重复经颅磁刺激联合认知训练对脑卒中后认知障碍病人影响的Meta分析

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Effect of repetitive transcranial magnetic stimulation combined with cognitive training on patients with cognitive impairment after stroke：a Meta-analysis

FENG Luye1，LEI Junfang2，MU Hui1，ZHOU Shanshan1，YANG Yuanyuan1，TANG Jiqin1*

1.School of Rehabilitation，Shandong University of Traditional Chinese Medicine，Shandong 250355 China；2.Shangqiu Institute of Technology School of Medicine

* Corresponding Author  TANG Jiqin，E-mail：tangjiqin0312@163.com

Abstract Objective：To systematically evaluate the efficacy of repetitive transcranial magnetic stimulation （rTMS） combined with cognitive training in the treatment of patients with post⁃stroke cognitive impairment （PSCI）.Methods：The databases of the Cochrane Library， PubMed， Web of Science， EMbase， SinoMed， CNKI， WanFang Database and VIP were searched for randomized controlled trials of rTMS combined with cognitive training in the treatment of PSCI from the establishment of the database to September 2023. Meta⁃analysis was performed using RevMan 5.4 software.Results：18 articles with a total of 1 407 PSCI patients were included. The results of Meta⁃analysis showed that observation group of montreal cognitive assessment score （MD=3.38，95%CI 3.03⁃3.72，P<0.000 01）， mini⁃mental state examination score （MD=3.14，95%CI 2.69⁃3.60，P<0.000 01）， modified barthel index score （MD=10.23，95%CI 8.05⁃12.41，P<0.000 01） and rivermead behavioral memory test score were higher than control group （P<0.05）. The treatment group was better in shortening event related potential latency and increasing amplitude （P<0.05）.Conclusion：Existing evidence shows that rTMS combined with cognitive training can effectively improve the cognitive ability and daily living ability of PSCI patients. Due to the limitations of the quantity and quality of included studies， more high⁃quality studies are needed to further confirm the efficacy of rTMS combined with cognitive training in the treatment of PSCI to provide more reliable evidence.

Keywords  repetitive transcranial magnetic stimulation;stroke;cognitive impairment;cognitive training;Meta⁃ananlysis;evidence⁃based nursing

摘要  目的：系统评价重复经颅磁刺激（rTMS）联合认知训练对脑卒中后认知障碍（PSCI）病人的治疗效果。（剩余10428字）