\u6587\u7ae0\u6765\u6e90\uff1a\u4e2d\u56fd\u8111\u8840\u7ba1\u75c5\u6742\u5fd7,2023,20(1):41-48.<\/p>\n
\u4f5c\u8005\uff1a\u674e\u5baa\u4e1c \u88f4\u8f76\u4e30 \u5f20\u695a\u6f4d \u9648\u4f1a\u751f<\/p>\n
\u57fa\u91d1\u9879\u76ee:\u56fd\u5bb6\u81ea\u7136\u79d1\u5b66\u57fa\u91d1(82071477);\u8fbd\u5b81\u7701\u79d1\u6280\u8ba1\u5212\u9879\u76ee(2019JH2\/10300027);\u6c88\u9633\u5e02\u79d1\u6280\u8ba1\u5212\u9879\u76ee(20-205-4-007)<\/p>\n
\u901a\u4fe1\u4f5c\u8005:\u9648\u4f1a\u751f,Email:chszh@ aliyun. com<\/p>\n
\u6458\u8981:\u9664\u4e86\u518d\u704c\u6ce8\u6cbb\u7597,\u6025\u6027\u7f3a\u8840\u6027\u5352\u4e2d(AIS)\u4ecd\u7f3a\u5c11\u8db3\u591f\u6709\u6548\u7684\u6cbb\u7597\u65b9\u6cd5\uff61\u7ecf\u9885\u76f4\u6d41\u7535\u523a\u6fc0(tDCS)\u80fd\u591f\u8c03\u8282\u8111\u90e8\u795e\u7ecf\u53ca\u8840\u7ba1\u7b49\u7ec4\u7ec7\u7ed3\u6784\u7684\u751f\u7406\u529f\u80fd,\u6210\u4e3aAIS\u540e\u795e\u7ecf\u529f\u80fd\u6062\u590d\u7684\u6f5c\u5728\u6cbb\u7597\u624b\u6bb5\uff61\u8fd1\u5e74\u6765\u7684\u4e00\u4e9b\u6587\u732e\u521d\u6b65\u63a2\u8ba8\u4e86tDCS\u5728AIS\u4e2d\u5e94\u7528\u7684\u53ef\u884c\u6027\u53ca\u6709\u6548\u6027,\u672c\u7814\u7a76\u5bf9\u76f8\u5173\u57fa\u7840\u53ca\u4e34\u5e8a\u7814\u7a76\u8fdb\u884c\u4e86\u7efc\u8ff0,\u65e8\u5728\u4e3atDCS\u5728AIS\u4e2d\u7684\u5408\u7406\u5e94\u7528\u63d0\u4f9b\u6709\u4ef7\u503c\u7684\u4fe1\u606f\uff61<\/p>\n
\u8fd1\u5e74\u6765,\u5352\u4e2d\u60a3\u75c5\u4eba\u6570\u663e\u8457\u589e\u957f,\u5df2\u8dc3\u5347\u81f3\u6211\u56fd\u6210\u4eba\u81f4\u6b7b\uff64\u81f4\u6b8b\u6027\u75be\u75c5\u7684\u9996\u4f4d,\u7ed9\u5bb6\u5ead\u53ca\u793e\u4f1a\u5e26\u6765\u4e86\u6c89\u91cd\u7684\u8d1f\u62c5[1]\uff61\u5c3d\u7ba1\u9759\u8109\u6eb6\u6813\u53ca\u673a\u68b0\u53d6\u6813\u7b49\u8840\u7ba1\u5185\u518d\u901a\u6280\u672f\u80fd\u591f\u6709\u6548\u5730\u6062\u590d\u8111\u8840\u6d41,\u5728\u4e00\u5b9a\u7a0b\u5ea6\u4e0a\u6539\u5584\u4e86\u6025\u6027\u7f3a\u8840\u6027\u5352\u4e2d(acute ischemic stroke,AIS)\u60a3\u8005\u7684\u9884\u540e,\u4f46\u8f83\u7a84\u7684\u65f6\u95f4\u7a97\u548c\u4e25\u91cd\u7684\u5e76\u53d1\u75c7\u9650\u5236\u4e86\u8fd9\u4e9b\u624b\u6bb5\u7684\u5e94\u7528[2-3]\uff61\u800c\u5316\u5b66\u836f\u7269\u5728\u795e\u7ecf\u4fdd\u62a4\u65b9\u9762\u4e5f\u672a\u663e\u793a\u51fa\u826f\u597d\u7597\u6548[4-5]\uff61\u56e0\u6b64,\u5f00\u53d1\u65b0\u7684\u6709\u6548\u7684\u624b\u6bb5\u6765\u51cf\u8f7b\u60a3\u8005\u7684\u795e\u7ecf\u635f\u4f24\uff64\u6539\u5584\u5176\u751f\u6d3b\u81ea\u7406\u80fd\u529b\u5df2\u6210\u4e3a\u5352\u4e2d\u7814\u7a76\u9886\u57df\u6025\u9700\u89e3\u51b3\u7684\u95ee\u9898\u4e4b\u4e00\uff61\u4f5c\u4e3a\u4e00\u79cd\u57fa\u4e8e\u7535\u751f\u7406\u7684\u6cbb\u7597\u6280\u672f,\u7ecf\u9885\u76f4\u6d41\u7535\u523a\u6fc0(transcranial direct current stimulation, tDCS)\u56e0\u5176\u5e7f\u6cdb\u7684\u795e\u7ecf\u8c03\u8282\u4f5c\u7528\u5f15\u8d77\u4e86\u7814\u7a76\u8005\u4eec\u7684\u5174\u8da3,\u5176\u975e\u4fb5\u5165\u6027\uff64\u5b89\u5168\uff64\u4f4e\u6210\u672c\u548c\u4fbf\u643a\u7684\u4f18\u52bf\u4f7f\u4eba\u4eec\u5bf9tDCS\u5728AIS\u4e2d\u7684\u5e94\u7528\u5145\u6ee1\u671f\u5f85\uff61\u6211\u4eec\u4ee5\u201cTranscranial Direct Current Stimulation\u201d\u201cIschemic Stroke\u201d\u4e3a\u4e3b\u9898\u8bcd\u68c0\u7d22\u4e86Web of Science\u6570\u636e\u5e93\uff64PubMed\u6570\u636e\u5e93,\u4ee5\u201c\u7ecf\u9885\u76f4\u6d41\u7535\u523a\u6fc0\u201d\u201c\u5352\u4e2d\u201d\u201c\u8111\u7f3a\u8840\u201d\u4e3a\u4e3b\u9898\u8bcd\u68c0\u7d22\u4e86\u4e2d\u56fd\u751f\u7269\u533b\u5b66\u6587\u732e\u6570\u636e\u5e93\uff64\u4e2d\u56fd\u77e5\u7f51\u548c\u4e07\u65b9\u6570\u636e\u5e93,\u5e74\u9650\u9650\u5b9a\u4e3a\u8fd110 \u5e74,\u5e76\u5bf9\u611f\u5174\u8da3\u7684\u6587\u732e\u8fdb\u884c\u4e86\u5f15\u6587\u68c0\u7d22\uff61\u6b64\u5916,\u6211\u4eec\u4e5f\u68c0\u7d22\u4e86\u7f8e\u56fd\u4e34\u5e8a\u8bd5\u9a8c\u6570\u636e\u4e2d\u5fc3(ClinicalTrials. gov)\u4e2d\u76f8\u5173\u7684\u4e34\u5e8a\u8bd5\u9a8c\uff61\u73b0\u5c06tDCS \u7684\u76f8\u5173\u77e5\u8bc6\u53ca\u5728AIS \u4e2d\u7684\u5e94\u7528\u7efc\u8ff0\u5982\u4e0b\uff61<\/p>\n
1 tDCS\u6982\u8ff0<\/p>\n
tDCS\u662f\u4e00\u79cd\u975e\u4fb5\u5165\u6027\u795e\u7ecf\u8c03\u8282\u6280\u672f,\u901a\u8fc7\u5411\u8111\u90e8\u8f93\u5165\u5fae\u5f31\u7684\u6052\u5b9a\u76f4\u6d41\u7535\u6d41\u589e\u52a0\u6216\u964d\u4f4e\u795e\u7ecf\u5143\u5174\u594b\u6027,\u4ece\u800c\u5f15\u8d77\u8111\u529f\u80fd\u6539\u53d8[6]\uff61\u4e0e\u7ecf\u9885\u78c1\u523a\u6fc0\u7b49\u5176\u4ed6\u8111\u523a\u6fc0\u5de5\u5177\u4e0d\u540c,tDCS\u4e0d\u80fd\u76f4\u63a5\u8bf1\u53d1\u795e\u7ecf\u5143\u4ea7\u751f\u52a8\u4f5c\u7535\u4f4d,\u800c\u662f\u901a\u8fc7\u9608\u4e0b\u523a\u6fc0\u6539\u53d8\u4e86\u795e\u7ecf\u5143\u653e\u7535\u7684\u9608\u503c,\u5f71\u54cd\u5176\u653e\u7535\u7684\u53ef\u80fd\u6027[7]\uff61\u8fd1\u5e74\u6765,tDCS \u5728\u8ba4\u77e5\u969c\u788d\uff64\u766b\u75eb\uff64\u5352\u4e2d\uff64\u6291\u90c1\uff64\u5934\u75db\u7b49\u8bf8\u591a\u65b9\u5411\u7684\u5e94\u7528\u9010\u6e10\u5c55\u5f00,\u5e76\u663e\u793a\u51fa\u826f\u597d\u7684\u7597\u6548[8-12],\u4f7f\u5f97\u7814\u7a76\u8005\u5bf9tDCS\u7684\u5174\u8da3\u9010\u6e10\u589e\u52a0\uff61<\/p>\n
