| Objective:The aim of this study was to investigate the clinical effects of acupuncture combined with repetitive transcranial magnetic stimulation(rTMS)on upper limb motor dysfunction in patients with stroke,and to explore the significance of the combined treatment of upper limb motor dysfunction in stroke patients,and also provide an objective basis for clinical treatment of upper limb motor dysfunction in stroke.Methods:According to the principle of randomized control,42 patients with hemiplegic stroke were randomly divided into two groups: control group(n=21)and observation group(n=21),all patients were given basic therapy,the control group was treated with acupuncture,the acupoints were selected from the affected hemiplegic side,including Jianyu,Quchi,Shousanli,Waiguan,Hegu,30min/time,once/day,5 times/week,for 4 consecutive weeks.On the basis of the control group,the observation group was given the primary motor cortex(M1)1Hz rTMS treatment,20min/time,once/day,5 times/week,for 4 consecutive weeks.The National Institutes of Health Stroke Scale(NIHSS),the upper limb part of the simplified Fugl-Meyer motor function scale(FMA-UE),and the modified Barthel index scale(MBI)were used in all patients to evaluate neurological deficits,upper limb motor function,activities of daily living,and the N20 latency of somatosensory evoked potential(SEP)in the affected upper limb was tested,before and after 4 weeks of treatment.The data were obtained for statistical analysis.Results:1.The effects of the NIHSS Scale: Before treatment,there was no significant difference in NIHSS scores(8.95 ± 1.93,9.25 ± 2.31)between the control group and the observation group(P>0.05).After 4 weeks of treatment,the NIHSS scores of both(6.90±2.10,5.55±1.79)were lower than those before treatment,and the extent of decrease in the observation group was significantly greater than that of the control group(P<0.05).2.The effects of FMA-UE scale: Before treatment,there was no significant difference in FMA-UE scores(8.30 ± 4.16,7.95 ± 4.07)between the control group and the observationgroup(P>0.05).After 4 weeks of treatment,the FMA-UE scores of both(17.70±6.35,23.05±7.98)were higher than those before treatment,and the extent of increase in the observation group was significantly greater than that of the control group(P<0.05).3.The effects of the MBI scale: Before treatment,there was no significant difference in MBI scores(17.70±6.35,23.05±7.98)between the control group and the observation group(P>0.05).After 4 weeks of treatment,the MBI scores of both(47.50±5.63,56.05±6.39)were higher than those before treatment,and the extent of increase in the observation group was significantly greater than that of the control group(P<0.05).4.The effects of N20 latency of SEP: Before treatment,there was no significant difference in the N20 latency(21.15±0.60,20.95±1.10)between the control group and the observation group(P>0.05).After 4 weeks of treatment,the N20 latency of both(20.70±0.65,20.11±1.01)was shorter than those before treatment,and the extent of the improvement in the observation group was significantly greater than that of the control group(P<0.05).Conclusions:1.Acupuncture,acupuncture combined with rTMS both have positive effects on NIHSS,FMA-UE,MBI scores,and also SEP N20 latency of stroke patients with upper extremity dyskinesia,which can promote the impaired nerve function,the recovery of upper limb motor function,and improve the quality of life of the patients.2.The SEP N20 latency,combined with FMA-UE and other related scales,play an important role on predicting the prognosis of upper limb motor function after stroke,and can objectively and accurately reflect the rehabilitation effects of stroke better.3.The combination of acupuncture with rTMS which shows synergistic action,is superior to simply acupuncture on the clinical efficacy of stroke patients with upper limb motor dysfunction.It has certain rehabilitation applications and promotion prospects. |
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