摘要
目的:探讨头皮针结合重复经颅磁刺激(rTMS)治疗帕金森病伴发抑郁状态(PDD)的临床疗效,以及对患者脑电图和血清白细胞介素-6(IL-6)、皮质醇(Cor)、神经元特异性烯醇化酶(NSE)水平的影响。方法:选择2021年7月至2023年1月我院中西医结合神经内科收治的138例PDD患者作为研究对象,按随机数字表法分为观察组和对照组,每组各69例。其中对照组患者采用常规西医基础治疗,观察组患者在对照组基础上联合给予头皮针与rTMS治疗,连续治疗12周。分别于治疗前及治疗4、8、12周对患者进行统一帕金森病评定量表(UPDRS)、24项汉密尔顿抑郁量表(HAMD-24)、匹兹堡睡眠质量指数(PSQI)、39项帕金森病生活质量问卷(PDQ-39)评定。并于治疗前后对患者进行脑电图检查以及血清IL-6、Cor、NSE检测。治疗过程中观察两组患者不良反应情况。结果:观察组患者治疗8、12周后,UPDRS-Ⅰ、UPDRS-Ⅱ、UPDRS-Ⅲ、UPDRS-Ⅳ、HAMD-24、PSQI、PDQ-39评分均低于同期对照组(P<0.05)。治疗后,两组患者脑电图异常活动均有所改善(P<0.05);且治疗后,观察组患者脑电图(P<0.05)优于对照组(P<0.05)。治疗后,两组患者血清IL-6、Cor、NSE水平均有所降低(P<0.05);且治疗后,观察组患者血清IL-6、Cor、NSE水平低于对照组(P<0.05)。观察组患者不良反应发生率为15.94%,与对照组患者的20.29%相比差异无统计学意义(P>0.05)。结论:头皮针结合rTMS治疗PDD能有效改善患者的脑电图及血清IL-6、Cor、NSE水平,减轻抑郁程度,改善睡眠及生活质量,且安全性较好。
Objective:To explore the clinical efficacy of scalp acupuncture combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of Parkinson's disease with depression(PDD),and to explore its effects on electroencephalogram(EEG)and serum interleukin-6(IL-6),cortisol(Cor),neuron-specific enolase(NSE)levels.Methods:A total of 138 PDD patients admitted to the neurology department of integrated traditional Chinese and western medicine in our hospital were selected as the research objects,and were divided into the observation group and the control group according to random number table method,with 69 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with scalp acupuncture and rTMS on the basis of the control group for 12 consecutive weeks.The Unified Parkinson's Disease Rating Scale(UPDRS),the 24-item Hamilton Depression Scale(HAMD-24),the Pittsburgh Sleep Quality Index(PSQI),and the 39-item Parkinson's Disease Question‐naire(PDQ-39)of the patients were assessed before treatment and after 4,8,and 12 weeks of treatment.EEG and serum IL-6,Cor,NSE were detected before and after the treatment.The adverse reactions of the two groups of patients were observed during the treatment.Results:At the 8 and 12 weeks of treatment,the scores of UPDRS-Ⅰ,UPDRS-Ⅱ,UPDRS-Ⅲ,UPDRS-Ⅳ,HAMD-24,PSQI,and PDQ-39 of patients in the observation group were lower than those of the control group(P<0.05).After treatment,the abnormal EEG activities improved in both groups(P<0.05),and the EEG of patients in the observation group(P<0.05)was better than that in the con‐trol group(P<0.05).After treatment,the serum IL-6,Cor and NSE levels of patients in both groups decreased(P<0.05),and the serum IL-6,Cor and NSE levels of patients in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 15.94%,which had no statistical difference compared with 20.29%in the control group(P>0.05).Conclusion:Scalp acupuncture combined with rTMS in the treatment of PDD can effectively improve the EEG and serum IL-6,Cor,and NSE levels,reduce depression,improve the quality of sleep and life,and has good safety.
作者
沈丽萍
顾竞
王厹东
王萍
沈利荣
陈雪莲
姚晓庆
SHEN Liping;GU Jing;WANG Qiudong;WANG Ping;SHEN Lirong;CHEN Xuelian;YAO Xiaoqing(Encephalopathy Department of Integrated Traditional Chinese and Western Medicine,Shanghai Pudong New Area Hospital of Traditional Chinese Medicine,Shanghai 201299,China)
出处
《中国医药导刊》
2024年第8期797-803,共7页
Chinese Journal of Medicinal Guide
基金
浦东新区科技发展基金(PKJ2021-Y100)。
关键词
头皮针
重复经颅磁刺激
帕金森病
抑郁
脑电图
白细胞介素-6
神经元特异性烯醇化酶
Scalp acupuncture
Repetitive transcranial magnetic stimulation
Parkinson's disease
Depression
Electroencephalo‐gram
Interleukin-6
Neuron-specific enolase