tDCS\u8bbe\u5907\u4e3b\u8981\u7531\u76f4\u6d41\u7535\u6e90\u548c\u7535\u6781\u7ec4\u4ef6\u6784\u6210\uff61\u7535\u7ea7\u7ec4\u4ef6\u5305\u62ec\u5bfc\u7ebf\uff64\u91d1\u5c5e\u6216\u6a61\u80f6\u7535\u6781\uff64\u7535\u6781\u6d77\u7ef5\u53ca\u7535\u89e3\u8d28\u7b49\u90e8\u4ef6\uff61\u76f4\u6d41\u7535\u6e90\u7684\u6b63\u6781\u8f93\u51fa\u6052\u5b9a\u7535\u6d41,\u901a\u8fc7\u9633\u6781\u7535\u6781\u8fdb\u5165\u8111\u90e8,\u7b49\u91cf\u7684\u7535\u6d41\u4ece\u4eba\u4f53\u6d41\u51fa\u540e\u518d\u7ecf\u9634\u6781\u7535\u6781\u6d41\u5411\u8d1f\u6781,\u6784\u6210\u4e86\u4e00\u4e2a\u95ed\u5408\u7684\u7535\u8def\u7cfb\u7edf\uff61\u9633\u6781\u7535\u6781\u548c\u9634\u6781\u7535\u6781\u4e4b\u95f4\u4ea7\u751f\u6b63\u5411\u7684\u7535\u538b\u5dee,\u8fd9\u53ef\u4ee5\u5f71\u54cd\u795e\u7ecf\u5143\u7684\u9759\u606f\u819c\u7535\u4f4d[13]\uff61<\/p>\n
\u7535\u6d41\u5f3a\u5ea6\uff64\u8f93\u51fa\u65f6\u95f4\uff64\u7535\u6781\u5c3a\u5bf8\uff64\u914d\u7f6e\u65b9\u5f0f\u53ca\u523a\u6fc0\u4f4d\u7f6e\u7b49\u53c2\u6570\u63a7\u5236\u7740\u8fdb\u5165\u8111\u7ec4\u7ec7\u7684\u7535\u6d41\u5bc6\u5ea6\u548c\u7535\u8377\u5bc6\u5ea6,\u662f\u5f71\u54cdtDCS\u5b89\u5168\u6027\u53ca\u6709\u6548\u6027\u7684\u91cd\u8981\u53ef\u8c03\u63a7\u56e0\u7d20\uff61\u591a\u6570\u4e34\u5e8a\u7814\u7a76\u4f7f\u7528\u7684tDCS\u53c2\u6570\u8f83\u4e3a\u4e00\u81f4,\u901a\u5e38\u5c06\u7535\u6d41\u8f93\u51fa\u8bbe\u7f6e\u4e3a1 mA \u62162 mA,\u523a\u6fc0\u65f6\u95f4\u591a\u572840 min\u5185,\u91c7\u7528\u7684\u7535\u6781\u5c3a\u5bf8\u4e3a25 cm2 \u621635 cm2,\u5e73\u5747\u7535\u6d41\u5bc6\u5ea6(\u7535\u6d41\u5f3a\u5ea6\u4e0e\u9885\u5916\u7535\u6781\u9762\u79ef\u7684\u6bd4\u503c)\u901a\u5e38\u4e0d\u8d85\u8fc72 A \/ m2[14-16]\uff61\u4e0e\u6b64\u4e0d\u540c,\u52a8\u7269\u5b9e\u9a8c\u91c7\u7528\u7684tDCS\u5f3a\u5ea6\u5f80\u5f80\u66f4\u9ad8,\u591a\u9879\u7814\u7a76\u8868\u660e,\u5f53\u5e73\u5747\u7535\u6d41\u5bc6\u5ea6\u5c0f\u4e8e142.9 A \/ m2 \u65f6,tDCS\u4e0d\u4f1a\u5f15\u8d77\u5927\u9f20\u7684\u8111\u7ec4\u7ec7\u635f\u4f24[17-20]\uff61\u7531\u4e8e\u4eba\u4f53\u5e94\u7528\u7684tDCS\u7535\u6d41\u5bc6\u5ea6\u6bd4\u52a8\u7269\u4f4e\u6570\u5341\u500d,\u56e0\u6b64,\u5728\u4eba\u4f53\u5e94\u7528\u66f4\u9ad8\u5f3a\u5ea6\u7684tDCS\u53ef\u80fd\u5b58\u5728\u4e00\u5b9a\u7684\u5b89\u5168\u7a7a\u95f4\uff61Chhatbar \u7b49[21]\u91c7\u7528\u4e864 mA\u7684\u7535\u6d41\u5bc6\u5ea6\u523a\u6fc0AIS\u60a3\u800530 min,\u60a3\u8005\u672a\u51fa\u73b0\u4e25\u91cd\u7684\u4e0d\u826f\u53cd\u5e94\uff61tDCS\u8bbe\u5907\u5305\u542b\u4f5c\u7528\u7535\u6781\u548c\u53c2\u6bd4\u7535\u6781\uff61\u4f5c\u7528\u7535\u6781\u53ef\u80fd\u4f1a\u5bf9\u5927\u8111\u529f\u80fd\u4ea7\u751f\u8c03\u8282\u4f5c\u7528,\u5e38\u7f6e\u4e8e\u76ee\u6807\u8111\u533a;\u800c\u53c2\u6bd4\u7535\u6781\u4e0d\u4f1a\u5f71\u54cd\u795e\u7ecf\u8c03\u8282,\u4e00\u822c\u653e\u7f6e\u5728\u5934\u90e8\u6216\u8eab\u4f53\u7684\u5176\u4ed6\u90e8\u4f4d[22]\uff61\u4f5c\u7528\u7535\u6781\u53ef\u4ee5\u4e3a\u9633\u6781\u7535\u6781\u6216\u9634\u6781\u7535\u6781,\u901a\u5e38\u5c06\u9633\u6781\u7535\u6781\u7f6e\u4e8e\u9776\u533a\u4e0a\u65b9\u79f0\u4e3a\u9633\u6781tDCS(anode tDCS,a-tDCS),\u800c\u9634\u6781\u7535\u6781\u7f6e\u4e8e\u9776\u533a\u4e0a\u65b9\u5219\u79f0\u4e3a\u9634\u6781tDCS(cathode tDCS,c-tDCS)[23]\uff61\u90e8\u5206\u7814\u7a76\u5c06\u9633\u6781\u548c\u9634\u6781\u7535\u6781\u5bf9\u79f0\u5730\u7f6e\u4e8e\u8111\u90e8\u9776\u533a\u53ca\u975e\u53d7\u7d2f\u4fa7\u76f8\u5e94\u533a\u57df\u7684\u65b9\u5f0f\u79f0\u4e3a\u53cc\u4fa7tDCS(bilateraltDCS,bi-tDCS)[24-25]\uff61\u5f53\u6539\u53d8\u7535\u6781\u7684\u6781\u6027\u65f6,\u53ef\u4ee5\u5b9e\u73b0\u5bf9\u76ae\u8d28\u5174\u594b\u6027\u7684\u53cd\u5411\u4f5c\u7528[26]\uff61\u7535\u6781\u653e\u7f6e\u4f4d\u7f6e\u7684\u4e0d\u540c\u4e5f\u4f1a\u5f71\u54cd\u4f20\u5165\u76ee\u6807\u533a\u7684\u7535\u6d41,\u6709\u7814\u7a76\u663e\u793a,\u7535\u6781\u4f4d\u7f6e\u79fb\u52a81 cm,\u5219\u80fd\u660e\u663e\u6539\u53d8\u5927\u8111\u7535\u6d41\u7684\u5206\u5e03,\u4ee5\u53ca\u7279\u5b9a\u8111\u533a\u7684\u523a\u6fc0\u5f3a\u5ea6[27]\uff61\u56e0\u6b64,\u5bf9\u6700\u4f73\u53c2\u6570\u7684\u63a2\u7d22\u5df2\u7ecf\u6210\u4e3a\u6709\u5173tDCS\u7814\u7a76\u7684\u91cd\u8981\u95ee\u9898\u4e4b\u4e00\uff61<\/p>\n
2 tDCS\u7684\u751f\u7269\u5b66\u4f5c\u7528\u53ca\u673a\u5236<\/p>\n
\u76ee\u524d,tDCS\u4fc3\u8fdbAIS\u540e\u795e\u7ecf\u529f\u80fd\u6062\u590d\u7684\u786e\u5207\u673a\u5236\u4ecd\u4e0d\u6e05\u695a,\u4f46\u591a\u9879\u7814\u7a76\u7ed3\u679c\u8868\u660e,tDCS\u53ef\u4ee5\u8c03\u8282\u8111\u5185\u795e\u7ecf\u548c\u8840\u7ba1\u7b49\u7ec4\u7ec7\u7ed3\u6784\u7684\u751f\u7406\u529f\u80fd,\u8fd9\u53ef\u80fd\u4e0etDCS\u51cf\u8f7bAIS\u5f15\u8d77\u7684\u795e\u7ecf\u635f\u4f24\u5bc6\u5207\u76f8\u5173\uff61<\/p>\n
2. 1 tDCS\u5bf9\u795e\u7ecf\u5143\u7684\u5f71\u54cd<\/p>\n
\u4f5c\u4e3a\u795e\u7ecf\u7cfb\u7edf\u6700\u57fa\u672c\u7684\u7ed3\u6784\u548c\u529f\u80fd\u5355\u4f4d,\u795e\u7ecf\u5143\u7684\u6d3b\u52a8\u76f4\u63a5\u5f71\u54cd\u7740\u5927\u8111\u529f\u80fd\uff61tDCS \u4ea7\u751f\u7684\u7535\u6d41\u80fd\u591f\u5f15\u8d77\u795e\u7ecf\u5143\u9759\u606f\u819c\u7535\u4f4d\u7684\u53d8\u5316,\u5bf9\u5176\u5174\u594b\u6027\u8fdb\u884c\u8c03\u8282\uff61\u5f53\u9633\u6781\u7535\u6781\u5e94\u7528\u4e8e\u9776\u533a\u65f6,\u795e\u7ecf\u5143\u7684\u7ec6\u80de\u819c\u53bb\u6781\u5316,\u795e\u7ecf\u5143\u81ea\u53d1\u6d3b\u52a8\u589e\u5f3a;\u800c\u5f53\u9634\u6781\u7535\u6781\u7528\u4e8e\u9776\u533a\u65f6,\u795e\u7ecf\u5143\u7684\u7ec6\u80de\u819c\u53d1\u751f\u8d85\u6781\u5316,\u795e\u7ecf\u5143\u7684\u5174\u594b\u6027\u51cf\u4f4e[28]\uff61\u7531\u4e8eAIS \u4f1a\u5bfc\u81f4\u534a\u7403\u95f4\u6291\u5236\u5931\u8861,\u56e0\u6b64,\u4e00\u4e9b\u7814\u7a76\u5c06\u9633\u6781\u7535\u6781\u7f6e\u4e8e\u60a3\u4fa7\u534a\u7403,\u9634\u6781\u7535\u6781\u7f6e\u4e8e\u975e\u53d7\u7d2f\u4fa7\u534a\u7403,\u4ee5\u91cd\u5efa\u5e73\u8861,\u5e2e\u52a9\u60a3\u8005\u6539\u5584\u8fd0\u52a8\u529f\u80fd[29-30],\u800c\u53e6\u4e00\u90e8\u5206\u7814\u7a76\u5c1d\u8bd5\u4f7f\u7528c-tDCS\u964d\u4f4e\u8111\u7f3a\u8840\u671f\u7684\u8017\u6c27\u91cf,\u4ee5\u51cf\u5c11\u795e\u7ecf\u5143\u7684\u6b7b\u4ea1\u548c\u51cb\u4ea1[31]\uff61\u51e0\u79d2\u949f\u7684tDCS\u5373\u53ef\u77ed\u6682\u5730\u6539\u53d8\u795e\u7ecf\u5143\u7684\u5174\u594b\u6027,\u88ab\u79f0\u4e3atDCS\u7684\u5373\u65f6\u6548\u5e94\uff61\u800c\u6301\u7eed\u6570\u5206\u949f\u7684tDCS\u53ef\u4ee5\u4f7f\u795e\u7ecf\u5143\u5174\u594b\u6027\u7684\u6539\u53d8\u7ef4\u6301\u8f83\u957f\u65f6\u95f4,\u5373tDCS\u7684\u540e\u6548\u4f5c\u7528\uff61\u5728\u6b64\u8fc7\u7a0b\u4e2d,tDCS \u6539\u53d8\u4e86N-\u7532\u57fa-D-\u5929\u51ac\u6c28\u9178(N-methyl-D-aspartic acid,NMDA)\u53d7\u4f53\u548c\u03b3-\u6c28\u57fa\u4e01\u9178(\u03b3-aminobutyric acid,GABA)\u53d7\u4f53\u7684\u6d3b\u6027,\u89e6\u53d1\u4e86\u7a81\u89e6\u53ef\u5851\u6027\u8fc7\u7a0b[27]\uff61\u6709\u7814\u7a76\u8868\u660e,5 min\u7684tDCS\u523a\u6fc0\u53ef\u4ea7\u751f\u7ea610 min\u7684\u540e\u6548\u4f5c\u7528,\u800c9 min\u7684c-tDCS\u523a\u6fc0\u621613 min\u7684a-tDCS\u523a\u6fc0\u80fd\u591f\u4ea7\u751f\u7ea61 h\u7684\u540e\u6548\u4f5c\u7528[32-34]\uff61tDCS\u5bf9\u5927\u8111\u6d3b\u52a8\u7684\u540e\u6548\u4f5c\u7528\u5e76\u4e0d\u5c40\u9650\u4e8e\u53d7\u523a\u6fc0\u7684\u533a\u57df,Jang \u7b49[35]\u4f7f\u7528\u529f\u80fd\u78c1\u5171\u632f\u6210\u50cf(functional magnetic resonance imaging,fMRI)\u8bc4\u4f30\u4e86tDCS\u5bf9\u521d\u7ea7\u8fd0\u52a8\u76ae\u8d28(M1)\u7684\u5f71\u54cd,\u5728\u8fdc\u5904\u529f\u80fd\u76f8\u5173\u7684\u8111\u533a\u540c\u6837\u68c0\u6d4b\u5230\u4e86\u76ae\u8d28\u5174\u594b\u6027\u7684\u589e\u52a0,\u8fd9\u8868\u660etDCS\u53ef\u901a\u8fc7\u5927\u8111\u95f4\u7684\u529f\u80fd\u8fde\u63a5\u53d1\u6325\u8c03\u63a7\u4f5c\u7528\uff61<\/p>\n
2. 2 tDCS\u5bf9\u795e\u7ecf\u80f6\u8d28\u7ec6\u80de\u7684\u5f71\u54cd<\/p>\n
\u795e\u7ecf\u80f6\u8d28\u7ec6\u80de\u7ea6\u5360\u4eba\u7c7b\u8111\u7ec6\u80de\u768450%,\u5728\u7ef4\u6301\u6b63\u5e38\u7684\u8111\u529f\u80fd\u548c\u4fc3\u8fdb\u795e\u7ecf\u5143\u7684\u635f\u4f24\u4fee\u590d\u4e2d\u8d77\u91cd\u8981\u4f5c\u7528\uff61\u80f6\u8d28\u7ec6\u80de\u5bf9\u7535\u538b\u53d8\u5316\u540c\u6837\u654f\u611f,\u4e5f\u4f1a\u5728tDCS\u4f5c\u7528\u4e0b\u53d1\u751f\u529f\u80fd\u53d8\u5316\uff61\u5df2\u6709\u7814\u7a76\u89c2\u5bdf\u5230tDCS\u53ef\u4ee5\u5728\u751f\u7406\u72b6\u6001\u4e0b\u8bf1\u5bfc\u661f\u5f62\u80f6\u8d28\u7ec6\u80de\u6fc0\u6d3b,\u6539\u53d8\u5927\u8111\u76ae\u8d28\u7684\u53ef\u5851\u6027[36]\uff61\u9664\u4e86\u5bf9\u661f\u5f62\u80f6\u8d28\u7ec6\u80de\u7684\u5f71\u54cd,tDCS\u4e5f\u53ef\u4ee5\u901a\u8fc7\u6291\u5236\u5c0f\u80f6\u8d28\u7ec6\u80de\u7684\u6fc0\u6d3b\u6765\u8c03\u8282\u795e\u7ecf\u708e\u6027\u53cd\u5e94\uff61\u6709\u7814\u7a76\u8868\u660e,\u5728\u5c0f\u9f20\u8111\u7f3a\u8840\u540e\u65e9\u671f\u7ed9\u4e88c-tDCS\u6cbb\u7597,\u53ef\u4f7f\u534a\u6697\u5e26\u533a\u5c0f\u80f6\u8d28\u7ec6\u80de\u5bc6\u5ea6\u663e\u8457\u964d\u4f4e,\u4e14\u5411\u975e\u6d3b\u5316\u5f62\u6001\u8f6c\u53d8[37-38]\uff61\u6b64\u5916,tDCS\u80fd\u591f\u4fc3\u8fdb\u795e\u7ecf\u53d1\u751f,\u52a0\u901f\u795e\u7ecf\u5e72\u7ec6\u80de\u5411\u8111\u53d7\u635f\u533a\u7684\u8fc1\u79fb\u4ee5\u53ca\u5411\u795e\u7ecf\u5143\u548c\u5c11\u7a81\u80f6\u8d28\u7ec6\u80de\u7684\u5206\u5316[39]\uff61<\/p>\n
2. 3 tDCS\u5bf9\u8111\u8840\u7ba1\u7684\u5f71\u54cd<\/p>\n
\u9002\u5b9c\u7684\u8111\u704c\u6ce8\u5bf9\u7ef4\u6301\u6b63\u5e38\u7684\u8111\u4ee3\u8c22\u81f3\u5173\u91cd\u8981\uff61tDCS\u80fd\u591f\u901a\u8fc7\u795e\u7ecf\u8840\u7ba1\u8026\u8054\u6216\u76f4\u63a5\u4f5c\u7528\u4e8e\u8840\u7ba1\u5bf9\u8111\u8840\u6d41\u91cf\u8fdb\u884c\u8c03\u63a7[40]\uff61\u5408\u7406\u5730\u8c03\u8282tDCS\u53c2\u6570\u53ef\u80fd\u6709\u52a9\u4e8e\u6539\u5584AIS\u60a3\u8005\u8111\u90e8\u7684\u8840\u6db2\u4f9b\u5e94,\u63d0\u9ad8\u76ae\u8d28\u7f3a\u8840\u7684\u8010\u53d7\u6027\uff61\u901a\u5e38\u60c5\u51b5\u4e0b,a-tDCS \u5f15\u8d77\u8840\u7ba1\u6269\u5f20,c-tDCS\u4f7f\u8840\u7ba1\u6536\u7f29[41]\uff61\u6709\u7814\u7a76\u4f7f\u7528600 \u03bcA\u7684c-tDCS\u523a\u6fc0\u5927\u9f20\u5927\u8111\u4e2d\u52a8\u8109\u533a15 min,\u53ef\u4f7f\u8111\u8840\u6d41\u91cf\u8f83\u57fa\u7ebf\u6c34\u5e73\u51cf\u5c1150%,\u6301\u7eed\u65f6\u95f4\u957f\u8fbe90 min[42]\uff61\u7136\u800c,\u4e5f\u6709\u7814\u7a76\u89c2\u5bdf\u5230\u4e86\u5728c-tDCS \u4f5c\u7528\u7684\u65e9\u671f,\u8111\u8840\u6d41\u91cf\u51fa\u73b0\u4e00\u8fc7\u6027\u589e\u52a0\u7684\u73b0\u8c61,\u8fd9\u53ef\u80fd\u4e0etDCS\u5bf9\u8c37\u6c28\u9178\u7684\u8c03\u8282\u6709\u5173[43]\uff61tDCS\u4e0d\u4ec5\u80fd\u591f\u8c03\u8282\u8840\u7ba1\u7684\u8212\u7f29\u6d3b\u52a8,\u8fd8\u53ef\u4ee5\u5f71\u54cd\u5185\u76ae\u7684\u901a\u900f\u6027\uff61Shin\u7b49[44]\u4f7f\u7528a-tDCS\u523a\u6fc0\u5927\u9f20\u8111\u90e8,\u7ed3\u679c\u663e\u793a,tDCS \u589e\u52a0\u4e86\u5185\u76ae\u7ec6\u80de\u7684\u95f4\u9699,\u5bfc\u81f4\u8840-\u8111\u5c4f\u969c\u7684\u901a\u900f\u6027\u589e\u52a0,\u4e14\u8fd9\u79cd\u5f71\u54cd\u4e0e\u4e00\u6c27\u5316\u6c2e\u7684\u751f\u6210\u6709\u5173\uff61<\/p>\n
3 tDCS\u5728AIS\u4e2d\u5e94\u7528\u7684\u7814\u7a76<\/p>\n
