重复经颅磁刺激联合多奈哌齐治疗脑卒中后认知障碍的临床观察

目的探讨重复经颅磁刺激（rTMS）联合多奈哌齐治疗脑卒中后认知障碍（PSCI）的临床疗效。 方法选取苏州瑞盛康复医院神经康复科自2018年1月至2019年9月收治的76例PSCI患者，按照随机数字表法分为观察组与对照组，每组38例。2组患者均给予常规康复治疗，观察组增加口服多奈哌齐联合左侧前额叶背外侧10 Hz的rTMS治疗。在治疗前和治疗4周后分别采用蒙特利尔认知评估量表（MoCA）、简明精神状态检查表（MMSE）、改良Barthel指数（MBI）对患者的认知功能、日常生活能力进行评价。 结果2组患者治疗4周后的MoCA评分、MMSE评分、MBI评分均高于治疗前，且观察组患者MoCA评分、MMSE评分、MBI评分高于对照组，差异均具有统计学意义（P<0.05）。 结论rTMS联合多奈哌齐能在短期内改善PSCI患者的认知功能障碍及日常生活能力，临床疗效较好。

Clinical study of treatments to cognitive impairment by repetitive transcranial magnetic stimulation combined with donepezil on patients with stroke

ObjectiveTo investigate the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with donepezil in the treatment of post-stroke cognitive impairment (PSCI) patients. MethodsSeventy-six PSCI patients, admitted to Department of Neurology Rehabilitation of Suzhou Ruisheng Rehabilitation Hospital from January 2018 to September 2019, were randomly divided into control group (n=38) and experimental group (n=38). Both groups were given routine rehabilitation treatment. In the experimental group, oral donepezil combined with 10 Hz rTMS was added. Before and 4 weeks after treatment, the cognitive function and the ability of daily living of the patients were evaluated by the Montreal cognitive assessment scale (MoCA), concise mental state check table (MMSE), modified Barthel index (MBI). ResultsThe MoCA score, MMSE score and MBI score of the two groups after 4 weeks of treatment were higher than those before treatment, and the MoCA score, MMSE score and MBI score of the experimental group after 4 weeks of treatment were higher than those of the control group, the differences were statistically significant (P<0.05). ConclusionDonepezil combined with rTMS can improve the cognitive dysfunction and daily living ability of PSCI patients on a short period of time.