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| 生物波早期综合康复疗法联合不同频率重复经颅磁刺激治疗重型颅脑损伤昏迷患者的临床研究 |
| Clinical Study on the Biological Wave Early Comprehensive Rehabilitation Therapy Combine With Different Frequencies Repetitive Transcranial Magnetic Stimulation in the Treatment of Coma Patients With Severe Craniocerebral Injury |
| 投稿时间：2023-12-25 修订日期：2023-12-25 |
| DOI： |
| 中文关键词: 生物波早期综合康复疗法 不同频率 重复经颅磁刺激 重型颅脑损伤 昏迷 临床研究 |
| 英文关键词: Biological wave early comprehensive rehabilitation therapy Different frequencies Repetitive transcranial magnetic stimulation Severe craniocerebral injury Coma Clinical study |
| 基金项目:山东省中医药科技项目（编号：Q-2022100） |
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| 中文摘要: |
| 目的：观察生物波早期综合康复疗法联合不同频率重复经颅磁刺激（rTMS）治疗重型颅脑损伤昏迷患者的临床研究。方法：选取2022年1月至2023年4月山东省立第三医院收治的90例重型颅脑损伤昏迷患者，按照随机数字表法将患者分为A组（n=45，给予生物波 早期综合康复疗法联合低频率rTMS治疗）和B组（n=45，给予生物波早期综合康复疗法联合高频率rTMS治疗）。对比两组治疗前后格拉斯哥昏迷量表（GCS）评分、残疾程度（DRS）评分、脑血流动力学指标、神经细胞因子和不良反应。结果：治疗后，B组GCS评分高于A组，DRS评分低于A组（P<0.05）。治疗后，B组平均血流速度（Vm）、大脑中动脉收缩期峰流速（Vs）高于A组，搏动指数（PI）低于A组（P<0.05）。治疗后，B组脑源性神经营养因子（BDNF）高于A组，胶质纤维酸性蛋白（GFAP）、神经元特异性烯醇化酶（NSE）、S100-β低于A组（P<0.05）。B组的不良反应发生率高于A组（P<0.05）。结论：生物波早期综合康复疗法联合rTMS治疗重型颅脑损伤昏迷患者，具有一定的促醒效果，其中以高频的促醒效果更佳，可有效改善机体脑血流动力学，调节神经细胞因子水平，改善GCS、DRS评分。但高频rTMS治疗不良反应较低频rTMS更大，值得引起临床重视。 |
| 英文摘要: |
| Objective: To observe the clinical study of biological wave early comprehensive rehabilitation therapy combine with different frequencies repetitive transcranial magnetic stimulation (rTMS) in the treatment of coma patients with severe craniocerebral injury. Methods: 90 coma patients with severe craniocerebral injury admitted to Shandong Provincial Third Hospital from January 2022 to April 2023 were selected and divided into A group (n=45, given biological wave early comprehensive rehabilitation therapy combine with low frequency rTMS treatment) and B group (n=45, given biological wave early comprehensive rehabilitation therapy combine with high frequency rTMS treatment) according to the random number table method. The Glasgow Coma Scale (GCS) score, Disability Rating Scale (DRS) score, cerebral hemodynamic indexes, nerve cell factors and adverse reactions were compared in two groups before and after treatment. Results: After treatment, the GCS score in group B was higher than that in group A, and the DRS score was lower than that in group A (P<0.05). After treatment, the mean blood flow velocity (Vm) and middle cerebral artery systolic peak velocity (Vs) in group B were higher than those in group A, and the pulsatility index (PI) was lower than that in group A (P<0.05). After treatment, brain-derived neurotrophic factor (BDNF) in group B was higher than that in group A, and glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE) and S100-β were lower than those in group A (P<0.05). The incidence of adverse reactions in group B was higher than that in group A (P<0.05). Conclusion: Biological wave early comprehensive rehabilitation therapy combine with rTMS in the treatment of coma patients with severe craniocerebral injury has a certain wake-up effect, among which high frequency wake-up effect is better, and it can effectively improve the body''s cerebral hemodynamics, regulate the level of nerve cell factors, and improve GCS and DRS scores. But the adverse reactions of high-frequency rTMS treatment are greater than those of low-frequency rTMS,which is worthy of clinical attention. |
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