目的 探讨醒脑开窍针刺联合重复经颅磁刺激(rTMS)治疗卒中后丘脑痛(PSTP)的临床效果.方法 选取2018 年 9 月至 2022 年 10 月于辽宁省金秋医院就诊的PSTP患者 198 例,通过随机数字表法将其分为三组,各66例.对照组 1接受rTMS治疗,对照组 2接受脑开窍针刺治疗,联合组接受脑开窍针刺联合rTMS治疗,三组均连续治疗6周.比较三组临床疗效和治疗后疼痛程度、炎症因子水平及安全性.结果 联合组临床疗效优于对照组1、对照组 2,差异有统计学意义(P<0.05).治疗后,三组视觉模拟评分法评分、现时疼痛强度评分、疼痛分级指数评分均低于治疗前,且联合组低于对照组 1、对照组2,差异有统计学意义(P<0.05).治疗后,三组血清白细胞介素-6、肿瘤坏死因子-α水平较治疗前降低,且联合组低于对照组 1、对照组 2,差异有统计学意义(P<0.05).三组患者治疗过程中均未出现明显的不良反应.结论 醒脑开窍针刺联合rTMS治疗PSTP的临床效果确切,能显著缓解疼痛症状,并降低血清炎症因子水平.
Objective To explore the clinical effect of xingnao kaiqiao acupuncture combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of post stroke thalamic pain(PSTP).Methods A total of 198 patients with PSTP admitted to Liaoning Jinqiu Hospital from September 2018 to October 2022 were selected and they were divided into three groups according to random number table method,with 66 cases in each group.Control group 1 received rTMS treatment,control group 2 received xingnao kaiqiao acupuncture treatment,and combined group received xingnao kaiqiao acupuncture combined with rTMS treatment,all three groups were treated for six weeks.The clinical efficacy,pain degree,inflammatory factor level,and safety of the three groups after treatment were compared.Results The clinical effect of combined group was better than control group 1 and control group 2,and the difference was statistically significant the difference was statistically significant(P<0.05).After treatment,visual analogue scale score,current pain intensity score and pain grading index score of the three groups were lower than those before treatment,and the combined group were lower than control group 1 and control group 2;serum levels of interleukin-6 and tumor necrosis factor-α in three groups were lower than those before treatment,and the combined group were lower than control group 1 and control group 2,the differences were statistically significant(P<0.05).No significant adverse reactions were observed during the treatment of the three groups.Conclusion The clinical efficacy of xingnao kaiqiao acupuncture combined with rTMS in the treatment of PSTP is definite,which can significantly alleviate pain symptoms and reduce serum inflammatory factor levels.