1. 南京医科大学,南京
2. 浙江中医药大学附属嘉兴中医院康复医学中心,嘉兴
3. 南京医科大学第一附属医院康复医学中心,南京
纸质出版:2025
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金文杰, 孟殿怀, 罗开涛, 等. 重复经颅磁刺激联合针灸治疗对血管性认知障碍患者认知功能及神经炎症因子的影响[J]. 中华物理医学与康复杂志, 2025,47(4):319-324.
金文杰, 孟殿怀, 罗开涛, et al. 重复经颅磁刺激联合针灸治疗对血管性认知障碍患者认知功能及神经炎症因子的影响[J]. 2025, 47(4): 319-324.
目的观察重复经颅磁刺激(rTMS)联合针灸治疗对血管性认知障碍(VCI)患者认知功能及神经炎症因子的影响。方法将40例VCI患者按照随机数字表法分为对照组和试验组
每组20例。2组患者均接受常规治疗
对照组在此基础上采用rTMS治疗
试验组采用rTMS联合针灸治疗
其中rTMS频率为10 Hz
强度为90%的运动阈值(MT)。治疗前及治疗4周后(治疗后)
采用蒙特利尔认知评估量表(MoCA)、简易精神状态量表(MMSE)和改良Barthel指数(MBI)对2组患者开展评估
同时利用酶联免疫吸附法(ELISA)检测患者外周血清白细胞介素-6(interleukin-6
IL-6)和肿瘤坏死因子α(TNF-α)水平。结果治疗后
2组患者的MoCA、MMSE、MBI评分及外周血清IL-6、TNF-α水平均有所改善(P<0.05)。治疗组治疗后的MoCA子项评分[视空间与执行功能(4.50±0.61)分、注意力(4.85±0.99)分、延迟回忆(4.35±0.67)分]及总分[(27.30±2.45)分]
MMSE评分[(27.45±2.37)分]、MBI评分[(80.25±14.55)分]均较对照组显著增加(P<0.05)
外周血清IL-6水平[(1.34±0.57)pg/ml]和TNF-α水平[(2.39±1.52)pg/ml]较对照组低(P<0.05)。Pearson相关分析结果显示
2组患者的MoCA、MMSE改善值与IL-6、TNF-α降低值之间均呈正相关关系(P<0.05)。结论 rTMS联合针灸治疗可有效改善VCI患者的认知功能
提高其生活自理能力
其作用机制可能与降低神经炎症因子IL-6和TNF-α水平有关。
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Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, the 127th of Changle Road, Xi’an 710032, Shaanxi, China,Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, the 127th of Changle Road, Xi’an 710032, Shaanxi, China,Medical Department of Xi’an Emergency Center, the 111th of Fengcheng 4th Road, Xi’an 718900, Shaanxi, China,School of Medical Psychology, Fourth Military Medical University, the 127th of Changle Road, Xi’an 710032, Shaanxi, China,Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, the 127th of Changle Road, Xi’an 710032, Shaanxi, China,Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, the 127th of Changle Road, Xi’an 710032, Shaanxi, China,Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, the 127th of Changle Road, Xi’an 710032, Shaanxi, China,Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, the 127th of Changle Road, Xi’an 710032, Shaanxi, China,Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, the 127th of Changle Road, Xi’an 710032, Shaanxi, China.Repetitive Transcranial Magnetic Stimulation Elicits Antidepressant- and Anxiolytic-like Effect via Nuclear Factor-E2-related Factor 2-mediated Anti-inflammation Mechanism in Rats[J].Neuroscience,2020.