\u5352\u4e2d\u60a3\u8005\u56e0\u8111\u795e\u7ecf\u5143\u5927\u91cf\u6b7b\u4ea1,\u901a\u5e38\u9057\u7559\u4e25\u91cd\u7684\u80a2\u4f53\u529f\u80fd\u969c\u788d\uff61\u5982\u4f55\u589e\u52a0\u795e\u7ecf\u5143\u7684\u5b58\u6d3b\u80fd\u529b\uff64\u4fc3\u8fdb\u795e\u7ecf\u529f\u80fd\u6062\u590d\u662f\u4e34\u5e8a\u9762\u4e34\u7684\u91cd\u8981\u6311\u6218\uff61\u8fd1\u671f,\u7814\u7a76\u8005\u4eec\u5f00\u5c55\u4e86\u4e00\u7cfb\u5217\u57fa\u7840\u7814\u7a76\u548c\u4e34\u5e8a\u7814\u7a76,\u4ee5\u63a2\u7d22tDCS\u5bf9AIS\u7684\u795e\u7ecf\u4fdd\u62a4\u4f5c\u7528\uff61<\/p>\n
3. 1 \u5352\u4e2d\u52a8\u7269\u6a21\u578btDCS\u7684\u5e94\u7528<\/p>\n
\u90e8\u5206\u7814\u7a76\u63a2\u7d22\u4e86\u5728\u8111\u7f3a\u8840\u540e\u6570\u5929\u5f00\u59cb\u5e94\u7528tDCS\u5bf9\u52a8\u7269\u6a21\u578b\u5352\u4e2d\u540e\u529f\u80fd\u6062\u590d\u7684\u5f71\u54cd\uff612010 \u5e74,Kim\u7b49[45]\u89c2\u5bdf\u4e86SD \u5927\u9f20\u6c38\u4e45\u6027\u5927\u8111\u4e2d\u52a8\u8109\u95ed\u585e(permanent middle cerebral artery occlusion,pMCAO)\u540e2 d\u5f00\u59cb\u5e94\u7528a-tDCS\u6216c-tDCS(\u7535\u6d41\u5f3a\u5ea6:100 \u03bcA,30 min \/\u6b21,1\u6b21\/ d,\u8fde\u7eed14 d)\u5bf9\u5927\u9f20\u8111\u7ec4\u7ec7\u548c\u529f\u80fd\u7684\u5f71\u54cd,\u4f5c\u7528\u7535\u6781\u4f4d\u4e8e\u8033\u95f4\u7ebf\u5de6\u4fa73 mm\u53ca\u5176\u524d\u65b92 mm\u5904,\u53c2\u6bd4\u7535\u6781\u4f4d\u4e8e\u80f8\u8179\u90e8,\u7814\u7a76\u7ed3\u679c\u8868\u660e,\u53ea\u6709a-tDCS\u6709\u52a9\u4e8e\u51cf\u5c11\u795e\u7ecf\u5143\u8f74\u7a81\u635f\u4f24\u548c\u6062\u590d\u5352\u4e2d\u5927\u9f20\u7684\u8fd0\u52a8\u529f\u80fd,\u800c\u4e0d\u540c\u523a\u6fc0\u65b9\u5f0f\u7ec4\u95f4\u7684\u6897\u6b7b\u4f53\u79ef\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49(\u03c72 = 1. 884,P > 0. 05)\uff61\u4e3a\u4e86\u8fdb\u4e00\u6b65\u4e86\u89e3a-tDCS\u7684\u4f5c\u7528,Longo\u7b49[46]\u5bf9\u5c40\u90e8\u573a\u7535\u4f4d\u8fdb\u884c\u4e86\u8bb0\u5f55,\u4ee5\u786e\u5b9a\u5352\u4e2dC57BL \/ 6\u5c0f\u9f20\u5728a-tDCS\u540e\u5927\u8111\u8fde\u63a5\u6027\u7684\u53d8\u5316,\u7ed3\u679c\u663e\u793a,\u9020\u6a21\u540e72 h\u5e94\u7528a-tDCS(\u7535\u6d41\u5f3a\u5ea6:250 \u03bcA,20 min \/\u6b21,1\u6b21\/ d,\u8fde\u7eed3 d;\u4f5c\u7528\u7535\u6781\u4f4d\u4e8e\u6897\u6b7b\u4fa7\u8fd0\u52a8\u76ae\u8d28,\u53c2\u6bd4\u7535\u6781\u4f4d\u4e8e\u975e\u53d7\u7d2f\u4fa7\u8fd0\u52a8\u76ae\u8d28)\u589e\u52a0\u4e86\u8111\u6e90\u6027\u795e\u7ecf\u8425\u517b\u56e0\u5b50\u7684\u8868\u8fbe\u548c\u534a\u6697\u5e26\u533a\u6811\u7a81\u68d8\u7684\u5bc6\u5ea6,\u540c\u65f6\u589e\u52a0\u4e86\u8fd0\u52a8\u76ae\u8d28\u4e0e\u611f\u89c9\u76ae\u8d28\u4e4b\u95f4\u7684\u529f\u80fd\u8fde\u63a5\uff61Yoon\u7b49[47]\u5219\u5bf9\u4e0d\u540c\u5e72\u9884\u65f6\u95f4\u5e94\u7528a-tDCS \u6cbb\u7597SD \u5927\u9f20\u5927\u8111\u4e2d\u52a8\u8109\u95ed\u585e\u518d\u704c\u6ce8(middle cerebral artery occlusion \/ reperfusion,MCAO \/R)\u6a21\u578b\u7684\u7597\u6548\u8fdb\u884c\u4e86\u6bd4\u8f83,\u5c06\u8111\u7f3a\u8840\u5927\u9f20\u5206\u4e3a\u5047\u523a\u6fc0\u7ec4\uff64\u65e9\u671f\u7ec4(\u9020\u6a21\u540e1 d\u5f00\u59cba-tDCS)\u548c\u665a\u671f\u7ec4(\u9020\u6a21\u540e1\u5468\u5f00\u59cba-tDCS),a-tDCS \u4f5c\u7528\u53c2\u6570\u4e3a\u7535\u6d41\u5f3a\u5ea6200 \u03bcA,20 min \/\u6b21,1 \u6b21\/ d,\u8fde\u7eed5 d;\u4f5c\u7528\u7535\u6781\u4f4d\u4e8eMRI \u5b9a\u4f4d\u7684\u7f3a\u8840\u8fb9\u754c\u5904,\u53c2\u6bd4\u7535\u6781\u4f4d\u4e8e\u80f8\u8179\u90e8;\u7ed3\u679c\u8868\u660e,3 \u7ec4\u6cbb\u7597\u540e\u6c34\u80bf\u6307\u6570\u548c\u6897\u6b7b\u4f53\u79ef\u5dee\u5f02\u5747\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49(\u5747P > 0. 05),\u4f46\u884ca-tDCS\u6cbb\u7597\u7684\u4e24\u7ec4\u5927\u9f20\u6cbb\u7597\u540e\u7684\u8ba4\u77e5\u8868\u73b0\u548c\u8fd0\u52a8\u529f\u80fd\u8bc4\u5206\u5747\u8f83\u6cbb\u7597\u524d\u6709\u6539\u5584,\u4e14\u6cbb\u7597\u540e\u665a\u671f\u7ec4\u7684\u8fd0\u52a8\u529f\u80fd\u6539\u5584\u7565\u597d\u4e8e\u65e9\u671f\u7ec4\uff61<\/p>\n
\u4e0e\u4e0a\u8ff0\u6709\u5173a-tDCS \u6539\u5584\u5352\u4e2d\u540e\u80a2\u4f53\u529f\u80fd\u7684\u62a5\u9053\u4e0d\u540c,\u5176\u4ed6\u7684\u4e00\u4e9b\u7814\u7a76\u8ba4\u4e3a,\u5728\u52a8\u7269\u9020\u6a21\u6570\u5929\u540e\u5f00\u59cb\u5e94\u7528c-tDCS\u540c\u6837\u53ef\u4ee5\u6539\u5584\u8111\u7f3a\u8840\u5927\u9f20\u7684\u8fd0\u52a8\u8868\u73b0,\u53d1\u6325\u795e\u7ecf\u4fdd\u62a4\u4f5c\u7528\uff61\u6709\u7814\u7a76\u540c\u65f6\u89c2\u5bdf\u4e86a-tDCS\u548cc-tDCS\u5bf9Wistar\u5927\u9f20MCAO \/ R\u6a21\u578b\u8fd0\u52a8\u529f\u80fd\u7684\u5f71\u54cd,\u4e8e\u7f3a\u8840\u540e\u7b2c3\u5929\u5f00\u59cb\u884ctDCS(\u7535\u6d41\u5f3a\u5ea6:500 \u03bcA,15 min\/\u6b21,1 \u6b21\/ d,5 d tDCS\u2014\u95f4\u65ad2 d\u20145 dtDCS)\u6cbb\u7597,\u4f5c\u7528\u7535\u6781\u4f4d\u4e8e\u524d\u56df\u540e2 mm \u53ca\u5176\u53f3\u4fa72 mm,\u53c2\u6bd4\u7535\u6781\u4f4d\u4e8e\u80f8\u8179\u90e8,\u7ed3\u679c\u8868\u660e,a-tDCS\u548cc-tDCS\u5747\u53ef\u4ee5\u52a0\u901f\u5352\u4e2d\u5927\u9f20\u7684\u8fd0\u52a8\u529f\u80fd\u5eb7\u590d,\u4e14tDCS\u53ef\u4ee5\u8bf1\u5bfc\u795e\u7ecf\u53d1\u751f,\u8fd9\u79cd\u4f5c\u7528\u5e76\u4e0d\u4f9d\u8d56\u4e8e\u6781\u6027[48]\uff61Zhang\u7b49[39]\u7684\u7814\u7a76\u8fdb\u4e00\u6b65\u652f\u6301\u4e86SD\u5927\u9f20\u5352\u4e2d\u6a21\u578b\u5efa\u7acb\u540e\u6570\u5929\u884cc-tDCS \u7684\u6709\u6548\u6027,\u5176\u5728MCAO \/ R\u540e2 d \u5f00\u59cb\u5bf9\u5927\u9f20\u884cc-tDCS(\u7535\u6d41\u5f3a\u5ea6:500 \u03bcA,15 min \/\u6b21,1 \u6b21\/ d,5 d tDCS\u2014\u95f4\u65ad2 d\u20145 d tDCS),\u5171\u523a\u6fc010\u6b21,\u7ed3\u679c\u663e\u793a,c-tDCS\u663e\u8457\u5730\u52a0\u901f\u4e86\u5352\u4e2d\u5927\u9f20\u7684\u8fd0\u52a8\u5eb7\u590d\u8fc7\u7a0b,\u8fd9\u53ef\u80fd\u4e0ec-tDCS\u4fc3\u8fdb\u4e86\u795e\u7ecf\u5e72\u7ec6\u80de\u5411\u7f3a\u8840\u533a\u8fc1\u79fb\u53ca\u5206\u5316\u6709\u5173\uff61\u5176\u8fdb\u884c\u7684\u53e6\u4e00\u9879\u7814\u7a76\u4f7f\u7528\u4e86\u76f8\u540c\u7684tDCS\u53c2\u6570,\u53d1\u73b0c-tDCS\u80fd\u591f\u51cf\u5c11\u5352\u4e2d\u5927\u9f20\u7684\u6897\u6b7b\u4f53\u79ef,\u964d\u4f4e\u708e\u6027\u53cd\u5e94\u56e0\u5b50\u6c34\u5e73,\u5e76\u6291\u5236\u795e\u7ecf\u5143\u7684\u51cb\u4ea1[49]\uff61<\/p>\n
