| 凤兆海,李美英,郑颖炜,等.低频重复经颅磁刺激联合药物治疗改善帕金森病睡眠障碍的作用及机制探讨[J].安徽医药,2026,30(3):598-602. |
| 低频重复经颅磁刺激联合药物治疗改善帕金森病睡眠障碍的作用及机制探讨 |
| Effect and mechanism of low frequency repetitive transcranial magnetic stimulation combined with drug therapy in improving sleep disorder in patients with Parkinson's disease |
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| DOI：10.3969/j.issn.1009-6469.2026.03.034 |
| 中文关键词: 帕金森病 睡眠障碍 经颅磁刺激 前额叶背外侧区 神经递质 机制研究 |
| 英文关键词: Parkinson's disease Sleep disorders Transcranial magnetic stimulation The dorsolateral prefrontal area Neu. rotransmitter Mechanism study |
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| 中文摘要: |
| 目的探讨低频重复经颅磁刺激( rTMS)联合药物治疗改善帕金森病睡眠障碍( PDSD)的作用及机制。方法以 80例 PDSD病人为研究对象，均于 2023年 3月至 2024年 4月在马鞍山市人民医院诊治。将受试者根据随机数字表法均分为对照组和观察组，各 40例，分别给予常规西药 +假刺激、常规西药 +低频 rTMS治疗。在治疗前及治疗后 1个月检测两组病人神经递质水平变化，同时期采用帕金森病睡眠量表( PDSS)、匹兹堡睡眠质量指数( PSQI)、汉密尔顿抑郁量表( HAMD)、汉密尔顿焦虑量表( HAMA)、帕金森生存质量量表( PDQ-39)评估两组病人睡眠质量、抑郁、焦虑及生活质量。评估两组病人临床疗效。结果较治疗前，治疗后两组 γ-氨基丁酸( GABA)、谷氨酸、 PDSS水平均升高( P<0.05)；较对照组，观察组治疗后上述指标水平更高［( 279.38±60.15)μmol/L比( 248.35±53.72)μmol/L、(62.18±8.16)μmol/L比( 50.15±7.41)μmol/L、(123.65±24.74)分比( 100.77±20.89)分，P<0.05］。较治疗前，两组治疗后 PSQI、HAMD、HAMA、PDQ-39量表中各维度评分水平均降低( P<0.05)；较对照组，观察组治疗后上述指标水平更低( P<0.05)。较对照组，观察组总有效率更高［92.50%(37/40)比 72.50%(29/40)P<0.05］。结论低频 rTMS联合药物可有效改善 PDSD病人睡眠质量、抑郁、焦虑情况，提高生活质量和临床疗效。低频 rTMS的，作用机制可能与其能调节 GABA、谷氨酸水平有关。 |
| 英文摘要: |
| Objective To explore the effect and mechanism of low frequency repetitive transcranial magnetic stimulation (rTMS) com.bined with drug therapy in improving sleep disorder in patients with Parkinson's disease.Methods A total of 80 patients with Parkin.son's disease sleep disorders (PDSD) were studied, all of whom were treated in Ma'anshan People's Hospital from March 2023 to April2024. The participants were randomly assigned to either the control group or the observation group using a random number table meth.od, with 40 cases in each group, and they received either conventional Western medicine combined with sham stimulation or conven.tional Western medicine in conjunction with low-frequency rTMS treatment. Changes in neurotransmitter levels were detected beforeand 1 month after treatment, and the Parkinson's disease sleep scale (PDSS), Pittsburgh sleepiness quotient index (PSQI), Hamilton de.pression scale (HAMD), Hamilton anxiety scale (HAMA), and Parkinson's disease questionnaire (PDQ-39) were used to assess thesleep quality, depression, anxiety, and quality of life of the two groups during the same period. The clinical efficacy of both groups wasassessed.Results Compared with pretreatment, the levels of γ-aminobutyric acid (GABA), glutamate (Glu) and PDSS in 2 groups were increased after treatment (P<0.05). Compared to the control group, after treatment, levels of the above indexes were higher in the obser.vation group [(279.38±60.15) μmol/L vs. (248.35±53.72) μmol/L, (62.18±8.16) μmol/L vs. (50.15±7.41) μmol/L, (123.65±24.74) points vs. (100.77±20.89) points, P<0.05]. Compared with pretreatment, scores of PSQI, HAMD, HAMA and PDQ-39 scales in both groups were decreased after treatment (P<0.05). Compared with the control group, scores of the above indexes in the observation group were lower after treatment (P<0.05). Compared with the control group, the total effective rate of the observation group was higher [92.50% (37/40) vs. 72.50% (29/40), P<0.05].Conclusions Low frequency rTMS combined with drug therapy can effectively improve the sleepquality, depression, anxiety, quality of life and clinical efficacy of PDSD patients. The mechanism of low-frequency rTMS may be relat. ed to its ability to regulate GABA and Glu levels. |
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