摘要
目的:观察人参养荣汤联合重复经颅磁刺激(rTMS)治疗气血两虚型帕金森病失眠的疗效及对5-羟色胺(5-HT)、去甲肾上腺素(NE)、脑源性神经营养因子(BDNF)的影响。方法:选择2023年1月—2024年7月浙江中医药大学附属温州市中医院收治的60例帕金森病失眠患者,按随机数字表法分为研究组及对照组各30例。对照组接受rTMS治疗,研究组在对照组基础上联合人参养荣汤治疗。2组均治疗4周。比较2组临床疗效及安全性,比较2组治疗前后多导睡眠图参数值、匹兹堡睡眠质量指数(PSQI)、帕金森病统一量表评分(UPDRS)、血清5-HT、NE、BDNF水平的变化。结果:治疗后,研究组临床疗效总有效率为93.33%(28/30),对照组为73.33%(22/30),2组比较,差异有统计学意义(P<0.05)。治疗后,2组睡眠总时间(TST)、睡眠效率(SE)、快动眼睡眠相潜伏期(RL)、快动眼睡眠相占睡眠总时间百分比(REM)、N2阶段占睡眠总时间百分比(N2)值均较治疗前升高(P<0.05),睡眠潜伏期(SL)、觉醒次数(AT)、觉醒时间(AWT)、N1阶段占睡眠总时间百分比(N1)、慢波睡眠占睡眠总时间百分比(SWS)值均较治疗前下降(P<0.05);研究组TST、SE、RL、REM、N2值均高于对照组(P<0.05),SL、AT、AWT、N1、SWS值均低于对照组(P<0.05)。治疗后,2组PSQI、UPDRS评分均较治疗前下降(P<0.05),研究组PSQI、UPDRS评分均低于对照组(P<0.05)。治疗后,2组血清5-HT、NE、BDNF水平均较治疗前上升(P<0.05),研究组血清5-HT、NE、BDNF水平均高于对照组(P<0.05)。治疗过程中,2组均未发生严重不良反应。结论:人参养荣汤联合rTMS治疗气血两虚型帕金森病失眠疗效较好,能有效提高患者睡眠质量,缓解帕金森症状,同时改善患者情绪状态,保护大脑神经功能。
Objective:To observe the therapeutic effect of Renshen Yangrong Decoction combined with repetitive transcranial magnetic stimulation(rTMS)on insomnia in Parkinson's disease with qi and blood deficiency type,and its impact on 5-hydroxytryptamine(5-HT),norepinephrine(NE),and brain-derived neurotrophic factor(BDNF).Methods:A total of 60 cases of patients with insomnia in Parkinson's disease admitted to Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University from January 2023 to July 2024 were randomly divided into the study group and the control group,with 30 patients in each group,using a random number table method.The control group received rTMS treatment,and the study group received treatment in combination with Renshen Yangrong Decoction on the basis of the control group.Both groups were treated for four weeks.Compared the clinical efficacy and safety of the two groups,and compared the changes in polysomnography parameters,Pittsburgh Sleep Quality Index(PSQI),Unified Parkinson's Disease Rating Scale(UPDRS),serum 5-HT,NE,and BDNF levels before and after treatment.Results:After treatment,the total effective rate of clinical efficacy was 93.33%(28/30)in the study group,while that of 73.33%(22/30)in the control group,the difference being significant(P<0.05).After treatment,the total sleep time(TST),sleep efficiency(SE),rapid eye movement sleep latency(RL),percentage of rapid eye movement(REM)sleep phase to total sleep time,and percentage of N2 phase to total sleep time(N2)in both groups were increased when compared with those before treatment(P<0.05),and the sleep latency(SL),awakening times(AT),awakening time(AWT),percentage of N1 phase to total sleep time(N1),and percentage of slow wave sleep(SWS)to total sleep time were decreased when compared with those before treatment(P<0.05);the TST,SE,RL,REM,and N2 values in the study group were higher than those in the control group(P<0.05),while the SL,AT,AWT,N1,and SWS values were lower than those in the control group(P<0.05).After treatment,the PSQI and UPDRS scores in both groups were decreased when compared with those before treatment(P<0.05),and the PSQI and UPDRS scores in the study group were lower than those in the control group(P<0.05).After treatment,the levels of serum 5-HT,NE,and BDNF in both groups were increased when compared with those before treatment(P<0.05),and the levels of serum 5-HT,NE,and BDNF in the study group were higher than those in the control group(P<0.05).During the treatment process,neither group experienced serious adverse reactions.Conclusion:The combination of Renshen Yangrong Decoction and rTMS has a good therapeutic effect on insomnia in Parkinson's disease with qi and blood deficiency type,which can effectively improve the sleep quality of patients and alleviate Parkinson's symptoms.It also improves the patient's emotional state and protects the neurological function of the brain.
作者
支海鸯
宋成城
陈凌
ZHI Haiyang;SONG Chengcheng;CHEN Ling(Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University,Wenzhou Zhejiang 325000,China)
出处
《新中医》
2025年第5期41-46,共6页
New Chinese Medicine
基金
温州市基础性科研项目(Y20240224)。
关键词
帕金森病
失眠
气血两虚型
人参养荣汤
重复经颅磁刺激
Parkinson's disease
Insomnia
Qi and blood deficiency type
Renshen Yangrong Decoction
Repetitive transcranial magnetic stimulation