ENT Team, EA4391, Faculty of Medicine, Paris Est Créteil University, Créteil, France,Clinical Neurophysiology Unit, Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France. Electronic address: jean-pascal.lefaucheur@hmn.aphp.fr.,Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Psychiatry and Medical Psychology, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium,Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.,Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.,PsyR2 Team, U1028, INSERM and UMR5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), Centre Hospitalier Le Vinatier, Lyon-1 University, Bron, France.,Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.,Department of Human Neuroscience, Institute for Medical Research, University of Belgrade, Belgrade, Serbia.,Department of Neurology, Cologne University Hospital, Cologne, Germany,Institute of Neurosciences and Medicine (INM3), Jülich Research Centre, Jülich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Defitech Chair in Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland,Defitech Chair in Clinical Neuroengineering, Swiss Federal Institute of Technology (EPFL) Valais and Clinique Romande de Réadaptation, Sion, Switzerland,Clinical Neuroscience, University of Geneva Medical School, Geneva, Switzerland.,Department of Clinical Neurophysiology, Turku University Hospital and University of Turku, Turku, Finland.,Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Department of Neurorehabilitation and Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), IRCCS San Raffaele, University Vita-Salute San Raffaele, Milan, Italy.,Department of Otorhinolaryngology - Head and Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Hôpital Européen Georges Pompidou, Paris, France.,Department of Neurology, Franz Tappeiner Hospital, Merano, Italy,Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria,Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria.,Multidisciplinary Pain Center, Clinique Bretéché, ELSAN, Nantes, France,Multidisciplinary Pain, Palliative and Supportive Care Center, UIC22-CAT2-EA3826, University Hospital, CHU Nord-Laënnec, Nantes, France.,Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland,Perception and Eye Movement Laboratory, Department of Neurology, University of Bern, Bern, Switzerland,Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland.,Champalimaud Research & Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal,Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal,NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.,FENNSI Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany,Medical Park Chiemseeblick, Bernau, Germany.,Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.,PsyR2 Team, U1028, INSERM and UMR5292, CNRS, Center for Neuroscience Research of Lyon (CRNL), Centre Hospitalier Le Vinatier, Lyon-1 University, Bron, France,Department of Emergency Psychiatry, Edouard Herriot Hospital, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France.,Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.,Private Practice, Geneva, Switzerland.,Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic,First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Medicine, Surgery and Neuroscience, Si-BIN Lab Human Physiology Section, Neurology and Clinical Neurophysiology Unit, University of Siena, Siena, Italy.,ENT Clinic, Mehiläinen and University of Turku, Turku, Finland.,Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Department of Psychiatry, Princess Grace Hospital, Monaco.,Department of Neurology and Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany..Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018).[J].Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology,2020.
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Department of Neurology and Sagol Center for Neurosciences, Sheba Medical Center, 52621, Ramat Gan, Israel. Nicola.Maggio@sheba.health.gov.il.,Department of Neurology, The Chaim Sheba Medical Center, 52621, Tel HaShomer, Israel. Nicola.Maggio@sheba.health.gov.il.,Talpiot Medical Leadership Program, The Chaim Sheba Medical Center, 52621, Tel HaShomer, Israel. Nicola.Maggio@sheba.health.gov.il.,Department of Neurology and Neurosurgery, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, 52621, Tel Aviv, Israel. Nicola.Maggio@sheba.health.gov.il.,Department of Neuroanatomy, Institute of Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, 79104, Freiburg, Germany. andreas.vlachos@anat.uni-freiburg.de..Tumor necrosis factor (TNF) modulates synaptic plasticity in a concentration-dependent manner through intracellular calcium stores.[J].Journal of molecular medicine (Berlin, Germany),2018.
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grid.266100.3, 0000 0001 2107 4242, Department of Neuroscience and Section of Neurobiology, Center for Neural Circuits and Behavior, University of California at San Diego, 92093, California, USA,grid.266100.3, 0000 0001 2107 4242, Department of Neuroscience and Section of Neurobiology, Center for Neural Circuits and Behavior, University of California at San Diego, 92093, California, USA,grid.266100.3, 0000 0001 2107 4242, Department of Neuroscience and Section of Neurobiology, Center for Neural Circuits and Behavior, University of California at San Diego, 92093, California, USA,grid.266100.3, 0000 0001 2107 4242, Department of Pharmacology, University of California at San Diego, 92093, California, USA,grid.266100.3, 0000 0001 2107 4242, Department of Pharmacology, University of California at San Diego, 92093, California, USA,grid.266100.3, 0000 0001 2107 4242, Howard Hughes Medical Institute, University of California at San Diego, 92093, California, USA,grid.266100.3, 0000 0001 2107 4242, Department of Neuroscience and Section of Neurobiology, Center for Neural Circuits and Behavior, University of California at San Diego, 92093, California, USA.Engineering a memory with LTD and LTP.[J].Nature,2014.
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