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目的:比较单次(45min)经皮电神经刺激(TENS)穴位治疗对脑卒中患者偏瘫侧上肢体感诱发电位(SEP)的影响。方法:符合入选条件并签署知情同意书的29例初发脑卒中患者分层后随机分为治疗组和安慰组。治疗组患者接受1次45minTENS治疗,刺激电极放在患侧上肢穴位上,刺激频率为100Hz,脉宽为200μs,强度为患者最大耐受量;安慰组患者接受45min安慰治疗,仪器与治疗组相同,有指示灯闪,但无电流输出。两组患者分别在治疗前后接受1次SEP检测,并比较其治疗前后的差异。结果:治疗前两组患者偏瘫侧与健侧SEP值相比,除N9潜伏期外差异均有显著性意义(P<0.05);治疗组治疗前后SEP值差异有显著性意义(P<0.05);治疗后两组患者组间SEP值N20潜伏期差异有显著性意义(P<0.05)。结论:单次45minTENS治疗能改善脑卒中患者偏瘫侧上肢的SEP,推测TENS改善脑卒中偏瘫患者肢体功能可能与TENS增加脑电活动,改善SEP,激活脑细胞的功能活动有关。
OBJECTIVE: To compare the effect of single 45min TENS acupoints treatment on the somatosensory evoked potential (SEP) of the upper limbs in patients with stroke. Methods: Twenty-nine patients with initial stroke that met the inclusion criteria and signed informed consent were randomly divided into treatment group and placebo group. Patients in the treatment group received 45minTENS treatment once. The stimulation electrodes were placed on the upper limbs of the affected side. The stimulation frequency was 100Hz and the pulse width was 200μs. The intensity was the maximum tolerated dose. The patients in the control group received the comfort treatment for 45min. The instruments were the same as the treatment group , A flashing light, but no current output. Two groups of patients before and after treatment were received 1 SEP test, and compare their differences before and after treatment. Results: There were significant differences in SEP values between the two groups before and after treatment (P <0.05) except for the N9 latency (P <0.05). The difference of SEP before and after treatment in the treatment group was significant (P <0.05). There was significant difference in the latent period of SEP N20 between the two groups after treatment (P <0.05). Conclusion: A single 45minTENS treatment can improve the SEP in the upper limbs of hemiparetic patients. It is speculated that TENS can improve limb function in patients with hemiplegia after stroke, which may be related to the increase of brain electrical activity, the improvement of SEP and the activation of brain cells.