中药熏蒸联合重复经颅磁刺激显著改善偏瘫肩痛患者的上肢运动功能

Traditional Chinese medicine fumigation combined with repetitive transcranial magnetic stimulation

摘要:

目的 探讨中药熏蒸联合重复经颅磁刺激（rTMS）对偏瘫肩痛患者的上肢运动功能障碍的影响。方 法 选取 2023年 9月至 2024年 5月在广东医科大学附属医院康复医学科住院部及门诊部进行康复治疗的脑卒中 患者 60 例，分为常规组（n = 16）、rTMS 组（n = 15）、中药熏蒸组（n = 15）和 rTMS + 中药熏蒸组（n = 14）。常规组行 40 min的常规康复治疗，rTMS组在常规康复的基础上行20 min的rTMS治疗，中药熏蒸组在常规康复的基础上行 20 min的中药熏蒸治疗，rTMS + 中药熏蒸组在常规康复的基础上行 rTMS及中药熏蒸治疗。4组在治疗前和治疗 12 d后采用数字评定量表（NRS）、Fugl-meyer上肢运动功能评定评分（FMA评分）及改良 Bathel指数（MBI）进行疗 效评价。结果 与治疗前比较，各组治疗后 NRS 评分均明显下降，FMA、MBI评分均明显升高，且以 rTMS + 中药 熏蒸组更为显著（P < 0.05）。结论 联合应用中药熏蒸和 rTMS 治疗可显著改善偏瘫患者肩痛理、生活质量和上 肢运动功能。

Abstract:

Objective To investigate the effect of Chinese herbal fumigation and repetitive transcranial magnetic stimulation (rTMS) on upper limb motor dysfunction in hemiplegic patients with shoulder pain. Methods Sixty stroke patients undergoing rehabilitation at the Rehabilitation Medicine Department of Guangdong Medical University Affiliated Hospital (inpatient and outpatient departments) from September 2023 to May 2024 were allocated into four groups: conventional group (n = 16), rTMS group (n = 15), herbal fumigation group (n = 15), and combined intervention group (rTMS + herbal fumigation, n = 14). All groups received 40-minute conventional rehabilitation therapy. The rTMS group received additional 20-minute rTMS, the herbal fumigation group received 20-minute herbal fumigation, while the combined group received both adjunctive therapies. Therapeutic outcomes were evaluated using Numerical Rating Scale (NRS), Fugl-meyer Assessment for Upper Extremity (FMA), and Modified Barthel Index (MBI) before and after 12 days of treatment. Results NRS scores were significantly decreased, while FMA and MBI scores increased in all groups after treatment, especially in rTMS + herbal fumigation group (P < 0.05). Conclusion Combined use of herbal fumigation and rTMS can significantly improve the shoulder pain, quality of life and upper limb motor function in hemiplegic patients.