\u7f3a\u8840\u4e8b\u4ef6\u7684\u65e9\u671f\u9636\u6bb5(\u51e0\u5206\u949f\u5230\u51e0\u5c0f\u65f6)\u662f\u633d\u6551\u534a\u6697\u5e26\u7684\u6700\u4f73\u65f6\u95f4\u7a97\u53e3\uff61\u53e6\u4e00\u90e8\u5206\u52a8\u7269\u7814\u7a76\u63a2\u7d22\u4e86\u8111\u7f3a\u8840\u6570\u5c0f\u65f6\u5185\u5f00\u59cb\u5e94\u7528tDCS \u5bf9\u7f3a\u8840\u8111\u7ec4\u7ec7\u6216\u7f3a\u8840\u540e\u518d\u704c\u6ce8\u635f\u4f24\u7684\u795e\u7ecf\u4fdd\u62a4\u4f5c\u7528\uff61Peruzzotti-Jametti\u7b49[50]\u4f7f\u7528\u5c0f\u9f20MCAO \/ R \u6a21\u578b,\u4e8e\u518d\u704c\u6ce8\u540e30 min\u62164. 5 h\u5f00\u59cba-tDCS\u6216c-tDCS(\u7535\u6d41\u5f3a\u5ea6:250 \u03bcA,20 min tDCS\u2014\u95f4\u65ad20 min\u201420 mintDCS,\u51712\u6b21),\u4f5c\u7528\u7535\u6781\u4f4d\u4e8e\u524d\u56df\u540e0. 5 mm\u53ca\u5176\u5de6\u4fa72. 5 mm,\u53c2\u6bd4\u7535\u6781\u4f4d\u4e8e\u80f8\u8179\u90e8,\u53d1\u73b0\u4e0e\u5047\u523a\u6fc0\u7ec4\u6bd4\u8f83,\u65e9\u671f\u5e94\u7528c-tDCS \u80fd\u591f\u51cf\u5c11\u5927\u9f20\u8111\u6897\u6b7b\u4f53\u79ef,\u5e76\u51cf\u8f7b\u708e\u6027\u53cd\u5e94,\u800c\u518d\u704c\u6ce830 min\u540e\u5e94\u7528a-tDCS\u5219\u589e\u52a0\u4e86\u6897\u6b7b\u4f53\u79ef,\u52a0\u5267\u4e86\u8840-\u8111\u5c4f\u969c\u7684\u7834\u574f\u53ca\u51fa\u8840\u8f6c\u5316\uff61\u8fd9\u8868\u660e\u5728\u7f3a\u8840\u6027\u5352\u4e2d\u7684\u65e9\u671f\u9636\u6bb5\u5e94\u7528c-tDCS\u800c\u975ea-tDCS\u53ef\u4ee5\u83b7\u5f97\u66f4\u597d\u7684\u529f\u80fd\u9884\u540e\uff61\u53e6\u6709\u7814\u7a76\u5c06\u9634\u6781\u7535\u6781\u548c\u9633\u6781\u7535\u6781\u5bf9\u79f0\u5730\u7f6e\u4e8e\u7f3a\u8840\u76ae\u8d28\u7684\u4e0a\u65b9\u4e0e\u975e\u53d7\u7d2f\u4fa7\u76ae\u8d28,\u89c2\u5bdf\u4e86\u518d\u704c\u6ce8\u540e3 h\u7ed9\u4e88\u7535\u6d41\u5f3a\u5ea6100 \u03bcA (10 min tDCS\u2014\u95f4\u65ad3 min,\u51718\u6b21)\u7684tDCS\u5bf9SD\u5927\u9f20MCAO\/ R\u6a21\u578b\u7684\u4f5c\u7528,\u53d1\u73b0\u4e0e\u5047\u523a\u6fc0\u7ec4\u76f8\u6bd4,tDCS \u6cbb\u7597\u7ec4\u7684\u884c\u4e3a\u5b66\u8bc4\u5206\u8f83\u597d,\u4e14\u6897\u6b7b\u4f53\u79ef\u8f83\u5c0f,Cezanne\u4f9d\u8d56\u7684\u6c89\u9ed8\u4fe1\u606f\u8c03\u8282\u56e0\u5b50\u4fe1\u53f7\u901a\u8def\u53ef\u80fd\u4ecb\u5bfc\u4e86c-tDCS \u5bf9\u7f3a\u8840\u795e\u7ecf\u5143\u7684\u795e\u7ecf\u4fdd\u62a4\u4f5c\u7528[51]\uff61Notturno \u7b49[52]\u8fdb\u4e00\u6b65\u7814\u7a76\u4e86\u65f6\u95f4\u56e0\u7d20\u5bf9tDCS\u51cf\u8f7bAIS \u540e\u795e\u7ecf\u635f\u4f24\u7684\u5f71\u54cd,\u7ed3\u679c\u663e\u793a,\u4e0e\u5bf9\u7167\u7ec4\u6bd4\u8f83,\u5728\u5bf9SD \u5927\u9f20\u95ed\u585e\u540c\u4fa7\u5927\u8111\u4e2d\u52a8\u8109\u540e45 min \u5f00\u59cb\u884c\u8fde\u7eed4 h\u7684c-tDCS(\u7535\u6d41\u5f3a\u5ea6:200 \u03bcA,15 min tDCS\u2014\u95f4\u65ad15 min,\u8fde\u7eed4 h;\u4f5c\u7528\u7535\u6781\u4f4d\u4e8e\u524d\u56df\u540e1 mm\u53ca\u5176\u5de6\u4fa72 mm,\u53c2\u6bd4\u7535\u6781\u4f4d\u4e8e\u80f8\u8179\u90e8)\u53ef\u4f7f\u5c40\u7076\u6027\u8111\u7f3a\u8840\u5927\u9f20\u6897\u6b7b\u4f53\u79ef\u51cf\u5c1120%,\u5728\u95ed\u585e\u540c\u4fa7\u5927\u8111\u4e2d\u52a8\u8109\u540e\u5373\u523b\u884c\u8fde\u7eed6 h\u7684c-tDCS(\u7535\u6d41\u5f3a\u5ea6:200 \u03bcA,15 min tDCS\u2014\u95f4\u65ad15 min)\u4f7f\u6897\u6b7b\u4f53\u79ef\u51cf\u5c1130%\uff61\u4e0e\u8fd9\u4e9b\u7814\u7a76\u7ed3\u679c\u4e0d\u540c,\u4e00\u9879\u7814\u7a76\u5728Cx3CR1GFP\/ +\u5c0f\u9f20\u5149\u5316\u5b66\u6813\u585e\u578b\u5c40\u7076\u6027\u8111\u7f3a\u8840\u6a21\u578b\u9020\u6a21\u6210\u529f\u540e6 h\u5f00\u59cb\u884cc-tDCS(\u7535\u6d41\u5f3a\u5ea6:250 \u03bcA,20 min tDCS\u2014\u95f4\u65ad20 min\u201420 min tDCS,\u51711\u6b21;\u4f5c\u7528\u7535\u6781\u4f4d\u4e8e\u524d\u56df\u540e0. 4 mm\u53ca\u65c1\u5f001.6 mm,\u53c2\u6bd4\u7535\u6781\u4f4d\u4e8e\u80f8\u8179\u90e8)\u6cbb\u7597,\u672a\u53d1\u73b0\u6897\u6b7b\u4f53\u79ef\u7f29\u5c0f\uff61\u7136\u800c,c-tDCS\u6539\u5584\u4e86\u5352\u4e2d\u5c0f\u9f20\u524d\u80a2\u529f\u80fd\u969c\u788d,\u540c\u65f6\u964d\u4f4e\u4e86\u7f3a\u8840\u5468\u56f4\u533a\u7684\u5c0f\u80f6\u8d28\u7ec6\u80de\u5bc6\u5ea6,\u5e76\u8bf1\u5bfc\u5c0f\u80f6\u8d28\u7ec6\u80de\u5411\u6297\u708e\u578b\u8f6c\u5316[37]\uff61<\/p>\n
Kaviannejad\u7b49[31]\u7814\u7a76\u4e86\u8111\u7f3a\u8840\u671f\u95f4\u7ed9\u4e88tDCS(a-tDCS\u6216c-tDCS,\u7535\u6d41\u5f3a\u5ea6:400 \u03bcA,15 min,\u51711 \u6b21)\u5bf9Wistar\u5927\u9f20\u7684\u795e\u7ecf\u4fdd\u62a4\u4f5c\u7528,\u8be5\u7814\u7a76\u5c06\u6d3b\u6027\u7535\u6781\u653e\u7f6e\u5728Lambda\u70b9\u548cBregma\u70b9\u4e4b\u95f4,\u5bf9\u6297\u7535\u6781\u7f6e\u4e8e\u5927\u9f20\u80f8\u8179\u90e8,\u5206\u522b\u5c06\u6d3b\u6027\u7535\u6781\u8fde\u4e8e\u9634\u6781\u6216\u9633\u6781\u523a\u6fc0\u5352\u4e2d\u5927\u9f20,\u7ed3\u679c\u663e\u793a,\u4ec5c-tDCS \u51cf\u5c11\u4e86\u6d77\u9a6c\u533a\u795e\u7ecf\u5143\u7684\u6b7b\u4ea1\u548c\u51cb\u4ea1,\u8fd9\u53ef\u80fd\u4e0ec-tDCS\u53ef\u4e0b\u8c03\u6c27\u5316\u5e94\u6fc0\uff64\u51cf\u8f7b\u795e\u7ecf\u708e\u6027\u53cd\u5e94\uff64\u964d\u4f4e\u4e00\u6c27\u5316\u6c2e\u5408\u9176\u548cNMDA\u53d7\u4f531\u6c34\u5e73\u7b49\u673a\u5236\u6709\u5173\uff61\u6b64\u5916,\u4f5c\u8005\u8fd8\u63a2\u7d22\u4e86\u5206\u522b\u5728\u8111\u7f3a\u8840\u53ca\u518d\u704c\u6ce8\u671f\u4f7f\u7528\u4e0d\u540c\u6781\u6027\u7684tDCS\u7ec4\u5408\u5bf9\u51cf\u8f7b\u7f3a\u8840\u795e\u7ecf\u5143\u635f\u4f24\u7684\u4f5c\u7528\uff61\u8be5\u7814\u7a76\u5171\u8bbe\u8ba1\u4e864\u79cd\u523a\u6fc0\u65b9\u6848,\u5206\u522b\u4e3a\u5728\u8111\u7f3a\u8840\u671f\u53ca\u518d\u704c\u6ce8\u671f\u5747\u7ed9\u4e88c-tDCS\u6216a-tDCS\uff64\u7f3a\u8840\u671f\u4f7f\u7528c-tDCS\u8054\u5408\u518d\u704c\u6ce8\u671f\u4f7f\u7528a-tDCS\u4ee5\u53ca\u7f3a\u8840\u671f\u4f7f\u7528a-tDCS\u8054\u5408\u518d\u704c\u6ce8\u671f\u8fdb\u884cc-tDCS,\u7535\u6d41\u5f3a\u5ea6\u5747\u4e3a400 \u03bcA,\u7f3a\u8840\u671f\u95f415 min tDCS,\u518d\u704c\u6ce8\u671f\u95f4\u4e3a30 min tDCS,2 \u6b21\/d,\u8fde\u7eed5d,\u4f5c\u7528\u7535\u6781\u4f4d\u4e8eLambda \u70b9\u548cBregma \u70b9\u4e4b\u95f4,\u53c2\u6bd4\u7535\u6781\u4f4d\u4e8e\u80f8\u8179\u90e8,\u7ed3\u679c\u8868\u660e,\u7f3a\u8840\u671f\u7ed9\u4e88c-tDCS\u8054\u5408\u518d\u704c\u6ce8\u671fa-tDCS\u523a\u6fc0\u5728\u6539\u5584\u5352\u4e2d\u5927\u9f20\u7684\u611f\u89c9\u548c\u8fd0\u52a8\u8868\u73b0\u65b9\u9762\u66f4\u4e3a\u6709\u6548[53]\uff61<\/p>\n
\u4ece\u4e0a\u8ff0\u52a8\u7269\u7814\u7a76\u4e2d\u53ef\u4ee5\u770b\u51fa,tDCS\u80fd\u591f\u5bf9\u5352\u4e2d\u52a8\u7269\u6a21\u578b\u4ea7\u751f\u795e\u7ecf\u4fdd\u62a4\u4f5c\u7528\uff61\u5728\u7f3a\u8840\u540e\u65e9\u671f\u5e94\u7528c-tDCS\u6709\u52a9\u4e8e\u7f29\u5c0f\u518d\u704c\u6ce8\u635f\u4f24\u7684\u6897\u6b7b\u4f53\u79ef,\u7f3a\u8840\u540e\u6570\u5929\u5f00\u59cb\u5e94\u7528a-tDCS\u6216c-tDCS\u53ef\u80fd\u6709\u76ca\u4e8e\u5352\u4e2d\u540e\u529f\u80fd\u6062\u590d\uff61\u7136\u800c,\u7531\u4e8e\u4f7f\u7528\u7684\u7535\u6d41\u5f3a\u5ea6\uff64\u523a\u6fc0\u6301\u7eed\u65f6\u95f4\uff64\u7535\u6781\u653e\u7f6e\u4f4d\u7f6e\u7b49\u4f5c\u7528\u53c2\u6570\u5e76\u4e0d\u4e00\u81f4,\u8fd9\u53ef\u80fd\u4f1a\u5bfc\u81f4\u4e0d\u540c\u7814\u7a76\u7684\u7ed3\u679c\u5dee\u5f02\uff61\u5982\u4f55\u5728\u5408\u9002\u7684\u4f5c\u7528\u65f6\u95f4\u66f4\u5408\u7406\u5730\u914d\u7f6e\u8fd9\u4e9b\u53c2\u6570,\u4ee5\u66f4\u597d\u5730\u5b9e\u73b0\u4e34\u5e8a\u8f6c\u5316,\u503c\u5f97\u8fdb\u4e00\u6b65\u63a2\u7a76\uff61<\/p>\n
3. 2 tDCS\u7528\u4e8eAIS\u7684\u4e34\u5e8a\u7814\u7a76\u65b9\u6848\u53ca\u7597\u6548<\/p>\n
\u9274\u4e8etDCS\u5728\u5352\u4e2d\u52a8\u7269\u6a21\u578b\u4e2d\u5e94\u7528\u7684\u4f18\u826f\u6548\u679c,tDCS\u5728AIS\u60a3\u8005\u4e2d\u5e94\u7528\u7684\u7814\u7a76\u4e5f\u76f8\u7ee7\u5f00\u5c55,\u8fd9\u4e9b\u7814\u7a76\u4e3b\u8981\u805a\u7126\u4e8etDCS\u5bf9AIS\u5f15\u8d77\u7684\u80a2\u4f53\u8fd0\u52a8\u529f\u80fd\u969c\u788d\u7684\u5f71\u54cd\uff61\u4e00\u9879\u5355\u4e2d\u5fc3\uff64\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7eb3\u5165\u4e8650\u4f8bAIS\u60a3\u8005,\u7f8e\u56fd\u56fd\u7acb\u536b\u751f\u7814\u7a76\u9662\u5352\u4e2d\u91cf\u8868(national institutes of health stroke scale,NIHSS)\u8bc4\u52066 ~20\u5206,\u4e8e\u5352\u4e2d\u540e\u7b2c2 \u5929\u5f00\u59cb\u8fde\u7eed5 d \u7ed9\u4e88a-tDCS(\u7535\u6d41\u5f3a\u5ea6:2 mA,20 min \/\u6b21,1 \u6b21\/ d)\u6216\u5047\u523a\u6fc0,\u9633\u6781\u7535\u6781\u4f4d\u4e8e\u6897\u6b7b\u4fa7M1\u533a,\u9634\u6781\u7535\u6781\u4f4d\u4e8e\u975e\u53d7\u7d2f\u4fa7\u7736\u4e0a\u533a,\u672a\u89c2\u5bdf\u5230\u660e\u663e\u7684\u526f\u4f5c\u7528;\u4e0e\u5047\u523a\u6fc0\u7ec4\u6bd4\u8f83,a-tDCS\u7ec4\u5352\u4e2d\u540e3\u4e2a\u6708\u7684Fugl-Meyer\u8fd0\u52a8\u529f\u80fd\u8bc4\u5206[(13.6 \u00b111. 2)\u5206\u6bd4(15. 2 \u00b1 9. 3)\u5206,P = 0. 82]\uff64NIHSS\u8bc4\u5206[(8. 1 \u00b1 4. 9)\u5206\u6bd4(7. 1 \u00b1 4. 6)\u5206,P = 0.75]\uff64Barthel\u6307\u6570(70. 6 \u00b1 15. 8 \u6bd465. 2 \u00b1 20. 3,P = 0. 91)\u53ca\u6539\u826fRankin\u91cf\u8868\u8bc4\u5206\u2264 2 \u5206\u7684\u60a3\u8005\u6bd4\u4f8b[40%(10\/ 25)\u6bd460%(15 \/ 25),P = 0. 15]\u5747\u672a\u80fd\u663e\u793a\u51fa\u4f18\u52bf[54]\uff61Di Lazzaro\u7b49[14]\u7814\u7a76\u4e86\u5355\u72ec\u4f7f\u7528bi-tDCS\u6216bi-tDCS\u8054\u5408\u5f3a\u5236\u8bf1\u5bfc\u8fd0\u52a8\u6cbb\u7597(constraint-induced movement therapy,CIMT)\u5bf9AIS \u540e\u795e\u7ecf\u53ef\u5851\u6027\u53ca\u529f\u80fd\u9884\u540e\u7684\u5f71\u54cd,\u5728\u5352\u4e2d\u540e48 ~96 h\u5f00\u59cbtDCS(\u7535\u6d41\u5f3a\u5ea6:2 mA,40 min\/\u6b21,1\u6b21\/ d)\u6cbb\u7597,\u8fde\u7eed5 d,\u901a\u8fc7\u7ecf\u9885\u78c1\u523a\u6fc0\u5bf9\u8111\u5174\u594b\u6027\u7684\u53d8\u5316\u8fdb\u884c\u6d4b\u91cf,\u5e76\u8bc4\u4f30\u4e86\u5352\u4e2d\u540e1\u5468(\u77ed\u671f)\u62163\u4e2a\u6708(\u957f\u671f)\u7684\u8fd0\u52a8\u529f\u80fd\u6539\u53d8\uff61\u7ed3\u679c\u663e\u793a,\u5bf9\u4e8eNIHSS\u8bc4\u5206\uff64\u6539\u826fRankin\u91cf\u8868\u8bc4\u5206\u4ee5\u53ca\u624b\u81c2\u52a8\u4f5c\u8c03\u67e5\u6d4b\u8bd5(action research arm test,ARAT)\uff64\u4e5d\u5b54\u67f1\u6d4b\u8bd5(9 hole peg test,NHPT)\uff64\u8fd0\u52a8\u6d3b\u52a8\u8bb0\u5f55(motor activity log,MAL)\u7b49\u6307\u6807,\u7ec4\u95f4\u56e0\u7d20\u4e0e\u65f6\u95f4\u56e0\u7d20\u5747\u4e0d\u5b58\u5728\u4ea4\u4e92\u4f5c\u7528(\u5747P > 0. 