粗针治疗帕金森病肌僵直31例

Thick Needle Treat Rigidity of Parkinson Diease 31 Cases

[目的]通过与单纯口服美多巴对照来评价粗针身柱穴平刺结合美多巴口服治疗帕金森病肌僵直的临床疗效,为帕金森病的临床治疗寻求一种效佳、安全、简单、实用的中医疗法。[方法]按统一的诊断、纳入及排除标准将61例确诊为帕金森病的患者,随机分为美多巴组和粗针组,其中美多巴组30例,粗针组31例。美多巴组继续服用美多巴1次125mg,1日4次;粗针组在此基础上加用粗针身柱穴平刺治疗,每周3次;治疗周期为三个月。分别于疗前、疗后30天、疗后90天和180天回访时进行统一帕金森病评定量表(UPDRS)评分和UPDRS附表评分(UPDRS中与肌僵直有关的16项评分),评价其肌僵直症状改善情况,并对其进行安全性和依从性评价。[结果]组内比较,粗针组的两个评分量表在疗后30天、疗后90天及180天回访时与疗前相比评分下降,差异均有统计学意义(P<0.05或P<0.01);美多巴组在疗后30天、疗后90天及180天回访时,评分与疗前相比评分上升,均有统计学意义(P<0.05或P<0.01)。组间比较,在疗后30天、疗后90天及180天回访时,两组之间均有统计学意义(P<0.01)。[结论]粗针身柱穴平刺加口服美多巴在改善帕金森病患者肌僵直症状方面,明显优于单纯口服美多巴,说明粗针治疗可有效改善并延缓帕金森病肌僵直症状的进展,具有积极的治疗意义。

[Objective]To evaluate the efficacy of the treatment for rigidity of Parkinson disease（PD） by means of horizontal inserted therapy of thick needle at shenzhu point and compared with treatment only by taking Madopar and to promote a kind of effective, simple, safe and applicated therapy of TCM for the clinical treatment of PD patients.[Methods] We chose the 60 cases suffering from PD which had taken Madopar once 125mg and four times a day with the curative effect having reduced for more than 3 months, according to uniform diagnosis, inclusion and exclusion criteria, which were randomly divided into two groups, thick needle group and Madopar group, 30 patients in each. Treatment group took Madopar once 125mg and four times a day, together with treatment of thick needle at shenzhu point, three times a week; Madopar group took Madopar once 125mg and four times a day; The treatment pe- riod was three months. The UPDRS, attached list of UPDRS（16 items in UPDRS relating to rigidity） were observed at the beginning as well as after treatment of 30 days,90 days,180 days for callback. So we could observe the improvement of symptoms, and evaluate the compliance and safety.[Resnlts] For the thick needle group, compared with before the treatment, there was statistical difference with the three scores after the 30 days, 90 days and 180 days for callback（P〈0.05）, and the scores gradually decreased. For the Madopar group, compared with before the treatment, there was also statistical differ- ence with the three scores after the 30 days, 90 days and 180 days for callback（P〈0.05, P〈0.01）. But the scores gradually increased. When it came to the group comparison, the two groups were statistically significant in the 30 days, 90 days and 180 days for callback（P〈0.01）. [Conclusion] Horizontal inserted therapy of thick needle at shenzhu point together with taking Madopar can impove and delay the symptom progress of PD rigidity and plays a positive role in the treatment.