左旋多巴普拉克索联合低频rTMS治疗帕金森病对照观察

Controlled observation of levodopa,pramipexole combined with low frequency rTMS in the treatment of Parkinsons disease

目的 探讨左旋多巴、普拉克索联合低频重复经颅磁刺激治疗帕金森病的疗效及对患者大脑皮质兴奋性的影响.方法 将60例帕金森病患者按随机数字表法分为两组,每组30例,对照组予以左旋多巴、普拉克索治疗,观察组予以左旋多巴、普拉克索联合低频重复经颅磁刺激治疗.比较两组治疗前后帕金森综合评分量表评分、大脑皮质兴奋性指标监测结果(静息态阈值、中枢传导时间、运动诱发电位波幅),统计不良反应发生率.结果 治疗后两组患者帕金森综合评分量表各部分评分均较治疗前显著降低(P<0.01),观察组显著低于对照组(P<0.01).治疗后两组静息态阈值较治疗前显著升高(P<0.05或0.01),中枢传导时间较治疗前显著延长(P<0.05或0.01),运动诱发电位波幅较治疗前显著降低(P<0.05或0.01);观察组静息态阈值显著高于对照组(P<0.05或0.01),中枢传导时间显著长于对照组(P<0.05或0.01),运动诱发电位波幅显著低于对照组(P<0.05).两组不良反应发生率比较差异无统计学意义(P>0.05).结论 左旋多巴与普拉克索联合低频低频重复经颅磁刺激治疗帕金森病疗效较好,可显著改善临床症状,抑制大脑皮质兴奋性.

Objective To explore the efficacy of levodopa,pramipexole combined with low frequency rT-MS in the treatment of Parkinson's disease.Methods 60 patients with PD were divided into two groups according to simple random number method,30 cases in each group.The control group was treated with levodopa and pramipexole,while the observation group was treated with levodopa and pramipexole com-bined with low frequency rTMS.UPDRS score,cortical excitability index(RT,CMCT,MEP Amp)and adverse reactions during treatment were compared between the two groups before and after treatment.Re-sults The scores of UPDRS in the two groups were lower than those before treatment(P<0.01),the observation group was significantly lower than the control group(P<0.01).fter treatment,the RT of.the two groups increased(P<0.05 or 0.01),ACMCT was significantly longer than before treatment(P<0.05 or 0.01),and the amplitude of MEP was sig nificantly lower than before treatment(P<0.05 or 0.01).The RT of the observation group was significantly higher than that of the control group(P<0.05 or 0.01),the CMCT was significantly longer than the control group(P<0.05 or 0.01),and the ampli-tude of MEP was significantly lower than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The ap-plication of levodopa and pramipexole in combination with low-frequency rTMS in the treatment of PD pa-tients is effective,which can significantly improve the clinical symptoms and inhibit the excitability of the cerebral cortex.