重复经颅磁刺激联合针刺夹脊穴治疗早中期帕金森病非运动症状的临床研究  

Clinical Study of Repetitive Transcranial Magnetic Stimulation Combined with Acupuncture at Jiaji Points in Treatment of Non-Motor Symptoms in Early and Middle Stage of Parkinson's Disease

作　　者：张玉娟 亓法英[1] 杨永芳[1] 车峰远[1,2] ZHANG Yujuan;QI Faying;YANG Yongfang;CHE Fengyuan(Linyi People's Hospital,Linyi 276003,Shandong,China;Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong,China)

机构地区：[1]临沂市人民医院,山东临沂276003 [2]广州中医药大学,广东广州510006

出　　处：《中华中医药学刊》2023年第3期208-211,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：山东省自然科学基金项目(ZR2016HL16)。

摘　　要：目的分析重复经颅磁刺激联合针刺夹脊穴治疗帕金森病(Parkinson's disease,PD)非运动症状的临床效果。方法将186例PD患者采用随机分为观察组、对照组,每组93例,观察组在重复经颅磁刺激治疗基础上采用针刺夹脊穴治疗,对照组仅采用重复经颅磁刺激治疗,通过比较两组患者治疗前、治疗后的统一帕金森病评分量表(unified Parkinson's disease rating scale,UPDRS)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评分及血液流变学指标变化情况,采用比色法测定超氧化物歧化酶(superoxide orgotein dismutase,SOD)活性、丙二醛(malonaldehyde,MDA)含量、酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测谷胱甘肽(glutathione peroxidase,GSH-px)水平;分析重复经颅磁刺激联合针刺夹脊穴的治疗效果。结果观察组治疗后UPDRS评分、HAMD评分、PSQI评分及全血高切黏度、全血低切黏度、血浆黏度、SOD、GSH-px水平均低于对照组,MDA水平高于对照组(均P<0.05);两组治疗方式均具有一定安全性;随访发现,观察组早期或轻度(1~1.5级)患者多于对照组,中期或中度(2~3级)患者少于对照组(P<0.05)。结论重复经颅磁刺激联合针刺夹脊穴治疗PD非运动症状短期效果显著,可明显改善患者非运动症状及血液流变学,并减轻患者机体氧化应激反应。Objective To analyze the clinical effect of repetitive transcranial magnetic stimulation combined with acupuncture at Jiaji points on non-motor symptoms of Parkinson's disease(PD).Methods A total of 186 patients with PD were randomly divided into observation group and control group,93 cases in each group.The observation group was treated with acupuncture at Jiaji points on the basis of repetitive transcranial magnetic stimulation,while the control group was only treated with repetitive transcranial magnetic stimulation.The Unified Parkinson's disease rating scale(UPDRS),Hamilton Depression scale(HAMD),Pittsburgh Sleep Quality Index(PSQI)scores and hemorheology before and after treatment were compared between the two groups.The activity of superoxide dismutase(SOD)and the content of malondialdehyde(MDA)were measured by colorimetry,and the level of glutathione(GSH-px)was detected by enzyme-linked immunosorbent assay(ELISA).Results After treatment,the UPDRS score,HAMD score,PSQI score,whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,SOD activity and GSH-px in the observation group were lower than those in the control group,and the MDA level in the observation group was higher than those in the control group(P<0.05).Conclusion Repeated transcranial magnetic stimulation combined with acupuncture at Jiaji points has a significant short-term effect in the treatment of non motor symptoms of PD,which can significantly improve the non-motor symptoms and hemorheology of patients,and reduce the oxidative stress response of patients.

关 键 词：帕金森病 非运动症状 重复经颅磁刺激 针刺夹脊穴 

分 类 号：R245.31[医药卫生—针灸推拿学] R277.742.5[医药卫生—中医临床基础]