重复经颅磁刺激(rTMS)联合头皮穴位针灸治疗血管性痴呆对脑循环、神经电生理的影响

doi:10.19854/j.cnki.1008-2425.2026.03.0005

立体定向和功能性神经外科杂志 ›› 2026, Vol. 39 ›› Issue (3): 160-167.DOI: 10.19854/j.cnki.1008-2425.2026.03.0005

重复经颅磁刺激(rTMS)联合头皮穴位针灸治疗血管性痴呆对脑循环、神经电生理的影响

马翠霞, 王艳苓, 马翠娥, 李国强, 李文宝, 张梅莉, 卢娟, 邱志新

061000 沧州河北省沧州中西医结合医院康复治疗科(马翠霞),神经康复二科(王艳苓,李国强,张梅莉,邱志新),影像科(马翠娥),脑病一科(李文宝),推拿整脊科(卢娟)

收稿日期:2025-10-29 发布日期:2026-10-16
通讯作者: 邱志新 1162706974@qq.com

Effects of repetitive transcranial magnetic stimulation (rTMS) combined with scalp acupuncture at acupoints on cerebral circulation and neuroelectrophysiology in the treatment of vascular dementia

Ma Cuixia¹, Wang Yanling², Ma Cui′e³, Li Guoqiang², Li Wenbao⁴, Zhang Meili², Lu Juan⁵, Qiu Zhixin²

1. Department of Rehabilitation Therapy,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine;
2. Second Department of Neurological Rehabilitation,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine;
3. Department of Medical Imaging,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine;
4. First Department of Encephalopathy,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine;
5. Department of Tuina and Spinal Orthopedics,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,061000,China

Received:2025-10-29 Published:2026-10-16
Contact: Qiu Zhixin 1162706974@qq.com

摘要/Abstract

摘要： 目的探讨重复经颅磁刺激(rTMS)联合头皮穴位针灸治疗血管性痴呆的效果及对脑循环动力学、神经电生理的影响。方法选取我院2021年1月至2023年6月血管性痴呆患者126例,按照随机数字表法分为对照1组、对照2组、联合组,各42例。在常规西医治疗基础上,对照1组给予rTMS治疗,对照2组给予重复经颅针刺法治疗,联合组给予重复经颅针刺法联合rTMS治疗,均治疗4周。比较3组治疗效果、治疗前后认知功能[血管性痴呆评估量表(VaDAS-Cog)、简易智能精神状态检查量表(MMSE)]评分、脑循环动力学参数[脑血管床特性阻抗(ZCV)、外周阻力(Rv)、平均血流量(Qm)、平均血流速度(Vm)]、神经电生理参数[P300波幅、P300潜伏期、(δ＋θ)/(α+β)比值]、日常生活能力[基本日常生活能力量表(ADL)]评分、生活质量[痴呆生活质量量表(DQOL)]评分及不良反应。结果联合组总有效率高于对照1组、对照2组(P＜0.05),对照1组与对照2组总有效率差异无统计学意义(P＞0.05);治疗4周后联合组MMSE评分高于对照1组、对照2组,VaDAS-Cog评分低于对照1组、对照2组(P＜0.05),对照1组与对照2组治疗4周后MMSE、VaDAS-Cog评分差异无统计学意义(P＞0.05);治疗4周后联合组脑循环平均血流量、平均血流速度高于对照1组、对照2组,对照1组高于对照2组,脑血管床特性阻抗、外周阻力低于对照1组、对照2组,对照1组低于对照2组(P＜0.05);治疗4周后联合组P300波幅高于对照1组、对照2组,对照1组高于对照2组,P300潜伏期、(δ＋θ)/(α+β)比值低于对照1组、对照2组,对照1组低于对照2组(P＜0.05);治疗4周后联合组ADL评分高于对照1组、对照2组(P＜0.05),对照1组与对照2组差异无统计学意义(P＞0.05),治疗4周后联合组DQOL评分高于对照1组、对照2组(P＜0.05),对照1组与对照2组差异无统计学意义(P＞0.05);联合组不良反应发生率14.29%与对照1组11.90%、对照2组7.14%比较差异无统计学意义(P＞0.05)。结论重复经颅磁刺激(rTMS)联合头皮穴位针灸治疗血管性痴呆相较于单纯使用rTMS或重复经颅针刺法治疗效果更加显著,能有效改善患者脑循环动力学参数和神经电生理参数,进而提升认知功能,同时也能提高患者日常生活能力和生活质量,具有较高安全性。

