目的 观察重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合中医适宜技术对卒中后疲劳患者疲劳严重程度、睡眠质量和生活质量的应用效果.方法 选取皖南康复医院神经康复科确诊为卒中后疲劳患者90例,随机分为3组:中医适宜技术组、rTMS组和联合治疗组(中医治疗+rTMS),每组30例.患者接受为期3周的治疗,并在疗程结束后分析治疗前后疲劳严重程度(FSS)评分、卒中专用生活质量(SS-QOL)评分和匹兹堡睡眠质量指数(PSQI)评分的变化.结果 3周治疗后FSS评分结果显示:与治疗前相比,3组患者FSS评分显著降低(P＜0.001),且联合治疗组的FSS评分降低幅度显著大于中医适宜技术组和rTMS组(P＜0.001);3组患者的PSQI评分较治疗前都显著下降(P＜0.001),其中rTMS治疗组效果优于中医适宜技术组(P＜0.001),联合组则更优于其他两组(P＜0.001);3组患者SS-QOL评分也显著提高(P＜0.001),且联合组的SS-QOL评分显著高于其他两组(P＜0.001).结论 中医适宜技术和rTMS均可改善卒中后疲劳患者的疲劳程度、睡眠质量和生活质量;但两者的联合使用疗效更优于单一应用,联合使用有利于协同增效,值得推广应用.
Study on the application of repetitive transcranial magnetic stimulation Combined with appropriate traditional Chinese medicine techniques in patients with post-stroke fatigue
Objective To observe the effect of repetitive transcranial magnetic stimulation(rTMS)com-bined with appropriate traditional Chinese medicine(TCM)techniques on fatigue severity,sleep quality,and quality of life in patients with post-stroke fatigue.Methods Ninety patients diagnosed with post-stroke fa-tigue in the Department of Neurological Rehabilitation at Wannan Rehabilitation Hospital were selected and randomly divided to three groups:the TCM techniques group,the rTMS group,and the combined treatment group(TCM+rTMS),with 30 patients in each group.Patients received a 3-week treatment,and the changes were anlyzed in the Fatigue Severity Scacle(FSS)scores,Stroke-Specific Quality of Life(SS-QOL)scores,and Pittsburgh Sleep Quality Index(PSQI)scores before and after treatment.Results After 3 weeks of treatment,the FSS scores in all three groups significantly decreased compared to before treatment(P＜0.001),with the combined treatment group showing a significantly greater reduction in FCC scores than the TCM techniques group and the rTMS group(P＜0.001).The PSQI scores in all three groups also significant-ly decreased compared to before treatment(P＜0.001)with the rTMS group showing better results than the TCM techniques group(P＜0.001),and the combined treatment group showing the best results among the three groups(P＜0.001).The SS-QOL scores in all three groups significantly increased(P＜0.001),with the combined treatment group showing significantly higher scores than the other two groups(P＜0.001).Conclusion Both appropriate TCM techniques and rTMS can improve fatigue severity,sleep quality,and the quality of life in patients with post-stroke fatigue.However,the combined use of the two provides better effi-cacy compared to their individual use.The combined treatment is beneficial for synergistic effects and is worthy of promotion.
repetitive transcranial magnetic stimulationappropriate traditional Chinese medicinestrokepost-stroke fatiguequality of life
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