05),\u8868\u660e\u4e0e\u5047\u523a\u6fc0\u7ec4\u76f8\u6bd4tDCS\u5355\u72ec\u4f7f\u7528\u6216\u662f\u4e0eCIMT\u8054\u5408\u4f7f\u7528\u5747\u4e0d\u80fd\u6539\u5584\u529f\u80fd\u9884\u540e\uff61\u4e00\u9879\u968f\u673a\u5bf9\u7167\u7814\u7a76\u7eb3\u5165\u4e8632 \u4f8b\u5e76\u53d1\u4e2d\u81f3\u91cd\u5ea6\u4e0a\u80a2\u8fd0\u52a8\u529f\u80fd\u969c\u788d\u7684AIS\u60a3\u8005,\u4e8e\u5352\u4e2d\u540e48 ~72 h\u5f00\u59cb\u5e94\u7528\u8fde\u7eed5 d \u7684bi-tDCS(\u7535\u6d41\u5f3a\u5ea6:2 mA,15 min \/\u6b21,1\u6b21\/ d),tDCS\u7ec4\u4e0e\u5047\u523a\u6fc0\u7ec4\u5728\u6cbb\u7597\u7ed3\u675f\u540e\u7b2c2\u5929\u4ee5\u53ca6\u4e2a\u6708\u7684\u65f6\u95f4\u70b9\u4e0a\u7684\u624b\u63e1\u529b\uff64\u8fd0\u52a8\u529b\u6307\u6570\uff64NIHSS \u8bc4\u5206\uff64Barthel \u6307\u6570\u5dee\u5f02\u5747\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49(\u5747P > 0. 05),\u540c\u6837\u672a\u80fd\u8bc1\u660etDCS\u5bf9AIS\u60a3\u8005\u9884\u540e\u7684\u6539\u5584\u4f5c\u7528[25]\uff61\u4e0e\u6b64\u7814\u7a76\u7ed3\u679c\u4e0d\u540c,\u53e6\u4e00\u9879\u7814\u7a76\u5c0650\u4f8bAIS\u60a3\u8005\u968f\u673a\u5206\u4e3a\u9633\u6781\u7535\u523a\u6fc0\u7ec4\u548c\u5047\u523a\u6fc0\u7ec4,\u4e8e\u5352\u4e2d\u540e48 h\u5f00\u59cb4 \u5468\u7684tDCS(\u7535\u6d41\u5f3a\u5ea6:1 mA,20 min \/\u6b21,1\u6b21\/ d,5\u6b21\/\u5468,\u8fde\u7eed4 \u5468)\u6cbb\u7597,\u9633\u6781\u7535\u6781\u4f4d\u4e8e\u6897\u6b7b\u4fa7M1 \u533a,\u9634\u6781\u7535\u6781\u4f4d\u4e8e\u975e\u53d7\u7d2f\u4fa7\u7736\u4e0a\u533a,\u5e76\u5728\u5352\u4e2d\u540e48 h\uff641\u5468\uff642\u5468\uff643\u5468\uff644\u5468\uff643\u4e2a\u6708\uff646\u4e2a\u6708\u53ca1 \u5e74\u4f7f\u7528Wolf \u8fd0\u52a8\u529f\u80fd\u6d4b\u8bd5\u91cf\u8868(Wolf motor function test ,WMFT)\u5bf9\u4e0a\u80a2\u529f\u80fd\u8fdb\u884c\u4e86\u8bc4\u4f30,\u53d1\u73b0\u9633\u6781\u7535\u523a\u6fc0\u7ec4\u5728WMFT\u8ba1\u65f6(F = 7. 83,P = 0. 0001)\u548c\u8d28\u91cf\u8ba1\u5206(F = 59. 60,P = 0.0001)\u4e2d\u5747\u4f18\u4e8e\u5047\u523a\u6fc0\u7ec4,\u4e14\u4e24\u7ec4\u95f4WMFT\u8ba1\u65f6\u7684\u663e\u8457\u5dee\u5f02\u4ec5\u5728\u5352\u4e2d\u540e4\u5468\u51fa\u73b0(\u9633\u6781\u7535\u523a\u6fc0\u7ec4\u4e3a\u5e73\u5747100 s,P =0. 04),\u5e76\u7ef4\u6301\u5230\u5352\u4e2d\u540e1 \u5e74,\u6b64\u65f6\u9633\u6781\u7535\u523a\u6fc0\u7ec4\u4e3a\u5e73\u5747101 s(P = 0. 02)[16]\uff61\u4e24\u9879\u7814\u7a76\u7684\u4e0d\u540c\u7ed3\u679c\u53ef\u80fd\u4e0e\u4eba\u7fa4\u7684\u7eb3\u5165\u6807\u51c6\u5dee\u5f02\u53catDCS\u7684\u4e0d\u540c\u4f5c\u7528\u53c2\u6570\u6709\u5173\uff61<\/p>\n
\u51e0\u9879\u7814\u7a76\u4e5f\u5173\u6ce8\u4e86\u5176\u4ed6\u7535\u6781\u914d\u7f6e\u65b9\u5f0f\u5bf9AIS\u540e\u80a2\u4f53\u529f\u80fd\u5eb7\u590d\u7684\u5f71\u54cd\uff61\u6709\u7814\u7a76\u7eb3\u5165\u4e8660 \u4f8bAIS\u60a3\u8005,\u89c2\u5bdf\u4e863\u79cd\u4e0d\u540c\u7535\u6781\u6392\u5217\u65b9\u5f0f\u5bf9\u8dcc\u5012\u98ce\u9669\u53ca\u4e0b\u80a2\u529f\u80fd\u7684\u5f71\u54cd\uff61\u8fd93\u79cd\u7535\u6781\u6392\u5217\u65b9\u5f0f\u5206\u522b\u4e3a\u9633\u6781\u7535\u6781\u4f4d\u4e8e\u60a3\u4fa7\u534a\u7403M1\u533a\u8054\u5408\u9634\u6781\u7535\u6781\u4f4d\u4e8e\u975e\u53d7\u7d2f\u4fa7\u7736\u4e0a\u533a\uff64\u9634\u6781\u7535\u6781\u4f4d\u4e8e\u975e\u53d7\u7d2f\u4fa7\u534a\u7403M1 \u533a\u8054\u5408\u9633\u6781\u7535\u6781\u4f4d\u4e8e\u60a3\u4fa7\u7736\u4e0a\u533a\u4ee5\u53ca\u9633\u6781\u7535\u6781\u548c\u9634\u6781\u7535\u6781\u5206\u522b\u7f6e\u4e8e\u60a3\u4fa7\u53ca\u975e\u53d7\u7d2f\u4fa7M1 \u533a,\u7ed3\u679c\u8868\u660e,\u4e0e\u5047\u523a\u6fc0\u7ec4\u76f8\u6bd4,3\u79cd\u7535\u6781\u6392\u5217\u65b9\u5f0f\u5728\u53cd\u6620\u8dcc\u5012\u98ce\u9669\u7684\u4e3b\u8981\u7ed3\u5c40\u6307\u6807\u56db\u683c\u79fb\u6b65\u8bd5\u9a8c(four square step test,FSST)\u548c\u6574\u4f53\u7a33\u5b9a\u6307\u6570(overall stability index,OSI)\u65b9\u9762\u5747\u5b58\u5728\u663e\u8457\u7684\u65f6\u95f4\u548c\u7ec4\u95f4\u7684\u4ea4\u4e92\u4f5c\u7528[\u5206\u522b\u4e3aF(3,56)=19.80,P = 0.001,\u03b72 = 0. 51 \u548cF(3,56) = 73.52,P =0.001,\u03b72 = 0. 79]\uff61\u4e8b\u540e\u5206\u6790\u663e\u793a,\u5404\u7535\u523a\u6fc0\u7ec4\u6cbb\u7597\u540e\u7684FSST \u548cOSI \u8bc4\u5206\u5747\u4f18\u4e8e\u5047\u523a\u6fc0\u7ec4(\u5747P <0.01)\uff61\u6b64\u5916,\u5728\u5bf9\u6b21\u8981\u7ed3\u5c40\u6307\u6807\u56fd\u9645\u7248\u8dcc\u5012\u6548\u80fd\u91cf\u8868(falls efficacy scale-international,FES-I)\u548c6 min\u6b65\u884c\u8bd5\u9a8c(six minute walk test,6MWT)\u7684\u4e8b\u540e\u5206\u6790\u4e2d\u53d1\u73b0,\u9633\u6781\u7535\u6781\u548c\u9634\u6781\u7535\u6781\u5206\u522b\u4f4d\u4e8e\u60a3\u4fa7\u53ca\u975e\u53d7\u7d2f\u4fa7M1\u533a\u7684\u53cc\u4fa7\u6392\u5217\u65b9\u5f0f\u7684tDCS \u8f83\u5176\u4ed6\u4e24\u79cd\u7535\u6781\u6392\u5217\u65b9\u5f0f\u5bf9\u6539\u5584\u4e0b\u80a2\u529f\u80fd\u8bc4\u5206\u66f4\u4e3a\u6709\u6548(\u5747P <0. 05)[24]\uff61\u6b64\u5916,\u53e6\u4e00\u9879\u7814\u7a76\u6d4b\u8bd5\u4e86\u5352\u4e2d\u540e96 h\u5185a-tDCS\u523a\u6fc0(\u7535\u6d41\u5f3a\u5ea6:2 mA,30 min \/\u6b21,2 \u5468\u5185\u517110\u6b21)\u5de6\u4fa7\u80cc\u5916\u4fa7\u524d\u989d\u53f6\u76ae\u8d28(dorsolateral prefrontal cortex, DLPFC)\u80fd\u5426\u589e\u5f3a\u8fd0\u52a8\u6062\u590d\u80fd\u529b\uff61\u8be5\u7814\u7a76\u7eb3\u516520\u4f8bAIS\u60a3\u8005\u5e76\u5206\u4e3a2\u7ec4,\u4e00\u7ec4\u7ed9\u4e88bi-tDCS(\u9633\u6781\u7535\u6781\u4f4d\u4e8e\u60a3\u4fa7M1 \u533a,\u9634\u6781\u7535\u6781\u4f4d\u4e8e\u975e\u53d7\u7d2f\u4fa7\u5bf9\u5e94\u533a),\u53e6\u4e00\u7ec4\u5728\u524d\u4e00\u7ec4\u7684\u57fa\u7840\u4e0a\u8054\u5408\u4e86tDCS\u5bf9\u5de6\u4fa7DLPFC\u7684\u523a\u6fc0(\u9633\u6781\u7535\u6781\u4f4d\u4e8eF3\u4e0a\u65b9,\u9634\u6781\u7535\u6781\u4f4d\u4e8e\u53f3\u4fa7\u7736\u4e0a\u65b9),\u7ed3\u679c\u8868\u660e,\u5728Fugl-Meyer\u4e0a\u80a2\u8fd0\u52a8\u529f\u80fd\u8bc4\u5206\u548cARAT \u8bc4\u5206\u7684\u589e\u957f\u6a21\u578b\u4e2d,\u5047DLPFC\u523a\u6fc0\u7ec4\u548c\u8054\u5408\u523a\u6fc0\u7ec4\u7684Fugl-Meyer\u4e0a\u80a2\u8fd0\u52a8\u529f\u80fd\u8bc4\u5206\u6bcf\u5929\u5206\u522b\u589e\u52a0\u5e73\u57471. 2 \u5206\u548c1. 7 \u5206(P = 0.003),ARAT\u8bc4\u5206\u6bcf\u5929\u5206\u522b\u589e\u52a0\u5e73\u57470. 50 \u5206\u548c0. 66 \u5206(P = 0. 006)\uff61DLPFC \u523a\u6fc0\u8054\u5408M1 \u523a\u6fc0\u8f83\u5355\u72ec\u523a\u6fc0M1\u66f4\u597d\u5730\u4fc3\u8fdb\u4e86\u8fd0\u52a8\u529f\u80fd\u6062\u590d,\u8fd9\u53ef\u80fd\u662f\u56e0\u4e3a\u5bf9DLPFC\u7684\u523a\u6fc0\u589e\u52a0\u4e86\u8fd0\u52a8\u8bf1\u53d1\u7535\u4f4d,\u5e76\u4e14\u6539\u5584\u4e86\u60a3\u8005\u7684\u8ba4\u77e5\u529f\u80fd[55]\uff61<\/p>\n
