阳极经颅直流电刺激联合多奈哌齐治疗卒中后认知障碍的疗效观察

doi:10.3969/j.issn.1673-5765.2021.06.013

摘要/Abstract

摘要： 目的探讨阳极经颅直流电刺激（transcranial direct current stimulation，tDCS）联合多奈哌齐治疗卒中后认知障碍（post-stroke cognitive impairment，PSCI）的临床疗效。方法前瞻性连续纳入2019年10月-2020年9月在河南大学附属南石医院康复医学科收治的PSCI 患者，按照随机数字表法分为观察组与对照组。两组患者均予基础药物治疗及常规康复治疗，在此基础上，观察组予阳极tDCS联合多奈哌齐治疗，对照组予假刺激联合多奈哌齐治疗，两组均治疗4周。评估两组治疗前和治疗后MoCA、洛文斯顿作业疗法认知评定量表（Loewenstein occupational therapy cognitive assessment，LOTCA）、Rivermead行为记忆测验（Rivermead behaviour memory test，RBMT）及改良Barthel指数（modified Barthel index，MBI）评分。结果最终纳入80例患者，观察组39例，对照组41例。治疗前，两组患者一般资料、MoCA总分及各子项评分、LOTCA、RBMT、MBI评分差异无统计学意义。治疗后，观察组MoCA、LOTCA、RBMT、MBI评分均高于治疗前（均P＜0.001）；对照组MoCA（P <0.001）、LOTCA（P=0.020）、MB（I P<0.001）评分高于治疗前。治疗后，观察组MoCA（P<0.001）、LOTCA（P=0.016）、RBMT（P=0.024）、MB（I P<0.001）评分均高于对照组；MoCA子项语言（P =0.006）、延迟记忆（P =0.020）、定向力（P＝0.001）评分高于对照组。结论阳极tDCS联合多奈哌齐治疗PSCI患者，可在短期内改善患者的认知功能、记忆水平及日常生活能力，临床疗效较好。

文章导读： 本研究探讨了阳极tDCS联合多奈哌齐治疗PSCI的临床疗效，研究结果显示阳极tDCS联合多奈哌齐可在短期内改善PSCI患者的认知功能、记忆水平及日常生活能力。

关键词: 经颅直流电刺激; 多奈哌齐; 卒中; 认知障碍

Abstract: Objective To investigate the clinical efficacy of anodic transcranial direct current stimulation (tDCS) combined with donepezil in the treatment of post-stroke cognitive impairment (PSCI). Methods The consecutive PSCI patients admitted in Department of Rehabilitation Medicine, Henan University Affiliated Nanshi Hospital from October 2019 to September 2020 were prospectively enrolled in this study. All the patients were randomly divided into observation group and control group. Both groups were given conventional medications and rehabilitation, on the basis of above treatment, the observation group were added anodic tDCS + donepezil treatment for 4 weeks and the control group was given pseudo-electric stimulation + donepezil treatment for 4 weeks. The cognitive function, memory capacity and the activity of daily life of the patients were evaluated using MoCA, Loewenstein occupational therapy cognitive assessment (LOTCA), Rivermead behavior memory test (RBMT) and modified Barthel index (MBI) before and after the treatment. Results A total of 80 patients were included, including 39 cases in observation group and 41 cases in control group. Before treatment, there was no statistical difference in general information, the

total and item scores of MoCA, LOTCA, RBMT, MBI scores between the two groups. After

treatment, MoCA, LOTCA, RBMT and MBI scores of the observation group were higher than those before treatment, and MoCA, LOTCA and MBI scores of the control group were higher than those before treatment, all the above differences were statistically significant. After treatment, MoCA total score and item score (language, delayed memory, orientation), LOTCA, RBMT, MBI scores of the observation group were all higher than those of the control group, and all the differences were statistically significant. Conclusions tDCS combined with donepezil can effectively improve the cognitive function, memory capacity and activity of daily life of the patients with PSCI in a short time.

Key words: Transcranial direct current stimulation; Donepezil; Stroke; Cognitive impairment

王建晖, 马静丽, 王云龙, 刘阳, 司艳琴. 阳极经颅直流电刺激联合多奈哌齐治疗卒中后认知障碍的疗效观察[J]. 中国卒中杂志, 2021, 16(06): 596-601.

WANG Jian-Hui, MA Jing-Li, WANG Yun-Long, LIU Yang, SI Yan-Qin. Anodic Transcranial Direct Current Stimulation Combined with Donepezil in the Treatment of Post-stroke Cognitive Impairment#br#[J]. Chinese Journal of Stroke, 2021, 16(06): 596-601.

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