重复经颅磁刺激联合“氧-针-康”方案对帕金森病患者运动功能以及血清C反应蛋白和血浆多巴胺的影响  

Effects of rTMS Combined with Hyperbaric Oxygen-acupuncture-rehabilitation Therapy on Motor Function,Serum CRP and Plasma Dopamine in Patients with Parkinson's Disease

作　　者：石强[1] 罗琴[1] 龚亲平 王岗[2] SHI Qiang;LUO Qin;GONG Qinping;WANG Gang(Department of Neurology,Zigong First People's Hospital,Zigong 643000,China;Department of Traditional Chinese Medicine,Zigong First People's Hospital,Zigong 643000,China)

机构地区：[1]四川省自贡市第一人民医院神经内科,643000 [2]四川省自贡市第一人民医院中医科,643000

出　　处：《中国全科医学》2020年第27期3460-3465,共6页Chinese General Practice

基　　金：四川省中医药管理局科学技术研究专项(2018QN073);自贡市市级重点科技计划项目专项(2018CXMZ04)。

摘　　要：背景随着人口老龄化的加剧,帕金森病(PD)的发病率逐渐增加。PD主要是以静止性震颤、肌张力增高、肌肉强直所导致的运动功能障碍为主,患者运动能力逐渐下降,最终造成生活难以自理。目前药物为干预PD的主要手段。而近年来,除药物治疗以外,非药物治疗干预PD患者运动功能障碍的研究也有所增加,如重复经颅磁刺激(r TMS)、针刺、高压氧疗法、康复功能训练等,然而尚未整合成统一的方案。目的探寻rTMS联合"氧-针-康"方案对PD患者运动功能以及血清C反应蛋白(CRP)、血浆多巴胺(DA)的影响。方法选择2017年4月-2019年2月于自贡市第一人民医院住院的PD患者90例,按照随机数字表法将其分为观察组、西药对照组、"氧-针-康"组,每组30例。西药对照组采用常规西药治疗;观察组在西药对照组治疗的基础上采用rTMS联合"氧-针-康"方案,"氧-针-康"方案是把多种干预手段融入90 min内的高压氧舱,包括五行音乐疗法、针刺、功能训练等;"氧-针-康"组流程同观察组的"氧-针-康"方案;三组均持续治疗8周。观察指标为PD评分量表-Ⅲ(UPDRS-Ⅲ)、Barthel指数、Berg平衡量表(BBS)、稳定极限范围(LOS),以及临床疗效、CRP、DA。结果治疗后观察组UPDRS-Ⅲ评分、BBS评分、LOS、CRP、DA以及疗效均优于西药对照组和"氧-针-康"组,差异有统计学意义(P<0.05);观察组Barthel指数高于西药对照组(P<0.05),与"氧-针-康"组相比,差异无统计学意义(P>0.05)。结论 rTMS联合"氧-针-康"方案治疗PD患者不仅疗效显著,而且可有效改善患者的运动、平衡的功能,降低炎性因子的表达,减少DA的丢失,同时还可高效率地融合多种治疗,让治疗时间得到充分利用。Background Along with the increase of population aging,the incidence rate of Parkinson's disease(PD)is gradually increasing.PD is mainly characterized by motor dysfunctions caused by static tremor,increased muscle tone,and muscle rigidity.The gradually decreased motor capacity makes it difficult for the patients to take care of themselves.In recent years,in addition to drug therapy,the main treatment for PD,the study in non-drug therapies has also obtained achievements,such as repetitive transcranial magnetic stimulation(rTMS),acupuncture,hyperbaric oxygen therapy,and rehabilitation function training,but a therapy incorporated with multiple interventions has not been developed.Objective To explore the effects of rTMS combined with hyperbaric oxygen-acupuncture-rehabilitation therapy on motor function,serum CRP and plasma dopamine(DA)in patients with PD.Methods 90 PD patients hospitalized in Zigong First People's Hospital from April 2017 to February 2019 were selected and equally divided into control group,observation group,and hyperbaric oxygen-acupuncturerehabilitation group according to a table of randomly generated numbers,receiving routine western medicine treatment,western medicine in combination with rTMS and hyperbaric oxygen-acupuncture-rehabilitation therapy(five-element music therapy,acupuncture and rehabilitation training are performed during a 90-minute hyperbaric oxygen therapy),and hyperbaric oxygenacupuncture-rehabilitation therapy,respectively.The treatment for three groups lasted for 8 weeks.The outcome was evaluated by the assessment results of Unified Parkinson's Disease Rating Scale-Ⅲ(UPDRS-Ⅲ),Barthel index,Berg Balance Scale(BBS),limit of stability(LOS),clinical response,serum C-reactive protein(CRP),and plasma DA.Results After treatment,the observation group showed better improvements in UPDRS-Ⅲ,BBS,LOS,CRP,DA and clinical responses than other two groups(P<0.05).The Barthel index in the observation group was higher than that of the control group(P<0.05),but was similar to that of the h

关 键 词：帕金森病 经颅磁刺激 针灸疗法 高压氧 康复 

分 类 号：R742.5[医药卫生—神经病学与精神病学]