不同刺激频率的重复经颅磁刺激治疗帕金森病疗效的网状Meta分析  

Efficacy of repetitive transcranial magnetic stimulation with different stimulation frequencies in the treatment of Parkinson’s disease:a network meta-analysis

作　　者：韩靓 席晓明 王贺 阚梦凡 于少泓[3,4] Han Liang;Xi Xiaoming;Wang He(School of Rehabilitation Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学康复医学院,济南250355 [2]首都医科大学附属北京康复医院康复诊疗中心,北京100144 [3]山东中医药大学医学院,济南250355 [4]山东中医药大学第二附属医院,济南250001

出　　处：《中国康复》2025年第4期240-248,共9页Chinese Journal of Rehabilitation

基　　金：教育部产学合作协同育人项目(202102424004);首都医科大学附属北京康复医院引进人才科研启动基金(2022R-006)。

摘　　要：目的:通过网状Meta分析比较不同频率重复经颅磁刺激(rTMS)对帕金森患者(PD)的疗效。方法:检索中国知网、万方数据库、维普、中国生物医学文献数据库、PubMed、Embase、Cochrane Library、Web of Science等数据库中有关rTMS治疗帕金森患者的随机对照试验,检索时间为2014年1月~2024年6月,采用RevMan对纳入研究进行质量评价,采用R软件、Stata进行数据分析。结果:共16篇文章被纳入分析,包括959例PD患者,rTMS频率包括0.1Hz、1Hz、5Hz、10Hz、20Hz、25Hz。网状Meta分析结果提示rTMS频率为0.1Hz、1Hz、5Hz能够改善患者统一帕金森病评定量表第三部分(UPDRSⅢ)评分,rTMS频率为1Hz、5Hz能够改善患者计时起立行走测试(TUG)评分,rTMS频率为1Hz、5Hz、10Hz能够改善患者汉密尔顿抑郁量表(HAMD)评分,rTMS频率为5Hz、20Hz rTMS能改善患者帕金森病生活质量评分量表(PDQ-39)评分,rTMS频率为1Hz、5Hz、20Hz能改善患者自主神经症状自评量表(SCOPA-AUT)评分。rTMS频率为5Hz对于UPDRSⅢ、TUG、HAMD、SCOPA-AUT的改善作用均优于其它频率,rTMS频率为20Hz对于PDQ-39效果最好。结论:rTMS频率为5Hz在改善PD患者运动功能、心理状态和自主神经功能方面更有效,rTMS频率为20Hz在改善PD患者生活质量方面更有效。Objective:To compare the effects of different frequencies of repetitive transcranial magnetic stimulation on patients with Parkinson’s disease(PD)by network Meta-analysis.Methods:Randomized controlled trials of rTMS on Parkinson’s patients were retrieved from CNKI,Wanfang database,VIP,Chinese biomedical literature database,PubMed,Embase,Cochranelibrary,Web of science and other databases.The search was from January 1,2014 to June 1,2024.Revman was used to evaluate the quality of the included studies.R software and Stata were used for data analysis.Results:A total of 16 articles were included in the analysis,including 959 PD patients.The frequency of rTMS included 0.1 Hz,1 Hz,5 Hz,10 Hz,20 Hz and 25 Hz.The results of network Meta-analysis suggested that 0.1 Hz rTMS,1 Hz rTMS and 5 Hz rTMS could improve unified Parkinson’s disease rating scale part III(UPDRS III)score,1 Hz rTMS and 5 Hz rTMS could improve timed up and go test(TUG)score,1 Hz rTMS,5 Hz rTMS and 10 Hz rTMS could improve Hamilton depression scale(HAMD)score.5 Hz rTMS and 20 Hz rTMS could improve the Parkinson’s disease questionnaire-39(PDQ-39)score of patients,and 1 Hz rTMS,5 Hz rTMS and 20 Hz rTMS could improve the scales for outcomes in Parkinson’s disease-autonomic(SCOPA-AUT)score of patients.5 Hz rTMS had the best effect on UPDRS III,TUG,HAMD and SCOPA-AUT,and 20 Hz rTMS had the best effect on PDQ-39.Conclusion:Based on the current research,we can conclude that rTMS can improve UPDRS III,TUG,HAMD,PDQ-39 and SCOPA-AUT in PD patients,and 5 Hz rTMS has the best effect on UPDRS III,TUG,HAMD and SCOPA-AUT,and 20 Hz rTMS has the best effect on PDQ-39.

关 键 词：重复经颅磁刺激 帕金森患者 频率 贝叶斯网状Meta分析 

分 类 号：R49[医药卫生—康复医学] R742.5[医药卫生—临床医学]