低频重复经颅磁刺激治疗帕金森病非运动症状的疗效观察

高玉良; 楼敏芳; 胡宁; 杨金美; 翁小建; 汪翔; 孙琳琳

doi:10.16766/j.cnki.issn.1674-4152.004333

低频重复经颅磁刺激治疗帕金森病非运动症状的疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.004333

衢州市中医医院神经内科，浙江衢州 324000

基金项目:

浙江省医药卫生科技计划项目 2022KY1353

衢州市科技计划项目 2022K154

详细信息

通讯作者:
楼敏芳, E-mail：qzlmf3059@126.com

中图分类号: R742.5
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- 文章访问数: 11
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出版历程
- 收稿日期: 2025-03-13
- 网络出版日期: 2026-04-01

Therapeutic effect of low-frequency repetitive transcranial magnetic stimulation on non-motor symptoms of Parkinson' s disease

Department of Neurology, Quzhou Hospital of Traditional Chinese Medicine, Quzhou, Zhejiang 324000, China

摘要

摘要: 目的分析低频重复经颅磁刺激(rTMS)对帕金森病(PD)患者认知功能、睡眠质量等非运动症状的疗效，为帕金森病的治疗提供更为有效的方式。方法前瞻性选取2023年1月—2024年6月衢州市中医医院收治的80例PD患者作为研究对象，按照随机数字表法将研究对象分为研究组和常规组，每组各40例，所有患者均接受美芭多治疗，研究组予以rTMS治疗，常规组予以假刺激。对比2组患者临床疗效、认知功能、睡眠质量、抑郁情况等。结果研究组治疗后有效患者38例, 常规组有效患者30例(95.00% vs. 75.00%，P＜0.05)；治疗后，2组患者认知功能各维度得分均较治疗前上升，且研究组各维度得分高于常规组(P＜0.05)；治疗后，2组患者汉密尔顿抑郁量表(HAMD)得分均较治疗前下降，且研究组低于常规组，2组PD睡眠量表(PDSS)得分均较治疗前上升，且研究组高于常规组(P＜0.05)。结论与假刺激比较，予以患者0.5 Hz rTMS治疗能够更好地改善患者的认知功能、睡眠质量以及抑郁情况，减轻非运动症状，进而获得更好的治疗效果。
- 帕金森病 /
- 不同频率经颅磁刺激 /
- 非运动症状 /
- 认知功能 /
- 睡眠质量
Abstract: Objective To analyze the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) on non-motor symptoms in patients with Parkinson' s disease (PD). Methods A prospective study was conducted involving 80 PD patients admitted to Quzhou Hospital of Traditional Chinese Medicine from January 2023 to June 2024. The patients were randomly divided into two groups using a random number table: a study group and a control group, with 40 patients in each group. All patients received Madopar treatment. The study group was additionally treated with rTMS, while the control group received sham stimulation. Clinical efficacy, cognitive function, sleep quality, and depression were compared between the two groups. Results After treatment, 38 patients in the study group showed improvement, compared to 30 patients in the control group (95.00% vs. 75.00%, P < 0.05). After treatment, scores across all dimensions of cognitive function increased in both groups compared to pre-treatment levels, with the study group exhibiting higher scores than the control group (P < 0.05). The Hamilton depression scale (HAMD) scores decreased in both groups after treatment, with the study group scoring lower than the control group. Conversely, the Parkinson' s disease sleep scale (PDSS) scores increased in both groups after treatment, with the study group scoring higher than the control group (P < 0.05). Conclusion Compared to sham stimulation, 0.5 Hz rTMS treatment significantly improves cognitive function, sleep quality, and depression in PD patients, alleviates non-motor symptoms, and leads to better therapeutic outcomes.
- Parkinson' s disease /
- Transcranial magnetic stimulation with different frequencies /
- Non-motor symptoms /
- Cognitive function /
- Sleep quality

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表 1 2组帕金森病患者一般资料比较

Table 1. Comparison of baseline characteristics between the two groups of Parkinson' s disease patients

