温肾通督针灸法联合重复经颅磁刺激治疗帕金森病抑郁症临床研究
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R742.5

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福州市科技局计划项目(2021-S-206)


Clinical Study on Warming Kidney and Unblocking Governor Vessel Acupuncture and Moxibustion Method Combined with Repetitive Transcranial Magnetic Stimulation for Parkinson's Disease Complicated with Depression
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    摘要:

    目的:观察温肾通督针灸法联合重复经颅磁刺激(rTMS) 治疗帕金森病合并抑郁症(PDD) 的临 床疗效及对同型半胱氨酸(Hcy)、血清尿酸(UA) 的影响。方法:将110例PDD患者按随机数字表法分为对 照组和观察组,每组55例。2组在常规服用抗帕金森病药物基础上,对照组予以rTMS治疗,观察组予以rTMS 联合温肾通督针灸法治疗。2组均治疗4周。治疗前后比较2组统一帕金森量表(UPDRS)、汉密尔顿抑郁量 表-17(HAMD-17) 评分及血清Hcy、UA水平,并比较2组临床疗效。结果:治疗后,2组UPDRS各项评分及 总分均降低(P<0.05),且观察组低于对照组(P<0.05)。随访1个月,观察组UPDRS各项评分及总分低于治 疗前、治疗后及周期对照组(P<0.05),且低于对照组(P<0.05),对照组UPDRS各项评分及总分低于治疗 前(P<0.05),但与治疗后比较,差异无统计学意义(P>0.05)。治疗后,2组HAMD-17评分均降低(P< 0.05),且观察组低于对照组。随访1个月,观察组HAMD-17指标低于治疗前、治疗后及周期对照组(P< 0.05),对照组HAMD-17评分低于治疗前(P<0.05),但与治疗后比较,差异无统计学意义(P>0.05)。治疗 后,2组血清Hcy水平均降低(P<0.05),且观察组低于对照组(P<0.05);UA水平均升高(P<0.05),且观 察组高于对照组(P<0.05)。随访1 个月,观察组血清Hcy 水平低于治疗前、治疗后及周期对照组(P< 0.05),血清UA水平高于治疗前、治疗后及周期对照组(P<0.05),对照组血清Hcy低于治疗前(P<0.05)、 UA水平高于治疗前(P<0.05),但与治疗后比较,差异无统计学意义(P>0.05)。治疗后观察组总有效率 92.73%,高于对照组81.82% (P<0.05)。结论:温肾通督针灸法联合rTMS在改善PDD患者运动症状的同时, 可降低大脑氧化应激损害及血清Hcy水平,提升UA水平,有效纠正抑郁情绪。

    Abstract:

    Abstract: Objective: To observe the clinical effect of the therapy of warming kidney and unblocking governor vessel acupuncture and moxibustion combined with repetitive transcranial magnetic stimulation (rTMS) on Parkinson's disease complicated with depression (PDD) and its effects on homocysteine (Hcy) and serum urine acid (UA). Methods: A total of 110 PDD patients were divided into the control group and the observation group according to the random number table method, with 55 cases in each group. In addition to routine antiparkinsonian medications,the control group was additionally treated with rTMS and the observation group with rTMS combined with warming kidney and unblocking governor vessel acupuncture and moxibustion. The two groups were treated for four weeks. The scores of Unified- Parkinson Disease Rating Scale (UPDRS) and Hamilton Depression Scale-17 items (HAMD-17), levels of serum Hcy and UA before and after treatment as well as clinical effects were compared between the two groups. Results: After treatment, each score in UPDRS and the total scores in the two groups were decreased (P<0.05), and each score in UPDRS and the total score in the observation group were lower than those in the control group (P<0.05). After one month of follow-up,each score in UPDRS and the total score in the observation group were lower than those before and after treatment and the control group at the same time (P<0.05),and each score in UPDRS and the total score in the observation group were lower than those in the control group (P<0.05); there was no significant difference being found in the comparisons of each score in UPDRS and the total score in the control group when compared with those after treatment (P>0.05). After treatment, the HAMD-17 scores in the two groups were decreased (P< 0.05),and the HAMD-17 score in the observation group was lower than that in the control group. After one month of follow-up, the HAMD-17 score in the observation group was lower than that before and after treatment and the control group at the same time (P<0.05),and there was no significant difference being found in the comparison of the HAMD-17 score in the control group when compared with that after treatment (P>0.05). After treatment, the serum Hcy levels in the two groups were decreased (P<0.05), and the serum Hcy level in the observation group was lower than that in the control group (P<0.05); the serum UA levels were increased (P<0.05), and the serum UA level in the observation group was higher than that in the control group (P<0.05). After one month of follow-up, the serum Hcy level in the observation group was lower than that before and after treatment and the control group at the same time (P<0.05),the serum UA level was higher than that before and after treatment and the control group at the same time (P<0.05),and there was no significant difference being found in the comparisons of the levels of Hcy and UA in the control group when respectively compared with those after treatment (P>0.05). After treatment,the total effective rate was 92.73% in the observation group,higher than that of 81.82% in the control group (P<0.05). Conclusion: The therapy of warming kidney and unblocking governor vessel acupuncture and moxibustion combined with rTMS can improve the motor symptoms of PDD patients and decrease the cerebral oxidative stress injuries and serum Hcy level, increase the UA level and effectively correct the depressed mood.

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黄燕熙,纪家武,林燕华.温肾通督针灸法联合重复经颅磁刺激治疗帕金森病抑郁症临床研究[J].新中医,2024,56(13):161-166

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  • 在线发布日期: 2024-07-10
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