\u8fd1\u671f\u7684\u4e00\u9879\u7814\u7a76\u8bc4\u4ef7\u4e86c-tDCS \u7528\u4e8eAIS \u60a3\u8005\u7684\u5b89\u5168\u6027\uff64\u53ef\u884c\u6027\u53ca\u6709\u6548\u6027[6]\uff61\u8be5\u7814\u7a76\u7eb3\u5165\u4e8645\u4f8b\u7b26\u5408\u8840\u7ba1\u5185\u518d\u901a\u6807\u51c6\u7684AIS\u60a3\u8005,\u5728\u8fdb\u884c\u6eb6\u6813\u6216\u8840\u7ba1\u5185\u518d\u901a\u624b\u672f\u65f6\u7ed9\u4e88c-tDCS(\u7535\u6d41\u5f3a\u5ea6:1.5 mA,20 min \/\u6b21;\u9633\u6781\u7535\u6781\u4f4d\u4e8e\u975e\u53d7\u7d2f\u4fa7\u7736\u4e0a\u533a,\u9634\u6781\u7535\u6781\u4f4d\u4e8e\u6897\u6b7b\u4fa7M1)\u6216\u5047\u523a\u6fc0,\u6bcf\u5c0f\u65f61\u6b21,\u51717\u6b21\uff61\u672a\u89c2\u5bdf\u5230\u4e0ec.tDCS\u76f8\u5173\u7684\u795e\u7ecf\u529f\u80fd\u6076\u5316\u6216\u6b7b\u4ea1\u7b49\u4e25\u91cd\u7684\u4e0d\u826f\u53cd\u5e94,\u800c\u7619\u75d2\uff64\u70e7\u707c\u611f\uff64\u5934\u75db\u7b49\u8f7b\u5fae\u4e0d\u826f\u53cd\u5e94\u5728\u4e24\u7ec4\u4e2d\u53d1\u751f\u7387\u76f8\u4f3c\uff61\u4e0e\u5047\u523a\u6fc0\u7ec4\u76f8\u6bd4,c.tDCS\u7ec4\u7684\u5165\u9662\u548c\u518d\u704c\u6ce8\u540e24 h\u7684\u6897\u6b7b\u4f53\u79ef\u53d8\u5316\u5dee\u5f02\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49[\u4e2d\u4f4d\u6897\u6b7b\u4f53\u79ef\u589e\u957f:5. 4(1. 8,12. 9)ml \u6bd48.3(1.8,25. 5)ml,P = 0. 28]\uff61\u5728\u968f\u540e\u5bf9\u4e2d\u91cd\u5ea6\u5352\u4e2d\u548c\u5927\u8840\u7ba1\u95ed\u585e\u7684\u4e9a\u7ec4\u5206\u6790\u4e2d\u540c\u6837\u672a\u53d1\u73b0c-tDCS\u7ec4\u4e0e\u5047\u523a\u6fc0\u7ec4\u518d\u704c\u6ce8\u540e24 h\u6897\u6b7b\u4f53\u79ef\u53d8\u5316\u5dee\u5f02\u6709\u7edf\u8ba1\u5b66\u610f\u4e49[\u4e2d\u4f4d\u6897\u6b7b\u4f53\u79ef\u5dee\u503c\u5206\u522b\u4e3a-5. 7 ml(95% CI:-21. 6 ~2.6)\u548c- 7. 7 ml(95% CI:- 24. 2 ~ 2. 6)],\u4f46\u8be5\u7ed3\u679c\u4f53\u73b0\u4e86c-tDCS \u6709\u52a9\u4e8e\u964d\u4f4e\u6897\u6b7b\u4f53\u79ef\u7684\u8d8b\u52bf,\u8868\u660e\u5bf9\u4e8eNIHSS \u8bc4\u5206\u5927\u4e8e10 \u5206\u548c\u5927\u8840\u7ba1\u95ed\u585e\u7684\u60a3\u8005,c-tDCS \u6cbb\u7597\u6709\u6f5c\u5728\u76ca\u5904\uff61\u4f46\u8be5\u7814\u7a76\u6837\u672c\u91cf\u8f83\u5c0f,\u65f6\u95f4\u8de8\u5ea6\u4ece2016\u5e74\u6301\u7eed\u81f32019\u5e74,\u4e2d\u95f4\u5165\u7ec4\u6761\u4ef6\u6839\u636e\u6307\u5357\u7684\u53d8\u5316\u8fdb\u884c\u4e86\u8c03\u6574,\u5c06\u53d1\u75c5\u65f6\u95f4<6 h\u6269\u5c55\u4e3a\u53d1\u75c5\u65f6\u95f4< 6 h\u53ca\u53d1\u75c5\u65f6\u95f4\u4e3a6 ~ 24 h\u4e14\u7b26\u5408\u7f3a\u8840\u6027\u5352\u4e2d\u5f71\u50cf\u5b66\u8bc4\u4f30\u540e\u8840\u7ba1\u5185\u6cbb\u75973(endovascular therapy following imaging evaluation for ischemic stroke,DEFUSE 3)\u6216\u5e94\u7528\u6269\u6563\u52a0\u6743\u6210\u50cf(DWI)\u6216CT\u704c\u6ce8\u6210\u50cf(CT perfusion,CTP)\u8054\u5408\u4e34\u5e8a\u4e0d\u5339\u914d\u5bf9\u9192\u540e\u5352\u4e2d\u548c\u665a\u5c31\u8bca\u5352\u4e2d\u60a3\u8005\u4f7f\u7528Trevo \u88c5\u7f6e\u884c\u795e\u7ecf\u4ecb\u5165\u6cbb\u7597(DWI or CTP assessment with clinical mismatch in the triage of wake up and late presenting strokes undergoing neurointervention with Trevo, DAWN)\u7814\u7a76\u7684\u5165\u7ec4\u6807\u51c6,\u884c\u9759\u8109\u6eb6\u6813\u540e\u6865\u63a5\u53d6\u6813\u7684\u60a3\u8005\u6269\u5927\u4e3a\u6865\u63a5\u53d6\u6813\u6216\u5355\u7eaf\u53d6\u6813\u7684\u60a3\u8005,NIHSS\u8bc4\u5206\u57284 ~ 25\u5206\u4e4b\u95f4\u66f4\u6539\u4e3a\u4e0d\u9650\u5236NIHSS\u8bc4\u5206,\u8fd9\u53ef\u80fd\u5f71\u54cd\u4e86\u7ed3\u679c\u7684\u51c6\u786e\u6027\uff61\u6b64\u5916,\u4e00\u9879\u5173\u4e8etDCS\u5bf9\u4e0d\u7b26\u5408\u518d\u704c\u6ce8\u6761\u4ef6\u7684AIS\u7684\u795e\u7ecf\u4fdd\u62a4\u4f5c\u7528\u7684\u7814\u7a76\u4e5f\u6b63\u5728\u8fdb\u884c(ClinicalTrials. gov: NCT03574038)\uff61<\/p>\n
\u4ece\u4e0a\u8ff0\u7814\u7a76\u53ef\u4ee5\u770b\u51fa,\u5728\u5408\u9002\u7684tDCS\u53c2\u6570\u914d\u7f6e\u4e0b,\u5e76\u53d1\u80a2\u4f53\u529f\u80fd\u969c\u788d\u7684AIS\u60a3\u8005\u53ef\u80fd\u4f1a\u5728a-tDCS\u4f5c\u7528\u4e0b\u83b7\u76ca,\u8fd9\u4e5f\u652f\u6301\u4e86\u534a\u7403\u95f4\u7ade\u4e89\u6a21\u578b\uff61\u800c\u5173\u4e8ec-tDCS\u80fd\u5426\u7f29\u5c0fAIS\u7684\u6897\u6b7b\u4f53\u79ef\u5e76\u6539\u5584\u9884\u540e\u7684\u4e34\u5e8a\u7814\u7a76\u8fc7\u5c11,\u6682\u4e0d\u80fd\u8bf4\u660eAIS\u540e\u65e9\u671f\u5e94\u7528c-tDCS\u662f\u5426\u5177\u6709\u795e\u7ecf\u4fdd\u62a4\u4f5c\u7528\uff61\u603b\u4f53\u770b\u6765,\u6709\u5173tDCS\u5bf9AIS\u540e\u795e\u7ecf\u4fdd\u62a4\u7684\u4e34\u5e8a\u7814\u7a76\u4ecd\u7136\u8f83\u5c11,\u4e14\u6837\u672c\u91cf\u8f83\u5c0f\uff61\u5982\u4f55\u66f4\u52a0\u5408\u7406\u5730\u8bbe\u8ba1\u8bd5\u9a8c,\u63a2\u7d22\u6700\u4f18\u523a\u6fc0\u53c2\u6570,\u4ecd\u7136\u662f\u9700\u8981\u89e3\u51b3\u7684\u96be\u9898\uff61<\/p>\n
4 \u5c55\u671b<\/p>\n
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