| 贾云晓
，张文豪
，高海峰
，满逸迪
，刘正旺
，张潇予
，李军.重复经颅磁刺激对脊髓损伤患者康复疗效的meta分析[J].神经损伤功能重建,2024,(11):630-638 |
| 重复经颅磁刺激对脊髓损伤患者康复疗效的meta分析 |
| The Rehabilitative Efficacy of Repetitive Transcranial Magnetic Stimulation in Patients withSpinal Cord Injury: a Meta-Analysis |
| |
| DOI： |
| 中文关键词: 重复经颅磁刺激 脊髓损伤 随机对照试验 系统评价 Meta分析 |
| 英文关键词: transcranial magnetic stimulation spinal cord injury randomized controlled trial systematic review meta-analysis |
| 基金项目:国家重点研发计
划（损伤后神经功
能康复重建技术
方法研究，No. 20
22YFC3602800） |
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| 摘要点击次数: 7 |
| 全文下载次数: 10 |
| 中文摘要: |
| 目的：系统评价重复经颅磁刺激（repeated transcranial magnetic stimulation，rTMS）对脊髓损伤（spinal
cord injury，SCI）患者康复疗效的影响。方法：计算机检索PubMed、Web of science、Embase、Cochrane Library、
中国知网、万方、维普及中国生物医学等电子数据库中关于rTMS治疗SCI的随机对照试验。检索时限为各
数据库建库至2023年9月21日。以脊髓功能独立性量表（SCIM）、功能独立性评分（FIM）、Barthel指数（BI）、
静息运动阈值（RMT）、运动诱发电位（MEP）波幅、下肢运动评分（LEMS）、脊髓损伤步行指数Ⅱ（WISCI-Ⅱ）、
改良Ashworth量表（MAS）、视觉模拟评分（VAS）为结局指标，按照Cochrane系统评价手册推荐的偏倚风险评
估工具进行风险评估，使用RevMan5.4软件进行Meta分析。结果：共纳入23个随机对照试验，包括1 478例
患者。Meta 分析结果显示，与对照组相比，rTMS 治疗组的 SCIM 评分[MD=6.93，95%CI (5.48, 8.37)，P＜
0.00001]、FIM[MD=16.17，95%CI (11.66, 20.69)，P＜0.00001]、BI 评分[MD=10.43，95%CI (5.17, 15.69)，P＜
0.00001]、RMT[MD=－3.99，95%CI (－4.88, －3.09)，P＜0.00001]、MEP 波幅[MD=0.33，95%CI (0.23, 0.43)，
P＜0.00001]、LEMS[MD=5.47，95%CI (3.80, 7.14)，P＜0.00001]、WISCI-Ⅱ[MD=1.79，95%CI (1.41, 2.18)，P＜
0.00001]、MAS 评分[MD=－0.15，95%CI (－0.20, －0.10)，P＜0.00001]、VAS 疼痛评分[MD=－1.37，95%CI
(－1.66, －1.08)，P＜0.00001] 显著改善。结论：rTMS治疗有助于SCI患者提高功能独立性及日常生活活动
能力，改善下肢运动功能障碍，缓解神经性疼痛、痉挛等。 |
| 英文摘要: |
| To systematically evaluate the impact of repeated transcranial magnetic stimulation
(rTMS) on the rehabilitation outcomes of patients with spinal cord injury (SCI). Methods: Computerized
searches were conducted in electronic databases including PubMed, Web of Science, Embase, Cochrane Library,
CNKI, Wanfang, VIP, and China Biology Medicine for randomized controlled trials (RCTs) on rTMS treatment for
SCI. The search period covered from the inception of each database to September 21, 2023. Outcome indicators
included the Spinal Cord Independence Measure (SCIM), Functional Independence Measure (FIM), Barthel Index
(BI), Resting Motor Threshold (RMT), Motor Evoked Potential (MEP) amplitude, Lower Extremity Motor Score
(LEMS), Walking Index for Spinal Cord Injury II (WISCI-II), Modified Ashworth Scale (MAS), and Visual
Analog Scale (VAS) for pain. Risk of bias was assessed using tools recommended by the Cochrane Handbook for
Systematic Reviews of Interventions, and Meta-analysis was performed using RevMan 5.4 software. Results: A
total of 23 RCTs involving 1 478 patients were enrolled. Meta-analysis results showed significant improvements in
the rTMS treatment group compared to the control group in SCIM score [MD=6.93, 95% CI (5.48, 8.37), P<
0.00001], FIM [MD=16.17, 95%CI (11.66, 20.69), P<0.00001], BI score [MD=10.43, 95%CI (5.17, 15.69), P<
0.00001], RMT [MD=－3.99, 95%CI (－4.88, －3.09), P<0.00001], MEP amplitude [MD=0.33, 95%CI (0.23,
0.43), P<0.00001], LEMS [MD=5.47, 95%CI (3.80, 7.14), P<0.00001], WISCI-II [MD=1.79, 95%CI (1.41, 2.18),
P<0.00001], MAS score [MD=－0.15, 95%CI (－0.20, －0.10), P<0.00001], and VAS pain score [MD=－1.37,
95%CI (－1.66, －1.08), P<0.00001]. Conclusion: rTMS treatment is beneficial for SCI patients in improving
functional independence and activities of daily living, ameliorating lower extremity motor dysfunction, and
alleviating neuropathic pain and spasms. |
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