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目的:观察经颅磁刺激(transcranial magnetic stimulation,TMS)联合高压氧(hyperbaricoxygen,HBO)治疗脑梗死的临床疗效。方法:采用随机数字表法将240例脑梗死患者分为联合治疗组、HBO组及常规组,每组80例。常规组患者给予常规治疗,HBO组患者在常规干预基础上辅以HBO治疗,联合治疗组患者则在常规干预基础上辅以HBO及TMS联合治疗。上述治疗均以10 d为1个疗程,共治疗2个疗程。于治疗前、治疗2个疗程后比较各组患者神经功能缺损程度,并同时于上述时间点检测各组患者中枢运动传导时间(CMCT)及血清中脑源性神经营养因子(BDNF)、神经生长因子(NGF)表达情况。结果:各组患者分别经2个疗程治疗后,发现联合治疗组NIHSS评分、总有效率均显著优于HBO组及常规组水平(均P<0.05);另外联合治疗组血清中BDNF含量与NGF含量均较治疗前明显升高(P<0.05),与常规组及HBO组间差异亦具有统计学意义(均P<0.05)。结论:TMS联合HBO治疗脑梗死具有协同作用,能进一步改善患者受损神经功能及日常生活质量,其治疗机制可能与增强神经营养因子表达有关。
Objective: To observe the clinical effect of transcranial magnetic stimulation (TMS) combined with hyperbaric oxygen (HBO) on cerebral infarction. Methods: 240 patients with cerebral infarction were randomly divided into the treatment group, the HBO group and the conventional group, with 80 cases in each group. Patients in the conventional group were given routine treatment. Patients in HBO group were supplemented with HBO on the basis of routine intervention. Patients in combined therapy group were treated with HBO and TMS combined with routine intervention. The above treatments are 10 days for a course of treatment, a total of 2 courses of treatment. Before treatment, the degree of neurological deficit in each group was compared after 2 courses of treatment. At the same time, CMCT, BDNF and nerve growth Factor (NGF) expression. Results: After 2 courses of treatment, the NIHSS score and total effective rate of the combined treatment group were significantly better than those of the HBO group and the conventional group (all P <0.05). In addition, the serum levels of BDNF and NGF (P <0.05). Compared with the control group and HBO group, the difference was also statistically significant (P <0.05). Conclusion: The combination of TMS and HBO has a synergistic effect on cerebral infarction, which can further improve the impaired neurological function and quality of life of patients. The therapeutic mechanism may be related to the enhancement of neurotrophic factor expression.