温肾通督针灸法联合重复经颅磁刺激治疗帕金森病抑郁症临床研究  

Clinical Study on Warming Kidney and Unblocking Governor Vessel Acupuncture andMoxibustion Method Combined with Repetitive Transcranial Magnetic Stimulation forParkinson's Disease Complicated with Depression

作　　者：黄燕熙 纪家武 林燕华 HUANG Yanxi;JI Jiawu;LIN Yanhua(Fuzhou Neuropsychiatry Prevention and Treatment Hospital of Fujian Province,Fuzhou Fujiang 350008,China)

机构地区：[1]福建省福州神经精神病防治院,福建福州350008

出　　处：《新中医》2024年第13期161-166,共6页New Chinese Medicine

基　　金：福州市科技局计划项目(2021-S-206)。

摘　　要：目的:观察温肾通督针灸法联合重复经颅磁刺激(rTMS)治疗帕金森病合并抑郁症(PDD)的临床疗效及对同型半胱氨酸(Hcy)、血清尿酸(UA)的影响。方法:将110例PDD患者按随机数字表法分为对照组和观察组,每组55例。2组在常规服用抗帕金森病药物基础上,对照组予以rTMS治疗,观察组予以rTMS联合温肾通督针灸法治疗。2组均治疗4周。治疗前后比较2组统一帕金森量表(UPDRS)、汉密尔顿抑郁量表-17(HAMD-17)评分及血清Hcy、UA水平,并比较2组临床疗效。结果:治疗后,2组UPDRS各项评分及总分均降低(P<0.05),且观察组低于对照组(P<0.05)。随访1个月,观察组UPDRS各项评分及总分低于治疗前、治疗后及周期对照组(P<0.05),且低于对照组(P<0.05),对照组UPDRS各项评分及总分低于治疗前(P<0.05),但与治疗后比较,差异无统计学意义(P>0.05)。治疗后,2组HAMD-17评分均降低(P<0.05),且观察组低于对照组。随访1个月,观察组HAMD-17指标低于治疗前、治疗后及周期对照组(P<0.05),对照组HAMD-17评分低于治疗前(P<0.05),但与治疗后比较,差异无统计学意义(P>0.05)。治疗后,2组血清Hcy水平均降低(P<0.05),且观察组低于对照组(P<0.05);UA水平均升高(P<0.05),且观察组高于对照组(P<0.05)。随访1个月,观察组血清Hcy水平低于治疗前、治疗后及周期对照组(P<0.05),血清UA水平高于治疗前、治疗后及周期对照组(P<0.05),对照组血清Hcy低于治疗前(P<0.05)、UA水平高于治疗前(P<0.05),但与治疗后比较,差异无统计学意义(P>0.05)。治疗后观察组总有效率92.73%,高于对照组81.82%(P<0.05)。结论:温肾通督针灸法联合rTMS在改善PDD患者运动症状的同时,可降低大脑氧化应激损害及血清Hcy水平,提升UA水平,有效纠正抑郁情绪。Objective:To observe the clinical effect of the therapy of warming kidney and unblocking governor vessel acupuncture and moxibustion combined with repetitive transcranial magnetic stimulation(rTMS)on Parkinson's disease complicated with depression(PDD)and its effects on homocysteine(Hcy)and serum urine acid(UA).Methods:A total of 110 PDD patients were divided into the control group andthe observation group according to the random number table method,with 55 cases in each group.Inaddition to routine antiparkinsonian medications,the control group was additionally treated with rTMS andthe observation group with rTMS combined with warming kidney and unblocking governor vesselacupuncture and moxibustion.The two groups were treated for four weeks.The scores of Unified-Parkinson Disease Rating Scale(UPDRS)and Hamilton Depression Scale-17 items(HAMD-17),levels ofserum Hcy and UA before and after treatment as well as clinical effects were compared between the twogroups.Results:After treatment,each score in UPDRS and the total scores in the two groups weredecreased(P<0.05),and each score in UPDRS and the total score in the observation group were lowerthan those in the control group(P<0.05).After one month of follow-up,each score in UPDRS and the totalscore in the observation group were lower than those before and after treatment and the control group atthe same time(P<0.05),and each score in UPDRS and the total score in the observation group were lowerthan those in the control group(P<0.05);there was no significant difference being found in thecomparisons of each score in UPDRS and the total score in the control group when compared with thoseafter treatment(P>0.05).After treatment,the HAMD-17 scores in the two groups were decreased(P<0.05),and the HAMD-17 score in the observation group was lower than that in the control group.After onemonth of follow-up,the HAMD-17 score in the observation group was lower than that before and aftertreatment and the control group at the same time(P<0.05),and there was no significant differe

关 键 词：帕金森病 抑郁症 温肾通督针灸法 重复经颅磁刺激 同型半胱氨酸 血尿酸 

分 类 号：R742.5[医药卫生—神经病学与精神病学]