuron-specific enolase (NSE), nerve growth factor-1 (NGF-1)] were compared between the two groups. Results: The total effective rate of the study group (92.50%) was significantly higher than that of the control group (70.00%) (P<0.05). 4 weeks after treatment, MBP and NSE of the study group were lower than those of the control group, and NGF-1 was higher than that of the control group (P<0.05). Compared with the control group, the NIHSS score of the study group at 4 weeks after treatment decreased and the FIM score increased (P<0.05). 4 weeks after treatment, the psychological/physical/material/social function score of the study group were higher than those of the control group (P<0.05). Conclusion: High frequency rTMS combined with Brunnstrom staging training is helpful to improve the rehabilitation effect of stroke patients in convalescent stage, and can also adjust the serum neurological indexes, and improve the quality of life.