温针灸联合r-TMS对帕金森病合并吞咽功能障碍患者的影响

Effect of Warm Acupuncture Combined with r-TMS on Patients with Parkinson Disease Complicated with Swallowing Dysfunction

目的:分析温针灸联合重复经颅磁刺激(repetitive transcranial magnetic stimulation,r-TMS)对帕金森病合并吞咽功能障碍患者的影响。方法:选取2020年6月-2021年6月泉州市第三医院和福建省福州神经精神病防治院76例帕金森病合并吞咽功能障碍患者。根据系统双盲法将其分成观察组和对照组,各38例。两组入院后均给予常规干预,在此基础上对照组予以温针灸,观察组予以温针灸联合r-TMS干预。比较两组干预前后吞咽功能、生活质量,干预后1个月临床效果及不良事件。结果:干预前两组吞咽功能各级别占比比较差异无统计学意义(P>0.05),观察组Ⅰ、Ⅱ级吞咽功能占比均明显高于对照组,Ⅲ、Ⅳ级吞咽功能占比均明显低于对照组(P<0.05)。干预后1个月,观察组临床总有效率高于对照组(P<0.05)。干预后,观察组生活质量评分高于对照组(P<0.05)。观察组不良事件发生率明显低于对照组(P<0.05)。结论:帕金森病合并吞咽功能障碍患者采用温针灸联合r-TMS治疗能够使其吞咽功能障碍得到显著改善,效果确切且能够减少患者不良事件,提高生活质量。

Objective:To analyze the effect of warm acupuncture combined with repetitive transcranial magnetic stimulation(r-TMS)on patients with Parkinson disease complicated with swallowing dysfunction.Method:From June 2020 to June 2021,76 patients with Parkinson disease complicated with swallowing dysfunction were selected from the Third Hospital of Quanzhou City and Fuzhou Neuropsychiatric Prevention and Treatment Hospital in Fujian.According to the systematic double-blind method,they were divided into observation group and control group,with 38 cases in each group.Both groups were given routine intervention after admission.On this basis,the control group was given warm acupuncture,and the observation group was given warm acupuncture combined with r-TMS intervention.The swallowing function,quality of life before and after the intervention,clinical effect 1 month after intervention and adverse events were compared between the two groups.Result:There were no significant differences in the proportion of each grade of swallowing function between the two groups before intervention(P>0.05).The proportions of grade Ⅰ,Ⅱ swallowing function in the observation group were significantly higher than those in the control group,and the proportions of grade Ⅲ,Ⅳswallowing function were significantly lower than those in the control group(P<0.05).One month after the intervention,the total clinical effective rate of the observation group was higher than that of the control group(P<0.05).After the intervention,the quality of life score of the observation group was higher than that of the control group(P<0.05).The incidence of adverse events in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Patients with Parkinson disease complicated with swallowing dysfunction treated with warm acupuncture combined with r-TMS can significantly improve their swallowing dysfunction,have definite curative effect,and reduce patients’adverse events and improve their quality of life.