文章摘要
王娟，郑婵娟，崔晓阳，徐婷，张阳普，夏文广.重复经颅磁刺激联合认知训练治疗脑卒中后 认知障碍的疗效观察[J].神经损伤功能重建,2019,14(1):11-14
重复经颅磁刺激联合认知训练治疗脑卒中后 认知障碍的疗效观察
Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Trainingon Stroke Patients with Cognitive Impairment
  
DOI：
中文关键词: 脑卒中  认知功能障碍  重复经颅磁刺激  计算机辅助认知训练
英文关键词: stroke  cognitive impairment  repetitive transcranial magnetic stimulation  computer-assisted cognitive training
基金项目:重大疑难疾病中西 医临床协作试点项 目（国中医药办医 政发《2018》3号- （No.SATCM-2018 0339）
作者单位
王娟，郑婵娟，崔晓阳，徐婷，张阳普，夏文广 湖北省中西医结合 医院康复医学科 
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中文摘要:
      目的：观察重复经颅磁刺激（rTMS）联合计算机辅助认知训练对脑卒中后认知障碍（PSCI）患者认知功 能及日常生活活动（ADL）能力的影响。方法：将90例脑卒中后认知障碍患者随机分为认知训练组、rTMS 组及联合治疗组各30例。3组均接受基础药物治疗和常规康复治疗，认知训练组予计算机辅助认知训练， rTMS组予rTMS治疗，联合治疗组在计算机认知训练基础上辅以rTMS治疗。于治疗前、治疗4周后采用简 易智力状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）对3组认知功能改善情况进行评定，采用改 良Barthel指数（MBI）评估3组ADL能力改善情况。结果：治疗前3组的MMSE、MoCA及MBI评分组间差 异均无统计学意义（P>0.05）。治疗 4 周后，3 组的 MMSE、MoCA 及 MBI 评分均较治疗前有明显改善（P< 0.05）；且联合治疗组的MMSE评分、MoCA评分、MBI评分均优于认知训练组、rTMS组（P<0.05）。结论：在 计算机辅助认知训练基础上辅以rTMS治疗能有效改善脑卒中患者认知功能及ADL能力。
英文摘要:
      To observe the effects of repetitive transcranial magnetic stimulation (rTMS) combined with computer-assisted cognitive training on the cognitive function and the ability to perform daily activities (ADL) in patients with post-stroke cognitive impairment (PSCI). Methods: A total of 90 PSCI patients were randomly assigned to the cognitive training group, rTMS group, and combined treatment group with 30 patients per group. The three groups were all treated with basic medication and traditional rehabilitation therapy while the cognitive training group was treated additionally with computer-assisted cognitive training, rTMS group was treated additionally with repetitive transcranial magnetic stimulation, and combined treatment group was treated additionally with rTMS and computer-assisted cognitive training. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used at pre-therapy and 4 weeks after treatment to assess changes in cognitive function in the three groups, and the Modified Barthel Index (MBI) was used to determine changes in ADL ability. Results: No statistical differences were found between the MMSE, MoCA, and MBI scores of the three groups before treatment (P>0.05)．MMSE, MoCA, and MBI scores improved in all three groups 4 weeks after treatment (P<0.05); furthermore, the MMSE, MoCA, and MBI scores of the combined treatment group were significantly higher than those of the cognitive training group and rTMS group (P<0.05). Conclusion: Computer-assisted cognitive training combined with rTMS can effectively improve cognitive function and ADL ability of stroke patients.
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