熊莉君,杨燕,王芳.重复经颅磁刺激联合心理干预治疗帕金森病抑郁患者的疗效观察[J].中华物理医学与康复杂志,2023,45(4):312-316
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| 重复经颅磁刺激联合心理干预治疗帕金森病抑郁患者的疗效观察 |
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| DOI：10.3760/cma.j.issn.0254-1424.2023.04.005 |
| 中文关键词: 重复经颅磁刺激 心理干预 帕金森病 抑郁 神经功能 生活质量 |
| 英文关键词: Transcranial magnetic stimulation Psychological interventions Parkinson′s disease Depression Neurological function Quality of life |
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| 中文摘要: |
| 目的 探讨重复经颅磁刺激（rTMS）联合心理干预对帕金森病抑郁（dPD）患者抑郁症状、神经功能及生活质量的改善作用。 方法 采用随机数字表法将120例dPD患者分为心理组、rTMS组及观察组，每组40例。所有患者均给予常规抗帕金森病及抗抑郁药物治疗，在此基础上心理组、rTMS组患者分别给予心理干预或高频（10 Hz）rTMS治疗（刺激部位为左侧背外侧皮质区），观察组患者则辅以心理干预及高频rTMS治疗，3组患者均持续治疗8周。于治疗前、治疗8周后分别采用汉密尔顿抑郁量表（HAMD-24）、新版帕金森病综合评价量表(MDS-UPDRS)及生活质量评价量表(SF-36)对3组患者抑郁症状、神经功能受损程度和生活质量进行评估。 结果 治疗8周后3组患者HAMD评分、MDS-UPDRS评分及SF-36评分均较治疗前明显改善（P<0.05），并且治疗后观察组HAMD评分［(13.98±2.46)分］、MDS-UPDRS评分、SF-36评分［(82.35±5.66)分］及临床缓解率（40.0%）、反应率（90.0%）等均显著优于心理组及rTMS组水平（P<0.05）。 结论 心理干预联合rTMS治疗dPD患者具有协同作用，能进一步缓解患者抑郁症状，改善受损神经功能及生活质量，该联合疗法值得临床推广、应用。 |
| 英文摘要: |
| Objective To explore any effect of supplementing psychological intervention with repeated transcranial magnetic stimulation (rTMS) in the rehabilitation of depressed persons with Parkinson′s disease (dPD). Methods A total of 120 dPD patients were randomly divided into a psychological intervention group, an rTMS treatment group and an observation group, each of 40. In addition to conventional anti-Parkinson′s treatment and anti-depressant treatment, the psychological intervention group received such treatment and the rTMS group received 10Hz rTMS applied over the left dorsolateral prefrontal cortex for 8 weeks. The observation group received both interventions. Before and after the treatment, depression, neurological functioning and life quality were evaluated in all of the subjects using the 24-item Hamilton Depression Scale, the Movement Disorder Society′s unified Parkinson′s disease rating scale and the SF-36 questionnaire. Results After the intervention, significant improvement was observed in all of the quantitative evaluations as well as in the remission rate (40%) and the reaction rate (90%). On average, the observation group′s results were significantly better than those of the other two groups. Conclusion Psychological intervention and rTMS a have synergistic effect in treating dPD patients and their combination is worthy of clinical promotion and application, as it can relieve their depression and improve their neurological functioning and life quality. |
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