重复经颅磁刺激联合普拉克索治疗老年帕金森的疗效评价

Evaluation of the efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Praxeol in the treatment of senile parkinson's disease

目的探讨重复经颅磁刺激联合普拉克索治疗老年帕金森病的临床疗效。方法选取2017年4月至2019年4月我院收治的60例帕金森病(Parkinson's disease,PD)患者,随机分为两组,每组30例。对照组给予普拉克索,起始治疗剂量为0.125mg,3次/d,逐步增加剂量至最佳维持治疗剂量,最大日剂量为4.5g。观察组同时采用重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)进行治疗,每天治疗1次,每周治疗5天,两组患者均治疗3个月。观察两组患者的治疗有效率,采用简易上肢机能检查(STEF)、Berg平衡量表(BBS)、改良Ashworth量表(MAS)以及10m折返运动试验评价运动症状,采用简易智能量表(MMSE)评价患者认知障碍改善情况。结果观察组治疗有效率为80%显著高于对照组的治疗有效率53.33%(P<0.05);治疗后观察组的STEF评分、BBS评分、MAS评分均高于对照组,而10m折返试验观察组时间为(31.29±5.46)s明显低于对照组的(35.33±5.12)s;观察组MMSE评分明显高于对照组(P<0.05)。结论rTMS治疗PD患者可显著提高临床疗效,明显改善患者的运动症状和认知功能障碍等。

Objective To explore the clinical effect of repeated transcranial magnetic stimulation combined with pramipexole in the treatment of elderly Parkinson's disease.Methods From April 2017 to April 2019,60 patients with Parkinson's disease(PD)in our hospital were randomly divided into two groups.Each group of 30 people.Control group was given pramipexole,the initial treatment dose was 0.125mg tid,and the dose was adjusted to the best maintenance treatment the maximum daily dose was 4.5g.Based on this,the observation group was given repetitive transcranial magnetic stimulation(rTMS)treatment.The treatment was performed once a day for 5 days per week.The two groups All patients were treated for 3 months,and the treatment efficiency of the two groups was observed.A simple test for evaluating hand function(STEF),Berg Balance Scale(BBS),Modified Ashworth Scale(MAS)and 10m reentry exercise test evaluate motor symptoms and the mini mental state examination(MMSE)evaluates patients with cognitive impairment.Results The treatment effective rate of 80%in the observation group was significantly higher than 53.33%in the control group(P<0.05).After treatment,the STEF score,BBS score,and MAS score of the observation group were higher than those of the control group,while the 10m reentry experiment observation group time(31.29±5.46)s was significantly lower than that of the control group(35.33±5.12)s.The MMSE score of the observation group was significantly higher than that of the control group(P<0.05).Conclusion The rTMS can significantly improve clinical efficacy in patients with PD,and significantly improve motor symptoms and cognitive dysfunction.