重复经颅磁刺激联合司来吉兰治疗帕金森病冻结步态的疗效  

Efficacy of rTMS combined with selegiline in the treatment of frozen gait in Parkinson’s disease

作　　者：胡晓辉 李婷[1] 王煜[1] 谢伟强 刘立平[1] HU Xiao-hui;LI Ting;WANG Yu;XIE Wei-qiang;LIU Li-ping(Department of Neurology,Xi'an Honghui Hospital ffiliated to Xi'an Jiaotong Unirersity,Xi'an,Shaanxi 710054,China)

机构地区：[1]西安交通大学附属红会医院神经内科,陕西西安710054

出　　处：《中国临床研究》2021年第10期1358-1361,共4页Chinese Journal of Clinical Research

摘　　要：目的探讨重复经颅磁刺激(rTMS)联合司来吉兰治疗帕金森病(PD)冻结步态患者的临床治疗疗效。方法连续收集2019年6月至2020年12月在西安市红会医院神经内科门诊及住院的56例临床确诊PD冻结步态患者,纳入患者完全随机分为rTMS组和对照组,各28例。rTMS组采用低频rTMS+司来吉兰片治疗;对照组采用伪线圈rTMS+司来吉兰片治疗;两组患者均口服司来吉兰5 mg,2次/d,rTMS(rTMS组)或伪线圈rTMS(对照组)治疗1次/d,每次20 min,连续14 d。采用统一帕金森病评分量表(UPDRS)、冻结步态量表(FOGQ)、Berg平衡步态量表、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评估患者情况。结果rTMS组患者治疗后UPDRS-Ⅱ、UPDRS-Ⅲ、FOGQ量表评分均低于治疗前和对照组,Berg量表评分高于治疗前和对照组,差异有统计学意义(P<0.01)。rTMS组患者治疗后UPDRS-Ⅰ、UPDRS-Ⅳ、HAMA、HAMD量表评分均低于治疗前和对照组,差异有统计学意义(P<0.05,P<0.01)。结论rTMS联合司来吉兰治疗,既可有效改善PD患者冻结步态及运动平衡障碍,也能有效改善患者的焦虑抑郁及PD药物并发症等非运动症状。Objective To explore the clinical therapeutic effect of repetitive transcranial magnetic stimulation(rTMS) combined with selegiline on the Parkinson’s disease(PD) patient with frozen gait. Methods Fifty-six PD patients with frozen gait were continuously recruited from June 2019 to December 2020 and randomly divided into rTMS group and control group(n=28, each). Low-frequency rTMS with oral selegiline tablets was given in rTMS group, and pseudo-coil rTMS with oral selegiline tablets was used in control group. In both groups, the patients were treated with oral selegiline 5 mg twice a day and rTMS once a day(20 min each time) for 14 consecutive days. Unified Parkinson’s rating scale(UPDRS), freezing of gait questionnaire(FOGQ), Berg balance scale(BBS), Hamilton anxiety scale(HAMA) and Hamilton depression scale(HAMD) were used to assess the situation of patients in two groups. Results Compared with those before treatment and in control group, the scores of UPDRS-Ⅱ,UPDRS-Ⅲ and FOGQ decreased significantly, and BBS score increased in rTMS group after treatment(P<0.01).UPDRS-Ⅰ, UPDRS-Ⅳ, HAMA and HAMD in rTMS group were statistically lower than those before treatment and in control group(P<0.05). Conclusion The rTMS combined with selegiline can effectively improve gait disorders in Parkinson’s disease patients with frozen gait, as well as the non motor symptoms such as anxiety, depression and PD drug complications.

关 键 词：重复经颅磁刺激 司来吉兰 帕金森病 冻结步态 

分 类 号：R714.05[医药卫生—妇产科学]