耳穴揿针联合重复经颅磁刺激治疗血管性帕金森综合征临床观察  

Clinical observation of thumbtack needling plus repetitive transcranial magnetic stimulation for vascular Parkinsonism

作　　者：刘丽 郑婵娟 张伟 徐婷 LIU Li;ZHENG Chanjuan;ZHANG Wei;XU Ting(Hubei Provincial Hospital of Integrated Chinese&Western Medicine,Wuhan 430000,China)

机构地区：[1]湖北省中西医结合医院,武汉430000

出　　处：《上海针灸杂志》2025年第3期322-325,共4页Shanghai Journal of Acupuncture and Moxibustion

基　　金：湖北省自然科学基金项目(2024AFD254)。

摘　　要：目的观察耳穴揿针联合重复经颅磁刺激治疗血管性帕金森综合征的临床疗效。方法将90例血管性帕金森综合征患者随机分为耳穴揿针组、重复经颅磁刺激组和联合组,每组30例。耳穴揿针组选择耳穴行揿针治疗,重复经颅磁刺激组采用重复经颅磁刺激初级运动皮质(左右交替);联合组行耳穴揿针和重复经颅磁刺激的联合治疗。观察3组治疗前后统一帕金森病评定量表(unified Parkinson's disease rating scale,UPDRS)、Berg平衡量表(Berg balance scale,BBS)和Barthel指数评分的变化。结果3组治疗1个疗程后、治疗2个疗程后和治疗后UPDRSⅢ评分低于治疗前,BBS及Barthel指数评分高于治疗前,差异有统计学意义(P<0.05);3组治疗2个疗程后和治疗后UPDRSⅢ评分低于治疗1个疗程后,BBS及Barthel指数评分高于治疗1个疗程后,差异有统计学意义(P<0.05);3组治疗后UPDRSⅢ评分低于治疗2个疗程后,BBS及Barthel指数评分高于治疗2个疗程后,差异有统计学意义(P<0.05)。同时,联合组治疗1个疗程后、治疗2个疗程后和治疗后UPDRSⅢ评分低于耳穴揿针组和重复经颅磁刺激组,BBS及Barthel指数评分高于耳穴揿针组和重复经颅磁刺激组,差异有统计学意义(P<0.05)。结论耳穴揿针和重复经颅磁刺激联合应用治疗血管性帕金森综合征疗效确切。Objective To observe the clinical efficacy of thumbtack needling at ear points combined with repetitive transcranial magnetic stimulation(rTMS)in treating vascular Parkinsonism(VP).Method Ninety VP patients were randomized into a thumbtack-needle ear-point group,an rTMS group,and an integrated group,each consisting of 30 participants.The thumbtack-needle ear point group was treated with thumbtack needles at ear points,the rTMS group was intervened by applying rTMS to the primary motor cortex(the left and right sides were stimulated in turns),and the integrated group was treated with both methods:thumbtack needles treating ear points and rTMS.The three groups were observed for the post-treatment changes in the unified Parkinson’s disease rating scale(UPDRS),Berg balance scale(BBS),and Barthel index(BI)scores.Result The UPDRSⅢscore dropped after 1 treatment course,after 2 treatment courses,and after the intervention in the three groups compared to the baseline,and the BBS and BI scores increased,all showing statistical significance(P<0.05);the UPDRSⅢscore after 2 treatment courses and after the intervention was lower than that after 1 treatment course in all three groups,and the BBS and BI scores were higher compared to those after 1 treatment course,all showing statistical significance(P<0.05);the UPDRSⅢscore after the intervention was lower than that after 2 treatment courses in the three groups,and the BBS and BI scores were higher,all showing statistical significance(P<0.05).Further,the UPDRSⅢscore was lower in the integrated group than in the thumbtack-needle ear-point group and the rTMS group after 1 treatment course,after 2 treatment courses,and after the intervention,and the BBS and BI scores were higher,all showing statistical significance(P<0.05).Conclusion Acupuncture at ear points with thumbtack needles plus rTMS can produce valid efficacy in treating VP.

关 键 词：揿针 皮内针疗法 耳穴 针药并用 重复经颅磁刺激 血管性帕金森综合征 帕金森病 继发性 

分 类 号：R246.6[医药卫生—针灸推拿学]