针刺联合TMS改善帕金森病患者认知功能的效果  

Effect of Acupuncture Combined with TMS on Improving Cognitive Function of Patients with Parkinson′s Disease

作　　者：林华俭 张颂华 叶泽根 吴思敏 刘春花 LIN Huajian;ZHANG Songhua;YE Zegen;WU Simin;LIU Chunhua(Lishui Hospital of Traditional Chinese Medicine,Lishui 323000,Zhejiang,China)

机构地区：[1]丽水市中医院,浙江丽水323000

出　　处：《辽宁中医杂志》2025年第3期150-153,共4页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的探讨针刺联合重复经颅磁刺激疗法(transcranial magnetic stimulation,TMS)对帕金森患者认知功能的改善效果。方法选择2021年5月—2023年4月于丽水市中医院就诊的87例帕金森患者,依照随机数字表法将其分为A组(43例)与B组(44例)。A组给予TMS治疗,B组在此基础上联合针刺治疗。两组均治疗8周,比较两组临床疗效、治疗前及治疗8周后P300潜伏期、波幅、血清脑神经递质5-羟色胺(5-hydroxytryptamine,5-HT)、去甲肾上腺(norepinephrine,NE)、神经营养因子-3(neurotrophic factor-3,NT-3)、胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)、过氧化氢酶(catalase,CAT)、丙二醛(malondialdehyde,MDA)、谷胱甘肽(glutathione,GSH-px)、髓过氧化物酶(myeloperoxidase,MPO)、简易智力状态评分量表(mini-mental state rating scale,MMSE)评分、统一帕金森病评定量表(unified Parkinson′s disease rating scale,UPDRS)评分、中医证候积分。结果与A组比较,B组临床总有效率更高;与治疗前比较,治疗8周后两组P300潜伏期均缩短,B组短于A组;与治疗前比较,治疗8周后两组波幅、MMSE、UPDRS评分、5-HT、NE、NT-3、IGF-1、CAT、MDA水平均增高,B组高于A组;与治疗前比较,治疗8周后两组中医证候积分、GSH-px、MPO水平均下降,B组低于A组;差异有统计学意义(P<0.05)。结论针刺联合TMS用于帕金森治疗可有效提升临床疗效,缓解相关症状,修复神经损伤,改善认知功能,且可降低氧化应激反应。Objective To explore the effect of acupuncture combined with repetitive transcranial magnetic stimulation(TMS)on cognitive function of Parkinson′s disease patients.Methods Eighty-seven patients with Parkinson′s disease admitted to the hospital from May 2021 to April 2023 were divided into the group A(43 cases)and the group B(44 cases)by the random number table method.The group A was treated with TMS,and the group B was treated with acupuncture on this basis.Both groups were treated for 8 weeks.The clinical efficacy,P300 latency,amplitude,serum levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE),neurotrophic factor-3(NT-3),insulin-like growth factor-1(IGF-1),catalase(CAT),malondialdehyde(MDA),glutathione(GSH)and myeloperoxidase(MPO),mini-mental state rating scale(MMSE)score,unified Parkinson′s disease rating scale(UPDRS)score and TCM syndrome score between the two groups before and after 8 weeks of treatment were compared.Results Compared with that of the group A,the clinical total effective rate of the group B was higher.Compared with that before treatment,P300 latency of the both groups shortened after 8 weeks of treatment,and P300 latency of the group B was shorter than that of the group A.Compared with those before treatment,the amplitude,MMSE and UPDRS scores,serum levels of 5-HT,NE,NT-3,IGF-1,CAT and MDA of the both groups all increasedafter 8 weeks of treatment,and the amplitude,socres and levels of the group B were higher than those of the group A.Compared with those before treatment,the TCM symptom score,serum levels of GSH-px and MPO of the both groups decreased after 8 weeks of treatment,and the scores and levels of group B were lower than those of the group A.The differences were statistically significant(P<0.05).Conclusion Acupuncture combined with TMS in the treatment of Parkinson′s disease can effectively improve clinical efficacy,relieve related symptoms,repair nerve damage,improve cognitive function and reduce oxidative stress.

关 键 词：帕金森 重复经颅磁刺激 针刺 认知功能 

分 类 号：R277.7[医药卫生—中医学]