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Objectives: To observe the effect of motor evoked potential (MEP)-oriented scalp acupuncture combined with transcranial magnetic stimulation (TMS) on limb motor ability in patients with ischemic stroke hemiplegia.

Methods: A total of 60 patients with ischemic stroke hemiplegia were randomized into an observation group and a control group, 30 cases in each one. In addition to the medication treatment of internal medicine and comprehensive training of hemiplegic limbs, MEP-oriented scalp acupuncture combined with TMS was applied in the observation group, conventional scalp acupuncture at bilateral anterior oblique line of parietal and temporal regions combined with TMS was applied in the control group. The treatment was given once a day, 5 days a week for 4 weeks totally in the two groups. Before and after treatment, the scores of Fugl-Meyer assessment (FMA), modified Ashworth scale (MAS) and modified Barthel index (MBI) were observed in the two groups.

Results: After treatment, the FMA and MBI scores were increased compared with those before treatment in the two groups ( P <0.001), and the FMA and MBI scores in the observation group were higher than those in the control group ( P <0.05). After treatment, the MAS scores of upper and lower limbs in the observation group were decreased compared with those before treatment ( P <0.01, P <0.001), the MAS score of lower limb in the control group was decreased compared with that before treatment ( P <0.05).

Conclusions: MEP-oriented scalp acupuncture combined with TMS can effectively improve the limb motor ability, daily living ability and limb spasticity in patients with ischemic stroke hemiplegia.

