柴甘解忧汤联合重复经颅磁刺激对帕金森病合并轻中度抑郁的随机对照研究

Study on the Clinical Efficacy of Chaigan Jieyou Decoction Combined with Repetitive Transcranial Magnetic Stimulation on Parkinson’s Disease with Mild-Moderate Depression:A Randomized Controlled Trial

目的观察柴甘解忧汤联合重复经颅磁刺激(rTMS)对帕金森病合并轻中度抑郁的临床疗效。方法将84例受试者随机将分为中药组、rTMS组、联合组和对照组,每组21例。干预各组分别给予柴甘解忧汤、rTMS及联合治疗,对照组维持原有药物治疗,治疗8周。采用汉密尔顿抑郁量表(HAMD)、贝克抑郁自评量表(BDI)评价患者抑郁情况,采用帕金森病生活质量问卷(PDQ-39)、世界运动障碍学会帕金森病综合评分量表(MDS-UPDRS)Ⅰ、Ⅱ、Ⅲ评价患者生活质量,并进行中医证候评分。结果与本组治疗前比较,干预组治疗后HAMD、BDI、PDQ-39、MDS-UPDRSⅠ、Ⅱ、Ⅲ、中医证候量表评分降低(P<0.01)。与对照组同期比较,干预组治疗后HAMD、BDI、PDQ-39、MDS-UPDRSⅠ、Ⅱ评分降低(P<0.05),r TMS组和联合组MDS-UPDRSⅢ评分降低(P<0.05)。与中药组比较,联合组治疗后HAMD、中医证候量表评分降低(P<0.05)。与rTMS组比较,联合组治疗后PDQ-39、MDSUPDRSⅠ、中医证候量表评分降低(P<0.05)。结论柴甘解忧汤联合rTMS对帕金森病合并轻中度抑郁患者抑郁症状及生活质量均有改善作用。

Objective To evaluate the efficacy of Chaigan Jieyou Decoction(CJD)combined with repetitive transcranial magnetic stimulation(rTMS)in treating Parkinson’s disease combined with mild-moderate depression(PDMMD).Methods A total of 84 participants were randomly assigned to the Chinese medicine(CM)group,rTMS group,combination group,and the control group,21 cases in each group.Participants received CJD,rTMS and CJD combined with rTMS in the CM group,rTMS group,combination group,respectively.The control group maintained previous treatment.The intervention duration lasted for 8 weeks.The Hamilton Depression Scale(HAMD),Beck Depression Inventory(BDI)were used to assess the depression symptom.The Movement Disorder Society-Unified Parkinson’s Disease Rating Scale(MDS-UPDRS)Ⅰ,Ⅱ,Ⅲand Parkinson’s Disease Questionnaire-39(PDQ-39)were used to evaluate the quality of life of participants.The CM symptom score was used to evaluate CM symptom.Results Compared with before treatment,the HAMD score,BDI score,MDS-UPDRS PartⅠ,Ⅱ,Ⅲscore,PDQ-39 score and CM symptom score of CM group,rTMS group,and combination group were significantly decreased(P<0.01).Compared with the control group,the HAMD score,BDI score,PDQ-39 score,and MDS-UPDRS PartⅠ,Ⅱ,Ⅲscore of CM group,rTMS group,and combination group were significantly decreased after treatment(P<0.05).Compared with the control group,MDS-UPDRS PartⅢscore of rTMS group,and combination group were significantly decreased after treatment(P<0.05).Compared with the CM group,HAMD score and CM symptom score of the combination group were significantly decreased(P<0.05).Compared with the rTMS group,the PDQ-39 score,MDS-UPDRS PartⅠscore,and CM symptom score of combination group were significantly decreased after treatment(P<0.05).Conclusion CJD combined with rTMS is effective in the improvement of depression symptoms and quality of life of Parkinson’s disease with depression.