重复经颅磁刺激联合加兰他敏治疗阿尔茨海默病的疗效观察

Effect of repetitive transcranial magnetic stimulation combined with galantamine in the treatment of Alzheimer's disease

目的:评价重复经颅磁刺激(r TMS)治疗的作用途径并观察r TMS和加兰他敏联合治疗阿尔茨海默病(AD)的效果。方法:43例AD病人随机分成加兰他敏组(21例)和加兰他敏+r TMS组(22例)。治疗前后用简易智能状态量表(MMSE)、临床痴呆量表(CDR)、日常生活能力量表(ADL)进行评分。结果:2组治疗6个月后总有效率差异无统计学意义(P>0.05)。治疗前,2组MMSE、ADL、CDR评分差异均无统计学意义(P>0.05)。治疗6个月后2组MMSE评分均较均线值增加(P<0.01),ADL、CDR评分均降低(P<0.01)。治疗6个月后,加兰他敏组MMSE评分低于加兰他敏+r TMS组(P<0.01),ADL、CDR评分均高于加兰他敏+r TMS组(P<0.01)。双侧高频及左侧高频+右侧低频组其治疗前N1、N2、P3潜伏期比较差异无统计学意义(P>0.05),2组N1、N2潜伏期和P3波幅在治疗前后均无显著变化(P>0.05),P3潜伏期在治疗后缩短(P<0.01)。与左侧高频+右侧低频组比较,双侧高频组P3潜伏期在治疗后缩短(P<0.01)。结论:r TMS+加兰他敏与单用加兰他敏治疗AD均有较高的总有效率,通过MMSE、ADL、CDR评分显示,r TMS+加兰他敏治疗对AD的治疗效果优于单用加兰他敏治疗。

Objective：To evaluate the effects of repetitive transcranial magnetic stimulation（ rTMS） combined with galantamine in the treatment of Alzheimer＇s disease（AD）. Methods：Forty-three AD patients were randomly divided into the galantamine group（21 cases） and galantamine ＋ rTMS group（22 cases）. The scores of simple intelligent state scale（MMSE）,clinical dementia scale（CDR）,daily life ability scale（ ADL ） in two groups were evaluated before and after treatment. Results：The difference of the total effective rate between two groups after 6 months of treatment was not statistically significant（P〉0. 05）. The differences of the scores of MMSE,ADL and CDR between two groups before treatment were not statistically significant（P〉0. 05）. After 6 months of treatment,the MMSE scores increased（P〈0. 05）,and the scores of ADL and CDR decreased in two groups（P〈0. 01）. After 6 months of treatment,the MMSE score in galantamine group was lower than that in galantamine ＋ rTMS group at the same point（P〈0. 01）,and the scores of ADL and CDR in galantamine group were higher than those in galantamine＋rTMS group（P〈0. 01）. The differences of the incubation of N1,N2 and P3 between double sides high frequency and right side high frequency complicated with left side low frequency groups before treatment were not statistically significant（P〉0. 05）. The wave amplitude of N1,N2 and P3 before and after treatment had no significant change in two groups（P〉0. 05）,the incubation of P3 wave shorten after treatment（P〈0. 01）. Compared with the right side high frequency complicated with left side low frequency group,the incubation of P3 in double sides high frequency group significantly shorten after treatment（P〈0. 01）. Conclusions：The total effective rate of rTMS combined with galantamine in the treatment of AD is higher than that of galantamine. The scores of MMSE,ADL and RAD show that the clinical effect of rTMS combined with galantamine in the treatment of AD is better than that of galantamine.