头穴丛刺联合重复经颅磁刺激治疗小脑梗死后平衡障碍的临床观察

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摘要目的探讨头穴丛刺联合重复经颅磁刺激（rTMS）治疗小脑梗死后平衡障碍的临床效果。方法选取2019年12月至2020年6月在深圳市宝安中医院（集团）针灸科门诊及病房就诊的小脑梗死后平衡障碍患者90例，将其根据随机数字表法分为A组、B组及C组，每组各30例。A组采用头穴丛刺联合低频rTMS治疗，B组采用假头穴丛刺联合低频rTMS治疗，C组采用头穴丛刺联合假低频rTMS治疗。观察各组治疗前、治疗后4周Berg平衡量表（BBS）评分、Fugl-Meyer平衡量表（FM-B）评分及运动诱发电位（MEP）阈值，并比较各组疗效。结果治疗后，各组BBS评分、FM-B评分及MEP阈值均高于治疗前，且A组均高于B组和C组，差异有统计学意义（P ＜ 0.05）。治疗后4周，A组整体疗效高于B组和C组（P ＜ 0.05）。结论头穴丛刺联合低频rTMS治疗小脑梗死患者后平衡障碍的效果优于单纯头穴丛刺及单纯低频rTMS治疗，可有效提高小脑梗死后平衡障碍的临床疗效。

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	单筱淳周鹏张瑜吴苗梁雪松

关键词 ：头穴丛刺, 低频重复经颅磁刺激, 小脑梗死, 平衡障碍

Abstract：Objective To discuss clinical effect of cluster needling of scalp points combined with repeated transcranial magnetic stimulation (rTMS) in treating balance disorder after cerebellar infarction. Methods Ninety patients with balance disorder after cerebellar infarction treated in outpatient and ward of Department of Acupuncture and Moxibustion, Shenzhen Baoan Hospital of Traditional Chinese Medicine (Group) from December 2019 to June 2020 were selected and they were divided into group A, group B, and group C according to the random number table method, with 30 cases in each group. Group A was treated with cluster needling of scalp points combined with low-frequency rTMS, group B was treated with pseudo cluster needling of scalp points combined with low-frequency rTMS, and group C was treated with cluster needling of scalp points combined with pseudo low-frequency rTMS. Berg balance scale (BBS) scores, Fugl-Meyer balance scale (FM-B) scores and motor evoked potential (MEP) threshold were observed before treatment and four weeks after treatment in each group. The curative effect of each group was compared. Results After treatment, BBS scores, FM-B scores and MEP threshold of each group were higher than those before treatment, and group A was higher than that of group B and group C (P ＜ 0.05). Four weeks after treatment, the overall efficacy of group A was higher than that of group B and group C (P ＜ 0.05). Conclusion The effect of cluster needling of scalp points combined with low-frequency rTMS in treating patients with balance disorder after cerebellar infarction is better than that of simple cluster needling of scalp points and simple low-frequency rTMS. It can effectively improve clinical effect of balance disorder after cerebellar infarction.

Key words： Cluster needling of scalp points Low-frequency repeated transcranial magnetic stimulation Cerebellar infarction Balance disorder

基金资助:广东省深圳市宝安区医疗卫生基础研究项目（2020JD561）；
广东省基础与应用基础研究基金项目（2019 A1515111010）。

通讯作者: 周鹏（1980.3-），男，博士，主任医师；研究方向：针灸治疗神经系统疾病。

作者简介: 单筱淳（1989.5-），女，博士；研究方向：针灸治疗神经系统疾病。

引用本文:

单筱淳周鹏张瑜吴苗梁雪松. 头穴丛刺联合重复经颅磁刺激治疗小脑梗死后平衡障碍的临床观察[J]. 中国医药导报, 2022, 19(20): 119-122.
SHAN Xiaochun ZHOU Peng ZHANG Yu WU Miao LIANG Xuesong. Clinical observation on cluster needling of scalp points combined with repeated transcranial magnetic stimulation in treating balance disorder after cerebellar infarction. 中国医药导报, 2022, 19(20): 119-122.

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