Objective:To observe the rehabilitation effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on dyskinesia of patients with cerebral infarction.Methods: 154 patients with acute cerebral infarction combined with dyskinesia were randomly divided into control group (77 cases) and observation group (77 cases) according to the random number table method. The patients of two groups received the routine pharmacotherapy for cerebral infarction. Besides, on the basic routine pharmacotherapy, the patients of observation group were implemented 1Hz rTMS (30 min/d , 10d/round), while the patients of control group were implemented false stimulation as placebo measurement. At the same time, both of two groups received training of exercise rehabilitation after they received rTMS. National institute of health stroke scale (NIHSS), Barthel index(BI), Fugl-Meyer assessment (FMA) of two groups between before and after treatment were compared, and then latency stage and amplitude of motor evoked potential (MEP) in encephalic region of lesions side for two patients were detected. Results:①The differences of NIHSS, BI and FMA before patients received treatment between the two groups were not statistically significant (t=0.153,t=0. 235,t=0.126,P>0.05). After 10 d, the NIHSS, BI and FMA of observation group were significantly better than that of control group (t=3.264,t=9.461,t=4.302,P<0.05).②The differences of latency stage and amplitude of MEP between the two groups were not statistically significant (t=0.027,t=0.032, P>0.05). And after 10d, the latency stage of MEP of observation group was significantly shorter than that of control group (t=3.764,P<0.05) and the amplitude of MEP of observation group was significantly higher than that of control group(t=6.020,P<0.05).Conclusion:The low-frequency rTMS has better rehabilitation effect on dyskinesia of patients with acute cerebral infarction in a certain degree, while its long-term curative effect needs further clinical observation to be verified.%目的:观察低频重复经颅磁刺激(rTMS)对脑梗死患者肢体运动功能障碍的康复作用.方法:选取154例急性脑梗死伴肢体运动功能障碍患者,按照数字列表法将患者随机分为对照组和观察组,每组77例.两组均进行脑梗死常规药物治疗;观察组在常规药物治疗基础上加以1 Hz的低频rTMS治疗,30 min/d,10 d为一个疗程;对照组则给予假刺激治疗;两组患者治疗后均进行运动康复训练.比较两组治疗前后神经功能缺损评分(NIHSS)、Barthel指数(BI)及Fugl-Meyer评估(FMA),同时对两组患者病变侧脑区运动诱发电位(MEP)潜伏期及波幅进行测定.结果:①两组治疗前NIHSS评分、BI及FMA评分差异无统计学意义(t=0.153,t=0.235,t=0.126;P>0.05);治疗10 d后观察组的NIHSS评分、BI及FMA评分均优于对照组,两组比较差异有统计学意义(t=3.264,t=9.461,t=4.302;P<0.05);②两组治疗前MEP潜伏期及MEP波幅差异无统计学意义(t=0.027,t=0.032,P>0.05).治疗10 d后观察组MEP潜伏期明显短于对照组,MEP波幅明显高于对照组,两组比较差异有统计学意义(t=3.764,t=6.020;P<0.05).结论:rTMS治疗对脑梗死患者肢体运动功能障碍有一定康复作用,但其远期疗效还有待于进一步的临床观察.
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