低频重复经颅磁刺激治疗小脑梗死后平衡障碍的疗效分析

摘要

目的 探讨低频重复经颅磁刺激(LF-rTMS)治疗小脑梗死后平衡障碍的临床疗效.方法 选择小脑梗死病人40例,按照完全随机对照分为rTMS组和对照组,各20例.rTMS组采用LF-rTMS+常规平衡障碍康复训练;对照组采用伪线圈rTMS+常规平衡障碍康复训练.纳入后即开始康复训练,两组病人刺激每日1次,每次20 min,连续28 d.记录两组病人治疗前和治疗后(第7天、第14天、第28天)Burg平衡量表(BBS)评分和Tinetti步态量表评分.结果 治疗后rTMS组病人BBS评分增加,平衡功能恢复良好,疗效明显优于对照组(P<0.01);rTMS组病人Tinetti步态量表评分增长快,平衡及步态功能康复理想,疗效显著优于对照组(P<0.01).结论 LF-rTMS可显著改善小脑梗死后平衡障碍及步态康复,且远期疗效显著优于近期疗效,证实LF-rTMS治疗小脑梗死后平衡障碍病人疗效的可靠性及有效性.%Objective To explore the clinical effect of low frequency repetitive transcranial magnetic stimulation (LF-rTMS) in the treatment of balance disorders after cerebellar infarction.Methods Forty patients with cerebellar infarction were randomly divided into two groups:control group (n=20) treated with pseudo-coil rTMS plus routine rehabilitation training of balance disorders,and treatment group (n=20) treated with LF-rTMS plus routine rehabilitation training of balance disorders for 14 days.The scores of Berg Balance Scale (BBS),Tinetti Gait and Balance Scale (TGBS) were observed before treatment and after treatment of 7 days,14 days,28 days.Results BBS scores increased quickly,the balance function recovered well in treatment group,which was better than that in control group (P<0.01).TGBS scores increased quickly,the balance and gait rehabilitation recovered well in treatment group,which was better than that in control group (P<0.01).The long-term efficacy was better than short-term one.Conclusion LF-rTMS can significantly improve the balance disorder and gait rehabilitation after cerebral infarction,and the long-term efficacy was better than the short-term one.It was confirmed that the reliability and validity of LF-rTMS in the treatment of balance disorders after cerebellar infarction.