低频重复经颅磁刺激联合普拉克索对帕金森病患者认知功能及氧化应激指标的影响

Effects of low frequency repetitive transcranial magnetic stimulation combined with pramipexole on cognitive function and oxidative stress in Parkinson′s patients

目的探讨低频重复经颅磁刺激联合普拉克索治疗对帕金森病患者认知功能及氧化应激指标的影响。方法选取2018年9月—2020年12月鹤壁市某医院收治的86例帕金森病患者作为研究对象,采用随机数字表法分为对照组和观察组,各43例。对照组患者给予低频重复经颅磁刺激治疗,观察组患者给予低频重复经颅磁刺激联合普拉克索治疗,2组患者均持续治疗1个月。比较2组患者治疗前后蒙特利尔认知评估量表(MoCA)评分、帕金森病运动功能评分量表(MDR-SPD)评分、肌力评分,比较2组患者治疗前后血清丙二醛(MDA)、谷胱甘肽-过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)水平,比较2组患者不良反应发生情况。结果治疗前,2组患者MoCA、MDR-SPD、肌力评分比较,差异均无统计学意义(P>0.05)。治疗后,2组患者MoCA、肌力评分高于治疗前,观察组高于对照组,差异均有统计学意义(P<0.05);MDR-SPD评分低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者MDA、GSH-PX、SOD水平比较,差异均无统计学意义(P>0.05)。治疗后,2组患者MDA水平低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05);GSH-PX、SOD水平高于治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05)。观察组患者的不良反应发生率为6.98%,低于对照组的13.95%,但差异无统计学意义(P>0.05)。结论低频重复经颅磁刺激联合普拉克索治疗能显著提高帕金森病患者认知及运动功能,减轻机体氧化应激反应,且安全性较高,值得在临床上推广应用。

Objective To investigate the effects of low-frequency repetitive transcranial magnetic stimulation combined with pramipexole on cognitive function and oxidative stress in patients with Parkinson′s disease.Methods Eighty-six patients with Parkinson′s disease admitted to a hospital in Hebi from September 2018 to December 2020 were selected as study subjects and divided into control and observation groups,43 cases each,using the random number table method.The patients in the control group were given low-frequency repetitive transcranial magnetic stimulation treatment,and the observation group was given low-frequency repetitive transcranial magnetic stimulation combined with pramipexole treatment,both groups treated continuously for 1 month.The Montreal Cognitive Assessment(MoCA)scores,Motor Dysfunction Rating Scale for Parkinson′s Disease(MDR-SPD)scores,muscle strength scores,plasma malondialdehyde(MDA)levels,glutathione-peroxidase(GSH-PX)levels,and superoxide dismutase(SOD)levels before and after treatment were compared between the two groups,and the occurrence of adverse effects was compared between the two groups.Results Before treatment,there was no statistically significant difference in MoCA,MDR-SPD,and muscle strength scores between the 2 groups of patients(P>0.05).After treatment,the MoCA and muscle strength scores of the 2 groups were higher than before treatment and higher in the observation group than in the control group,with statistically significant differences(P<0.05);the MDR-SPD scores were lower than before treatment and lower in the observation group than in the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference between the levels of MDA,GSH-PX and SOD in the 2 groups(P>0.05).After treatment,the MDA levels of patients in the 2 groups were lower than those before treatment and lower in the observation group than in the control group,with statistically significant differences(P<0.05);the GSH-PX and SOD levels were higher than before treatment and higher in the observation group than in the control group,with statistically significant differences(P<0.05).The incidence of adverse reactions was 6.98%in the observation group,which was lower than that of 13.95%in the control group,and the difference was not statistically significant(P>0.05).Conclusion Low-frequency repetitive transcranial magnetic stimulation combined with pramipexole therapy significantly improves cognitive and motor functions and reduces oxidative stress in patients with Parkinson′s disease,and the safety is relatively high;it is worth promoting in clinical application.