项目	常规组(40例)	研究组(40例)	统计量	P值
性别[例(%)]			0.208^a	0.648
男性	23(57.50)	25(62.50)
女性	17(42.50)	15(37.50)
年龄(x±s，岁)	58.52±17.28	59.84±19.41	0.321^b	0.749
病程(x±s，月)	39.52±13.46	40.12±12.05	0.210^b	0.834
Hoehn-Yahr分级[例(%)]			-0.997^c	0.319
Ⅰ级	18(45.00)	16(40.00)
Ⅱ级	19(47.50)	15(37.50)
Ⅲ级	3(7.50)	9(22.50)
非运动症状[例(%)]
抑郁	24(60.00)	28(70.00)	0.879^a	0.348
认知障碍	18(45.00)	16(40.00)	0.205^a	0.651
失眠	17(42.50)	21(52.50)	0.802^a	0.370
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组帕金森病患者临床疗效比较[例(%)]

Table 2. Comparison of clinical outcomes between the two groups of patients with Parkinson' s disease[cases(%)]

组别	例数	临床痊愈	显效	有效	无效	总有效
研究组	40	5(12.50)	21(52.50)	12(30.00)	2(5.00)	38(95.00)
常规组	40	2(5.00)	12(30.00)	16(40.00)	10(25.00)	30(75.00)
统计量		-2.840^a				6.275^b
P值		0.005				0.015
注：^a为Z值，^b为χ²值。

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表 3 2组帕金森病患者治疗前后认知功能比较(x±s，分)

Table 3. Comparison of cognitive function assessment scores before and after treatment in Parkinson' s disease patients(x±s, points)

组别	例数	定向力		t值	P值
组别	例数	治疗前	治疗后	t值	P值
研究组	40	5.49±0.13	8.12±0.31	10.154	＜0.001
常规组	40	5.51±0.15	7.94±0.25	8.933	＜0.001
统计量		0.637^a	5.397^b
P值		0.526	＜0.001

组别	例数	注意力与计算力		t值	P值
组别	例数	治疗前	治疗后	t值	P值
研究组	40	2.14±0.31	4.67±0.14	11.289	0.005
常规组	40	2.24±0.28	4.39±0.22	6.816	＜0.001
统计量		1.514^a	8.154^b
P值		0.134	＜0.001

组别	例数	记忆力		t值	P值
组别	例数	治疗前	治疗后	t值	P值
研究组	40	1.02±0.11	2.64±0.11	13.792	＜0.001
常规组	40	1.04±0.15	2.28±0.23	9.068	＜0.001
统计量		0.680^a	6.147^b
P值		0.499	＜0.001

组别	例数	回忆能力		t值	P值
组别	例数	治疗前	治疗后	t值	P值
研究组	40	1.57±0.15	2.78±0.24	7.578	＜0.001
常规组	40	1.59±0.16	2.48±0.31	4.177	＜0.001
统计量		0.577^a	15.247^b
P值		0.566	＜0.001

组别	例数	语言能力		t值	P值
组别	例数	治疗前	治疗后	t值	P值
研究组	40	3.27±1.05	7.11±1.08	12.019	0.001
常规组	40	3.25±1.12	6.37±1.18	8.026	＜0.001
统计量		0.082^a	19.352^b
P值		0.935	＜0.001
注：^a为t值，^b为F值。

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表 4 2组帕金森病患者治疗前后睡眠质量以及抑郁情况比较(x±s，分)

Table 4. Comparison of sleep quality and depression status before and after treatment in two groups of Parkinson' s disease patients(x±s, points)

组别	例数	PDSS		t值	P值	HAMD		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	40	93.49±14.83	110.62±12.71	7.718	＜0.001	15.52±5.81	10.14±3.02	22.116	＜0.001
常规组	40	90.91±17.45	99.34±18.75	2.840	＜0.001	16.24±4.75	12.74±4.43	15.615	＜0.001
统计量		0.713^a	6.378^b			0.607^a	5.142^b
P值		0.478	＜0.001			0.546	＜0.001
注：^a为t值，^b为F值。

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