重复经颅磁刺激对帕金森病抑郁患者的生活质量及运动症状疗效的影响

Effects of repetitive transcranial magnetic stimulation on quality of life and motor symptoms in patients with depression in Parkinson's disease

目的探讨重复经颅磁刺激对帕金森病抑郁（d PD）患者生活质量及运动症状疗效的影响。方法回顾性分析2011年2月-2015年1月收集的286例dPD患者的病历和随访资料,其中118例行常规药物治疗（对照组）,余168例在常规药物治疗的基础上加行重复经颅磁刺激治疗（治疗组）。采用健康状况调查问卷（SF-36量表）和改良Webster症状量表,评价两组的生活质量和运动症状疗效。结果治疗后,两组患者的生活质量都得到改善（P〈0.05）。治疗组患者在生活质量评分的心理健康（t=4.44,P〈0.01）、情绪角色功能（t=2.47,P=0.01）和精力（t=4.45,P〈0.01）三个维度显著高于对照组。治疗组的PD运动症状疗效的特别显效率显著高于对照组（χ-2=4.73,P〈0.05）。结论重复经颅磁刺激可显著提高dPD患者生活质量,且在心理、情绪和精力方面的效果优于常规药物治疗,此外,它也能在一定程度上改善dPD患者的运动症状。

Objective To investigate the effects of repetitive transcranial magnetic stimulation on quality of life（ QOL） and motor symptoms in patients with depression in Parkinson＇s disease（ dPD）. Methods The medical records and follow-up data of 286 dPD patients from February 2011 to January 2015 were analyzed retrospectively,and among these patients,118 received conventional drug therapy（ control group） and 168 received repetitive transcranial magnetic stimulation in addition to the conventional drug therapy（ treatment group）. The health status survey questionnaire（ SF-36 scale） and modified Webster scale were applied to evaluate QOL and motor symptoms in the two groups. Results After treatment,both groups had an improvement in the quality of life（ P 〈0. 05）.Compared with the control group,the treatment group had significantly higher QOL scores on the subscales of mental health（ t = 4. 44,P 〈0. 01）,role-emotional（ t = 2. 47,P = 0. 01）,and energy（ t = 4. 45,P 〈0. 01）. The treatment group also had a significantly higher marked response rate for motor symptoms than the treatment group（ χ^2= 4. 73,P 〈0. 05）. Conclusions Repetitive transcranial magnetic stimulation can significantly improve the QOL in d PD patients,and has better effects in the aspects of mentality,emotion,and energy. In addition,it can also improve motor symptoms in d PD patients.