康复学报2025，Vol.35Issue(4)：378-384,7.DOI:10.3724/SP.J.1329.2025.04007
经颅交流电刺激联合电针对脑卒中注意障碍患者的影响
Effects of Transcranial Alternating Current Stimulation Combined with Electroacupuncture on Patients with Attention Deficit after Stroke
摘要
Abstract
Objective To investigate the effects of transcranial alternating current stimulation(tACS)combined with elec-troacupuncture on attention function and walking ability in stroke patients with attention deficit.Methods A total of 60 stroke pa-tients with attention deficit treated in the Department of Rehabilitation Medicine at Yueyang Hospital of Integrated Traditional Chi-nese and Western Medicine,Shanghai University of Traditional Chinese Medicine from January to December 2023 were randomly assigned to control group and observation group using a random number table generated by SPSS 26.0 statistical software,with 30 cases in each group.One patient in the control group voluntarily withdrew,and one in the observation group dropped out due to early hospital discharge.The control group received tACS treatment and sham EA stimulation,with a tACS treatment frequency of 6 Hz,current of 1 mA,and intervention duration of 20 minutes a time.Sham EA stimulation was applied at Shenting(DU24)and Baihui(DU20)acupoints,with acupuncture needles stimulating only the epidermis without skin penetration or electrical current,and the stimulation duration was 20 minutes a time.The observation group received tACS treatment and EA stimulation.The tACS treat-ment was the same as that in the control group.EA stimulation was applied at Shenting(DU24)and Baihui(DU20)acupoints,with acupuncture needles inserted at a 30° angle to the scalp.Electroacupuncture used dense-disperse waves with a frequency of 2/10 Hz and current intensity adjusted to the subject's tolerance,and each intervention lasted 20 minutes.Both groups received treatment once daily,five times per week,for a total of two weeks.Before and after treatment,the Montreal Cognitive Assessment(MoCA)was used to assess the cognitive function.The MoCA attention score,trail making test A(TMT-A)and trail making test B(TMT-B)were used to assess the attention function.Functional Ambulation Category Scale(FAC)was used to assess the walking ability.A digital monitoring treadmill was used to assess gait kinematics(hip and knee joint range of motion).The correlation between chang-es in walking ability scores and cognitive attention function scores was analyzed.Results(1)MoCA total score and attention func-tion score:compared with those before treatment,the MoCA score and MoCA attention score in both groups after treatment in-creased significantly(P<0.05),and the TMT-A score and TMT-B score decreased significantly(P<0.05).Compared with the control group,the MoCA score and MoCA attention score in the observation group after treatment were significantly higher(P<0.05),and the TMT-B score was significantly lower(P<0.05).(2)FAC score and hip/knee joint range of motion:compared with those before treatment,the FAC score,hip joint range of motion and knee joint range of motion in both groups after treatment increased signifi-cantly(P<0.05).Compared with the control group,the FAC score and hip joint range of motion in the observation group after treat-ment were significantly higher(P<0.05),while the difference was not statistically significant in knee joint range of motion(P>0.05).(3)Correlation between walking ability difference and cognitive attention difference:there was positive correlation between the FAC difference and the MoCA score difference(r=0.333,P<0.05),and the FAC difference was positively correlated with the difference in MoCA attention score(r=0.308,P<0.05);the difference in hip joint range of motion was positively correlated with the difference in MoCA score(r=0.425,P<0.05),with the difference in MoCA attention score(r=0.442,P<0.05),and with the difference in TMT-A score(r=0.2931,P<0.05).Conclusion tACS combined with EA can improve the attention function and walking ability of stroke patients with attention deficit,and the walking ability improvement is closely related to cognitive and attentional functions.关键词
脑卒中/经颅交流电刺激/电针/注意功能/步行能力Key words
stroke/transcranial alternating current stimulation/electroacupuncture/attention function/walking ability引用本文复制引用
郭清娟,武佳丽,张晶晶,张国辉,张思聪,薛夏琰,单春雷..经颅交流电刺激联合电针对脑卒中注意障碍患者的影响[J].康复学报,2025,35(4):378-384,7.基金项目
国家自然科学基金面上项目(82272612,82074572) （82272612,82074572）
上海市青年科技英才扬帆计划(21YF1448400) （21YF1448400）
国家中医药管理局高水平中医药重点学科建设项目(zyyzdxk-2023065) （zyyzdxk-2023065）
