重复经颅磁刺激结合认知训练治疗血管性认知障碍临床疗效观察.docVIP

重复经颅磁刺激结合认知训练治疗血管性认知障碍临床疗效观察 　　[摘要]目的 探?重复经颅磁刺激联合认知训练治疗血管性认知障碍的临床效果。方法 选择2015年7月～2016年6月在我院康复医学科接受康复治疗的血管性认知障碍患者共91例，随机分为治疗组（46例）及对照组（45例）。治疗组采用复经颅磁刺激联合认知训练训练治疗，对照组为单纯认知训练，应用蒙特利尔认知评估量表（MoCA）及洛文斯顿认知评价箱（LOTCA）评估患者认知功能。比较两组患者治疗前后MoCA及LOTCA总分及各单项评分。结果 治疗后，治疗组MoCA总分及其单项（执行、抽象、记忆、定向）评分均高于对照组，差异有统计学意义（P0.05）；治疗组LOTCA总分及其单项（定向、知觉、思维能力）评分均高于对照组，差异有统计学意义（P0.05）。治疗后两组MoCA总分及LOTCA总分均高于治疗前，差异有统计学意义（P0.01）。治疗后，LOTCA单项中，对照组知觉、思维、视运动评分均高于治疗前，差异有统计学意义（P0.05）；治疗组各项评分均高于治疗前，差异有统计学意义（P0.01）。治疗后，MoCA单项中，对照组除命名项外，其他项评分均高于治疗前，差异有统计学意义（P0.01）；治疗组各项评分均高于治疗前，差异有统计学意义（P0.01）。结论 重复经颅磁刺激联合认知训练可提高血管性认知障碍患者认知功能水平，改善患者生活质量。 　　[关键词]重复经颅磁刺激；认知训练；血管性认知障碍；认知功能 　　[中图分类号] R749.13 [文献标识码] A [文章编号] 1674-4721（2017）10（a）-0051-04 　　[Abstract]Objective To observe the clinical effect of rTMS combined with cognitive training in the treatment of VCI.Methods A total of 91 patients with VCI who received rehabilitation treatment in our hospital from July 2015 to June 2016 were enrolled.The treatment group was treated with rTMS combined with cognitive training.The control group was given only cognitive training.Application of MoCA and LOTCA in patient`s cognitive assessment.Results After treatment，the MoCA total scores and individual items （execution，abstract，memory and orientation） of the treatment group were higher than those in the control group，the differences were statistically significant （P0.05）.The total score of LOTCA and the individual items （orientation，perception，thinking） in the treatment group were higher than those in the control group，the differences were statistically significant （P0.05）.After treatment scores of MoCA and LOTCA scales were both increased in the two groups compared with before treatment，the differences were statistically significant （P0.01）；After treatment，in the LOTCA individual，the scores of perception，thinking and visual and spatial perception in the control group were higher than before treatment，the differences were statistically significant （P0.01）；in the MoCA single item，