鼠神经生长因子联合rTMS治疗帕金森病的疗效观察  

Efficacy of mouse nerve growth factor combined with rTMS on patients with Parkinsons disease

作　　者：王磊[1] 黄廷[1] 张真[1] WANG Lei;HUANG Ting;ZHANG Zhen(Department of Neurology,Zaoyang First Peoples Hospital,Zaoyang,Hubei,China,441299)

机构地区：[1]枣阳市第一人民医院神经内科,湖北枣阳441299

出　　处：《分子诊断与治疗杂志》2023年第11期1913-1916,1920,共5页Journal of Molecular Diagnostics and Therapy

基　　金：湖北省卫健委面上项目(WJ2021M088)。

摘　　要：目的 观察使用鼠神经生长因子联合重复经颅磁刺激(rTMS)治疗帕金森病(PD)的临床效果。方法 选取2019年9月至2022年9月枣阳市第一人民医院收治的92例PD患者,随机分为对照组(n=46)和观察组(n=46)。两组均给予鼠神经生长因子治疗,观察组在药物治疗基础上予以rTMS辅助治疗,对照组在药物治疗基础上给予伪刺激,两组均治疗两周。分别于治疗前和治疗后采用统一帕金森病评分量表第Ⅲ部分(UPDRS Ⅲ)评估患者的运动功能;采用简易精神状态检查量表(MMSE)评估认知功能;采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评估焦虑、抑郁情况;采用冻结步态问卷(FOGQ)和起立-行走计时测验(TUGT)评估步态障碍;采用脑电超慢涨落分析仪测定5-羟色胺(5-HT)、多巴胺(DA)水平。结果 两组治疗一周、两周的UPDRS Ⅲ评分均低于治疗前,差异有统计学意义(P均<0.05);且观察组UPDRS Ⅲ评分低于对照组,差异均有统计学意义(t=2.212、3.930,P均<0.05)。两组治疗一周、两周的MMSE评分均高于治疗前,差异有统计学意义(P均<0.05);且观察组MMSE评分高于对照组,差异均有统计学意义(t=2.236、3.412,P均<0.05)。治疗两周后,两组HAMA、HAMD量表评分均低于治疗前,差异有统计学意义(P均<0.05);且观察组HAMA、HAMD量表评分均低于对照组,差异均有统计学意义(t=2.507、3.719,P均<0.05)。治疗两周后,两组FOGQ评分、TUGT测验时间均低于或短于治疗前,差异有统计学意义(P均<0.05);且观察组FOGQ评分、TUGT测验时间均低于或短于对照组,差异均有统计学意义(t=3.789、5.450,P均<0.05)。治疗两周后,两组5-HT、DA水平均高于治疗前,差异有统计学意义(P均<0.05);且观察组5-HT、DA水平均高于对照组,差异有统计学意义(t=2.200、3.518,P均<0.05)。结论 鼠神经生长因子联合rTMS治疗PD患者疗效确切,能有效改善患者的脑神经递质水平,对运动症状和非运动症状均Objective To observe the efficacy of mouse nerve growth factor(NGF)combined with repetitive transcranial magnetic stimulation(rTMS)on Parkinsons disease(PD).Methods A total of 92 patients with PD admitted to Zaoyang First Peoples Hospital were enrolled and randomly divided into the control group(n=46)and the observation group(n=46)between September 2019 and September 2022.On basis of mouse NGF treatment,the observation group was given rTMS,while the control group was given pseudo-stimulation for 2 weeks.Before and after treatment,motor function of patients was evaluated by Unified Parkinsons Disease Rating ScaleⅢ(UPDRSⅢ).The cognitive function was assessed by mini-mental state examination(MMSE).The anxiety and depression were evaluated by Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD).The gait disorders were evaluated by Freezing of Gait-Questionnaires(FOGQ)and timed up and go test(TUGT).The levels of 5-hydroxytryptamine(5-HT)and dopamine(DA)were detected by encephalofluctuogram analyzer.Results After 1 week and 2 weeks of treatment,UPDRSⅢscores were decreased in both groups(P<0.05)and were much lower in the observation group(t=2.212,3.930,P<0.05).After 1 week and 2 weeks of treatment,MMSE scores were increased in both groups,and were much higher in the observation group(P<0.05).After 2 weeks of treatment,scores of HAMA and HAMD in both groups were decreased(P<0.05)and were much lower in the observation group(t=2.236,3.412,P<0.05).After 2 weeks of treatment,FOGQ score and TUGT time were decreased in both groups(P<0.05)and were much lower in the observation group(t=2.507,3.719,P<0.05).After 2 weeks of treatment,levels of 5-HT and DA were increased in both groups(P<0.05)and were much higher in the observation group(t=2.200,3.518,P<0.05).Conclusion Curative effect of mouse NGF combined with rTMS is significant on PD patients,which can effectively improve levels of brain neurotransmitters and has significant improvement effect on motor symptoms and non-motor symptoms.

关 键 词：帕金森病 鼠神经生长因子 重复经颅磁刺激 冻结步态 神经递质 

分 类 号：R742.5[医药卫生—神经病学与精神病学]