止颤汤联合重复经颅磁刺激治疗帕金森病合并睡眠障碍、抑郁的临床疗效观察

Clinical Effect of Zhichan Decoction Combined with Repeated Transcranial Magnetic Stimulation in Parkinson's Disease Combined with Sleep Disorder and Depression

目的:评价止颤汤联合重复经颅磁刺激(r TMS)治疗帕金森(PD)合并睡眠障碍、抑郁的临床疗效。方法:选入我院2022年9月~2023年1月收治的PD合并睡眠障碍、抑郁患者80例,随机分为对照组和观察组,各40例。对照组予以常规西药+r TMS治疗,观察组在对照组基础上加服中药止颤汤。评价两组的临床疗效、睡眠及抑郁状况等,并进行统计比较。结果:两组治疗后中医证候积分较治疗前下降(P<0.05),而观察组下降幅度显著高于对照组(P<0.05);两组总有效率无明显差异(P>0.05),但观察组愈显率较对照组高(P<0.05);与治疗前比较,两组治疗后UPDRS-Ⅰ、UPDRS-Ⅱ、UPDRS-Ⅲ,NMSE和HAMD量表得分明显下降,PDSS得分明显上升(P<0.05),而观察组下降幅度更大(P<0.05);两组不良反应发生率无差异(P>0.05)。结论:止颤汤联合r TMS治疗PD合并睡眠障碍、抑郁疗效肯定,可有效改善患者的临床症状,提高睡眠质量,缓解抑郁状态,且安全性良好。

Objective:To evaluate the clinical efficacy of Zhichan decoction combined with repeated transcranial magnetic stimu-lation(rTMS)in the treatment of Parkinson's disease(PD)and its impact on sleep and depression in patients.Methods:80 PD patients admitted to our hospital from September 2022 to January 2023 were randomly divided into a control group and an observation group,with 40 patients in each group.The control group was treated with conventional Western medicine and rTMS,while the observation group was supplemented with traditional Chinese medicine Zhichan decoction.Evaluate and compare the clinical efficacy,sleep and depression status between the two groups.Results:After treatment,the traditional Chinese medicine syndrome scores of the two groups decreased compared to before treatment(P<0.05),while the observation group showed a higher decrease than the control group(P<0.05).There was no difference in total effective rate between the two groups(P>0.05),but the observation group had a higher marked improve-ment rate than the control group(P<0.05).Compared with before treatment,the scores of UPDRS-I,UPDRS-II,UPDRS-III,NMSE and HAMD scales were increased,while the PDSS scores were increased(P<0.05)in the two groups after treatment.However,the obser-vation group showed a greater increase/decrease(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combination of Zhichan decoction and rTMS has a definite therapeutic effect on PD,which can effec-tively improve clinical symptoms,improve sleep quality,alleviate depression,and has good safety.