经颅磁刺激治疗阿尔茨海默病患者记忆障碍的疗效观察

Efficacy of transcranial magnetic stimulation in treatment of memory disorder in patients with Alzheimer disease

摘要:

目的 探讨重复经颅磁刺激(rTMS)对阿尔茨海默病(AD)患者前瞻性记忆障碍的改善情况。方法 回顾性分析2016年12月至2017年6月南充市身心医院精神科接受治疗的前瞻性记忆障碍AD患者60例,根据其治疗方式分为常规治疗组和rTMS组,常规治疗组患者口服康复春口服液,rTMS组患者口服药基础上给予rTMS,2组患者均接受4周治疗。比较2组患者治疗前后认知功能、日常生活能力和血清肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平差异。采用SPSS 11.5 统计软件对数据进行分析,组间比较采用t检验、单因素方差分析或χ²检验。结果 治疗前,2组患者认知功能差异无统计学意义(P＞0.05)。治疗后,rTMS组患者相比常规治疗组定向力[(4.41±1.02) vs(3.56±0.95)分]、瞬时记忆[(4.78±1.25) vs(3.11±0.74)分]、注意力和计算[(3.97±1.12) vs(2.55±1.02)分]、短时记忆[(1.95±0.21) vs(1.32±0.13)分]、语言[(5.68±1.98) vs(4.42±1.52)分]以及视觉空间感觉[(4.87±1.35) vs(3.58±1.12)分]认知功能得分增高,日常生活能力得分也明显增高[(97.25±8.91) vs(70.52±7.14)分],差异具有统计学意义(P＜0.05)。rTMS组患者治疗后相比常规治疗组TNF-α[(18.48±2.68) vs(23.87±3.11)ng/L]、IL-6[(7.03±1.03) vs(9.35±1.12)mg/L]水平降低,差异具有统计学意义(P＜0.001)。2组患者在治疗过程中未发生头痛、耳鸣等不良事件。结论 rTMS对AD患者有较好的治疗效果,可改善患者认知功能和日常生活能力,且无不良反应发生。

Abstract:

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the prospective memory impairment in the patients suffering from Alzheimer disease (AD). Methods A retrospective analysis was carried out on 60 AD patients with prospective memory impairment in the Nanchong Physical and Mental Hospital from December 2016 to June 2017. According to the treatment they got, the patients were divided into conventional treatment group (control) and the rTMS group. The patients of the control group were given oral administration of Kangfuchun Oral Liquid, while those of the rTMS group were given the same medication plus rTMS. The 2 groups of patients were treated for 4 weeks. Their cognitive function, daily living ability and serum TNF-α and IL-6 levels were observed before and after treatment, and the results were compared. SPSS statistics 11.5 was used to perform the statistical analysis. Student′s t test, analysis of variance, or Chi-square test was employed for comparison between the groups. Results Before treatment, there was no difference in cognitive function between the 2 groups (P>0.05). After treatment, the rTMS group had significantly better cognitive function in direction [(4.41±1.02) vs (3.56±0.95)scores], instantaneous memory [(4.78±1.25) vs (3.11±0.74)scores], attention and calculation [(3.97±1.12) vs (2.55±1.02)scores], short-term memory [(1.95±0.21) vs (1.32±0.13)scores], language [(5.68±1.98) vs (4.42±1.52)scores], and visual and spatial skills [(4.87±1.35) vs (3.58±1.12)scores], when compared with the treatment group (P<0.05), and such improvement was also seen in daily living ability [(97.25±8.91) vs (70.52±7.14)scores, P<0.05]. The serum levels of TNF-α [(18.48±2.68) vs(23.87±3.11)ng/L] and IL-6 [(7.03±1.03) vs (9.35±1.12)mg/L] were significantly lower in the rTMS group than in the control group (P<0.001). No headache, tinnitus or other adverse events were seen in the 2 groups of patients in the course of treatment. Conclusion rTMS shows good therapeutic effect on AD patients in improving the cognitive and memory function of the patients without adverse reactions.