关键词: 重复经颅针刺法, 重复经颅电刺激, 血管性痴呆, 脑循环动力学, 神经电生理

Abstract: Objective To investigate the effect of repeated transcranial acupuncture combined with repeated transcranial electrical stimulation (rTMS) in the treatment of vascular dementia and its influence on cerebral circulation dynamics and neuroelectrophysiology. Methods A total of 126 patients with vascular dementia in our hospital from January 2021 to June 2023 were selected and divided into control group 1,control group 2 and combination group according to random number table method,with 42 cases each.On the basis of conventional Western medicine treatment,control group 1 was given rTMS treatment,control group 2 was given repeated transcranial acupuncture treatment,and combination group was given repeated transcranial acupuncture combined with rTMS treatment for 4 weeks.Compare the treatment effect of the 3 groups,as well as Cognitive function[Vascular Dementia Assessment Scale (VaDAS-Cog),Simple Intelligent Mental State Examination Scale (MMSE)] scores,cerebral circulation dynamics parameters[cerebrovascular bed characteristic impedance (ZCV),peripheral resistance (Rv),mean blood flow (Qm),mean blood velocity (Vm)] and neuroelectrophysiological parameters[P300 amplitude,P300 latency],(δ+θ)/(α+β) ratio],ability of daily living[ADL] score,quality of life[Dementia Quality of Life Scale (DQOL)] score and adverse reactions before and after treatment. Results The total effective rate of combination group was higher than that of control group 1 and control group 2 (P＜0.05),but there was no significant difference between control group 1 and control group 2 (P＞0.05).After 4 weeks of treatment,MMSE score in combination group was higher than that in control group 1 and control group 2,and VaDAS-Cog score was lower than that in control group 1 and control group 2 (P＜0.05).There was no statistical significance in MMSE and VaDAS-Cog scores between control group 1 and control group 2 after 4 weeks of treatment (P＞0.05).After 4 weeks of treatment,the average cerebral circulation blood flow and average blood flow velocity in combined group were higher than those in control group 1 and control group 2,the characteristic impedance and peripheral resistance of cerebral vascular bed in combined group were lower than those in control group 1 and control group 2,and those in control group 1 were lower than those in control group 2 (P＜0.05).After 4 weeks of treatment,P300 amplitude in combination group was higher than that in control group 1 and control group 2,control group 1 was higher than that in control group 2,P300 latency and (δ+θ)/(α+β) ratio were lower than that in control group 1 and control group 2,and control group 1 was lower than that in control group 2 (P＜0.05).After 4 weeks of treatment,ADL and DQOL scores in combination group were higher than those in control group 1 and control group 2 (P＜0.05),but there was no significant difference between control group 1 and control group 2 (P＞0.05).The incidence of adverse reactions in the combined group was 14.29%,11.90% in the control group and 7.14% in the control group (P＞0.05). Conclusion Transcranial repeated acupuncture combined with rTMS in the treatment of vascular dementia is more effective than rTMS alone or transcranial repeated acupuncture,which can effectively improve the cerebral circulation dynamic parameters and neuroelectrophysiological parameters of patients,thus improving cognitive function,and improving patients'daily living ability and quality of life,with high safety.

Key words: Repeated transcranial acupuncture, Repeated transcranial electrical stimulation, Vascular dementia, Cerebral circulation dynamics, Neuroelectrophysiology

中图分类号:

R749.16

马翠霞, 王艳苓, 马翠娥, 李国强, 李文宝, 张梅莉, 卢娟, 邱志新. 重复经颅磁刺激(rTMS)联合头皮穴位针灸治疗血管性痴呆对脑循环、神经电生理的影响[J]. 立体定向和功能性神经外科杂志, 2026, 39(3): 160-167.

Ma Cuixia, Wang Yanling, Ma Cui′e, Li Guoqiang, Li Wenbao, Zhang Meili, Lu Juan, Qiu Zhixin. Effects of repetitive transcranial magnetic stimulation (rTMS) combined with scalp acupuncture at acupoints on cerebral circulation and neuroelectrophysiology in the treatment of vascular dementia[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2026, 39(3): 160-167.

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重复经颅磁刺激(rTMS)联合头皮穴位针灸治疗血管性痴呆对脑循环、神经电生理的影响

Effects of repetitive transcranial magnetic stimulation (rTMS) combined with scalp acupuncture at acupoints on cerebral circulation and neuroelectrophysiology in the treatment of vascular dementia

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