重复经颅磁刺激对血管性帕金森综合征的临床疗效观察

Clinical Observation of rTMS in the Treatment of Vascular Parkinsonism

目的:观察重复经颅磁刺激(rTMS)对血管性帕金森综合征(VP)患者的临床疗效,为临床应用提供理论。方法:将80例VP患者随机分为治疗组和对照组各40例,两组均给予改善循环、稳定斑块、抗血小板聚集、常规功能康复治疗等基础治疗,治疗组在此基础上给予rTMS,每周治疗5次,共治疗10次,治疗前后对患者运用统一帕全森评定量表(UPDRS)和蒙特利尔认知量表(MoCA)进行疗效评估,并通过UPDRS进行疗效评估。结果:治疗后对照组和治疗组患者的UPDRS总分分别由(43.89±5.52)分和(46.38±5.64)分降低为(38.18±5.12)分和(33.01±6.22)分,而MoCA各项评分显著增高,差异均具有统计学意义(P<0.01);与对照组相比,治疗组患者的UPDRS各项评分及总分降低更多,而MoCA各项评分增高更多,差异均具有统计学意义(P<0.05);两组患者总有效率比较,治疗组87.5%,对照组67.5%,治疗组总有效率显著高于对照组(P<0.05)。结论:在基础治疗上配合应用rTMS可以显著改善VP患者的临床症状,值得在临床进行推广。

Objective:To observe the effects of repeated transcranial magnetic stimulation(rTMS) on the clinical efficacy of patients with vascular Parkinson’s Parkinsonism(VP),and to provide theoretical basis for clinical application.Methods:80 cases of VP patients were randomly divided into a treatment group and a control group with 40 cases each.Both groups were given basic treatments such as circulation improvement,plaque stabilization,anti-platelet aggregation,and conventional functional rehabilitation.The treatment group was given rTMS on this basis.The patients were treated 5 times a week,10 times in total.Before and after treatment,the patients were evaluated by the Unified Parkinson’s Disease Rating Scale(UPDRS) and the Montreal Cognitive Assessment(MoCA),and the effect was evaluated by UPDRS.Results:After treatment,the total score of UPDRS in the control group and the treatment group decreased from(43.89±5.52) and(46.38±5.64) to(38.18±5.12) and(33.01±6.22) respectively,while the MoCA scores were significantly increased,and the differences were statistically significant(P<0.01);compared with the control group,the UPDRS scores of the treatment group The score and total score decreased more,while the MoCA scores increased more,the difference was statistically significant(P<0.01,P<0.05);the total effective rate of the two groups of patients was compared,87.5% in the treatment group and 67.5% in the control group.The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05).Conclusion:The combined application of rTMS in basic treatment can significantly improve the clinical symptoms of VP patients,which is worthy of clinical promotion.