吴杨　单晶丽　李红颖　王丽莹

摘要：目的 分析臨床用低频重复经颅磁刺激改善脑卒中后抑郁患者的抑郁状态和神经功能缺损的效果。方法 用2020年7月-2021年3月院内收治的72例脑卒中后抑郁患者，随机均分两组，各36例。参照组用常规治疗，观察组用低频重复经颅磁刺激治疗，比较治疗前后1个月的抑郁评分和神经功能缺损评分。结果 治疗后，参照组比观察组的抑郁评分和神经功能评分略高，体现差异（P<0.05）。结论 低频重复经颅磁刺激对脑部组织的刺激适中，能改善神经系统状态，促进神经间传导，让抑郁评分等持续下降，提高临床效果。

关键词：低频重复经颅磁刺激;脑卒中后抑郁;神经功能缺损

[Abstract] Objective To analyze the effect of low frequency repetitive transcranial magnetic stimulation on depressive state and neurological deficit in patients with post-stroke depression. Methods 72 patients with post-stroke depression treated in our hospital from July 2020 to March 2021 were randomly divided into two groups，36 cases in each group. The reference group was treated with routine treatment and the observation group was treated with low-frequency repetitive transcranial magnetic stimulation. The depression score and neurological deficit score before and after treatment were compared. Results after treatment，the depression score and neurological function score of the reference group were slightly higher than those of the observation group（P < 0.05）. Conclusion the stimulation of low-frequency repetitive transcranial magnetic stimulation on brain tissue is moderate，which can improve the state of nervous system，promote neural conduction，continuously reduce the depression score and improve the clinical effect.

[Key words] low frequency repetitive transcranial magnetic stimulation;Post stroke depression;Neurological deficit

脑卒中后抑郁会降低患者的求生意识，阻碍机体恢复。很多患者还自残或咀嚼进食，机体和心理状态十分差，容易引发其他问题【1】。为提高疗效，研究比较常规治疗和低频重复经颅磁刺激，低频重复经颅磁刺激干预力更强，抑郁评分和神经功能损伤评分更低，可尽快调整好患者状态，治疗效果更佳，详见下述。

1  资料和方法

1.1一般资料

用2020年7月-2021年3月院内收治的72例脑卒中后抑郁患者，随机均分两组，各36例。共有37例男、35例女，均（51.48±9.74）岁，无资料差异（P>0.05）。家属已签知情同意书。

1.2方法

1.2.1参照组

常规治疗：口服抗抑郁药物、改善脑血管功能药物等，用药时间同下。

1.2.2观察组

低频重复经颅磁刺激治疗：用武汉依瑞德医疗设备新技术有限公司生产的磁场刺激仪，型号为YRD CCY-1，将线圈直径调整到12cm，峰值刺激强度控制在1.2Tesla、脉冲时限在100μs，将患者改为平卧，将刺激强度最大值控制在60%（大概0.72Tesla）对双侧前额叶进行刺激，每侧大概刺激30次，频率在0.5MHz，每日进行一次，连续7天。