Titel:	Effect of MEP-oriented scalp acupuncture combined with transcranial magnetic stimulation on limb motor ability in patients with ischemic stroke hemiplegia.
Autor/in / Beteiligte Person:	Wu, S ; Zhang, J ; Zhang, F ; Zhu, Z ; Fu, B
Zeitschrift:	Zhongguo zhen jiu = Chinese acupuncture & moxibustion, Jg. 44 (2024-03-12), Heft 3, S. 251-254
Veröffentlichung:	Pei-Ching : Guoji Shudian ; <i>Original Publication</i>: Beijing : Zhonghua quan guo Zhong yi zhen jiu xue hui : Zhong yi yan jiu yuan zhen jiu yan jiu suo, 1981-, 2024
Medientyp:	academicJournal
ISSN:	0255-2930 (print)
DOI:	10.13703/j.0255-2930.20230520-k0003
Schlagwort:	Humans Hemiplegia etiology Hemiplegia therapy Transcranial Magnetic Stimulation Scalp Evoked Potentials, Motor Treatment Outcome Upper Extremity Stroke complications Stroke therapy Ischemic Stroke Stroke Rehabilitation Acupuncture Therapy
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Transliterated Title: MEP定位下头针联合经颅磁刺激对缺血性脑卒中偏瘫患者肢体运动能力的影响. Publication Type: Randomized Controlled Trial; Journal Article Language: English; Chinese [Zhongguo Zhen Jiu] 2024 Mar 12; Vol. 44 (3), pp. 251-254. MeSH Terms: Stroke* / complications ; Stroke* / therapy ; Ischemic Stroke* ; Stroke Rehabilitation* ; Acupuncture Therapy* ; Humans ; Hemiplegia / etiology ; Hemiplegia / therapy ; Transcranial Magnetic Stimulation ; Scalp ; Evoked Potentials, Motor ; Treatment Outcome ; Upper Extremity References: 《中国脑卒中防治报告》编写组. 《中国脑卒中防治报告2019》概要[J]. 中国脑血管病杂志, 2020, 17(5): 272- 281. ; 马震震, 胡军, 徐亭亭, 等. 脑卒中后肌痉挛的治疗进展[J]. 中华中医药学刊, 2015, 33(7): 1617- 1621. ; Dionísio A, Duarte IC, Patrício M, et al. The use of repetitive transcranial magnetic stimulation for stroke rehabilitation: a systematic review[J]. J Stroke Cerebrovasc Dis, 2018, 27(1): 1- 31. ; 刘盼, 刘世文. 经颅直流电刺激的研究及应用[J]. 中国组织工程研究与临床康复, 2011, 15(39): 7379- 7383. ; 张子迪, 王锐卿, 刘敬萱, 等. 头针不同流派比较与分析[J]. 针刺研究, 2021, 46(9): 809- 814. ; 钟迪, 张舒婷, 吴波. 《中国急性缺血性脑卒中诊治指南2018》解读[J]. 中国现代神经疾病杂志, 2019, 19(11): 897- 901. ; 闵友江, 姚海华, 邵水金, 等. 浅析《头针穴名国际标准化方案》的科学性[J]. 中国针灸, 2007, 27(8): 612- 616. ; 许光旭, 高晓阳, 陈文红. Fugl-Meyer运动功能评分的敏感性及实用性[J]. 中国康复, 2001, 16(1): 18- 19. ; 魏鹏绪. 关于改良Ashworth量表的探讨[J]. 中国康复医学杂志, 2014, 29(1): 67- 68. ; 闵瑜, 吴媛媛, 燕铁斌. 改良Barthel指数(简体中文版)量表评定脑卒中患者日常生活活动能力的效度和信度研究[J]. 中华物理医学与康复杂志, 2008, 30(3): 185- 188. ; Kuo CL, Hu GC. Post-stroke spasticity: a review of epidemiology, pathophysiology, and treatments[J]. Int J Gerontol, 2018, 12(4): 280- 284. ; 李洪天, 魏凯, 刘杰, 等. 头针治疗脑卒中后下肢运动功能障碍研究进展[J]. 老年医学研究, 2023, 4(1): 67- 71. ; Wang H, Sun JP, Cui D, et al. Quantitative assessment of inter-individual variability in fMRI-based human brain atlas[J]. Quant Imaging Med Surg, 2021, 11(2): 810- 822. ; 王舒娅, 王佳, 刘坤, 等. 头针与脑联系的捷径通路[J]. 针刺研究, 2020, 45(12): 947- 953. ; 唐萍萍, 许骞, 陈栋, 等. 头针刺激层次影响大脑皮层功能的机制探讨[J]. 针刺研究, 2020, 45(6): 504- 507. ; Wang Q, Zhang D, Zhao YY, et al. Effects of high-frequency repetitive transcranial magnetic stimulation over the contralesional motor cortex on motor recovery in severe hemiplegic stroke: a randomized clinical trial[J]. Brain Stimul, 2020, 13(4): 979- 986. ; 高天昊, 姜从玉, 白玉龙. 有关脑卒中后运动功能障碍重复经颅磁刺激治疗靶点定位的研究进展[J]. 上海医药, 2023, 44(5): 11- 13, 54. ; 孔健, 曹瑾. 头针刺激靶点研究新思路[J]. 针刺研究, 2023, 48(6): 606- 609. Contributed Indexing: Keywords: hemiplegia; ischemic stroke; motor dysfunction; motor evoked potential; randomized controlled trial (RCT); scalp acupuncture; transcranial magnetic stimulation ; Local Abstract: [Publisher, Chinese] 目的 : 观察运动诱发电位（MEP）定位下头针联合经颅磁刺激对缺血性脑卒中偏瘫患者肢体运动能力的影响。方法 : 将60例缺血性脑卒中偏瘫患者随机分为观察组和对照组，各30例。两组均予内科药物治疗及偏瘫肢体综合训练。在此基础上，观察组患者接受MEP定位下取穴的头针联合经颅磁刺激治疗；对照组患者接受常规头针（双侧顶颞前斜线）联合经颅磁刺激治疗。两组治疗均每天1次，每周5 d，共4周。分别于治疗前后观察两组患者Fugl-Meyer运动功能评定量表（FMA）、改良Ashworth量表（MAS）及改良Barthel指数（MBI）评分。结果 : 治疗后，两组患者FMA、MBI评分均较治疗前升高（ P <0.001），且观察组高于对照组（ P <0.05）；观察组患者上肢及下肢MAS评分较治疗前降低（ P <0.01， P <0.001），对照组患者下肢MAS评分较治疗前降低（ P <0.05）。结论 : MEP定位下头针联合经颅磁刺激可有效改善缺血性脑卒中偏瘫患者肢体运动能力，提高其日常生活能力，减轻肢体痉挛。. Entry Date(s): Date Created: 20240311 Date Completed: 20240313 Latest Revision: 20240313 Update Code: 20240313

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Effect of MEP-oriented scalp acupuncture combined with transcranial magnetic stimulation on limb motor ability in patients with ischemic stroke hemiplegia.