rTMS联合抗阻训练对老年帕金森病患者的干预价值及非运动症状观察

Intervention value of rTMS combined with resistance training in elderly patients with Parkinson′s disease and the effect on non-motor symptoms

目的观察重复经颅磁刺激(rTMS)联合抗阻训练对老年帕金森患者的干预价值及对非运动症状的影响。方法选取106例老年帕金森患者,随机分为2组,所有受试者均给予常规西药治疗,观察组53例另给予rTMS联合抗阻运动,对照组53例给予rTMS治疗。比较2组患者临床疗效、下肢肌群肌力、帕金森病非运动症状评价量表(NMSS)评分、帕金森患者生活质量问卷(PDQ-39)评分。结果观察组疗效优于对照组(P<0.05);治疗后,2组患者小腿踝关节背屈肌群、膝关节伸肌群、髋关节伸肌群肌力均有所提升(P<0.05);治疗后,观察组小腿踝关节背屈肌群、膝关节伸肌群、髋关节伸肌群肌力高于对照组(P<0.05);治疗后,2组患者NMSS评分中非运动症状频率、严重程度的评分均有所降低(P<0.05);治疗后观察组NMSS评分中非运动症状频率、严重程度的评分低于对照组(P<0.05);治疗后4、8、12周,2组患者PDQ-39评分逐渐下降(P<0.05);治疗后4、8、12周,观察组PDQ-39评分均低于对照组(P<0.05)。结论rTMS联合抗阻运动治疗老年帕金森患者在改善下肢肌群肌力、非运动症状及生活质量方面均有良好效果。

Objective To observe the intervention value of repetitive transcranial magnetic stimulation(rTMS)combined with resistance training in elderly patients with Parkinson′s disease and the effect on non-motor symptoms.Methods 106 elderly patients with Parkinson′s disease were enrolled in our hospital and randomly divided into two groups.All subjects were given conventional western medicine treatment,53 cases in the observation group were given rTMS combined with resistance exercise,and 53 cases in the control group were given rTMS treatment.The clinical efficacy,muscle strength,NMSS score and PDQ-39 score of Parkinson′s disease patients were compared between the two groups.Results The curative effect of the observation group was better than that of the control group(P<0.05).After treatment,the muscle strength of the ankle dorsiflexor,knee extensor and hip extensor were improved in both groups(P<0.05),and the muscle strength of ankle dorsiflexor,knee extensor and hip extensor in the observation group was higher than that in the control group(P<0.05).After treatment,NMSS scores of non-motor symptom frequency and severity were decreased in both groups(P<0.05),and the NMSS scores of non-motor symptom frequency and severity in the observation group were lower than those in the control group(P<0.05).At 4,8 and 12 weeks after treatment,PDQ-39 scores in both groups decreased gradually(P<0.05).Aftert 4,8 and 12 weeks treatment,PDQ-39 scores in the observation group were lower than those in the control group(P<0.05).Conclusion rTMS combined with anti-resistance exercise has good effects on improving the muscle strength,non-motor symptoms and quality of life in elderly patients with Parkinson′s disease.