重复经颅磁刺激联合多巴丝肼片治疗帕金森病的疗效分析

doi:10.3969/j.issn.1004-583X.2026.07.008

摘要/Abstract

摘要：

目的探究重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合多巴丝肼片治疗帕金森病(parkinson's disease,PD)的疗效及对血清表皮生长因子(epidermal growth factor,EGF)和神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平及步态指标的影响。方法选取2022年1月-2025年1月南阳市中心医院治疗的246例PD患者,以随机数字表法进行分组,对照组(n=123)采用多巴丝肼片治疗,试验组(n=123)在此基础上联合rTMS治疗。比较两组帕金森评估量表(unified parkinson's disease rating scale,UPDRS),治疗前后相关血清指标(EGF和NSE)、步态指标[上肢功能评分(simple test for evaluating hand function,STEF)、改良Barthel指数(modified barthel index,MBI)、改良肌张力评估量表(modified ashworth scale,MAS)]、生活质量[生活质量综合评定问卷-74(generic quality of life inventory-74,GQOLI-74)],以及不良反应发生情况。结果治疗后,试验组UPDRS评分较对照组明显降低(P<0.05)。试验组STEF、MBI评分及EGF水平均高于对照组,NSE水平和MAS分级较对照组降低(P<0.05)。试验组GQOLI-74评分较对照组升高(P<0.05)。试验组共有16例(13.01%)患者出现不良反应,对照组为14例(11.38%),2组不良反应差异无统计学意义(P>0.05)。结论 rTMS结合多巴丝肼片的治疗方案对改善PD患者的运动障碍和日常活动能力具有显著效果,其机制可能与上调血清EGF、下调NSE水平以促进神经修复有关,显著改善患者生活质量的同时未增加不良反应发生率。

关键词: 帕金森病, 重复经颅磁刺激, 多巴丝肼片, 表皮生长因子, 神经元特异性烯醇化酶

Abstract:

Objective To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with levodopa and benserazide hydrochloride tablets in the treatment of Parkinson’s disease (PD), and to evaluate its effects on serum epidermal growth factor (EGF) and neuron-specific enolase (NSE) levels, as well as gait-related indicators. Methods A total of 246 patients with PD treated at Nanyang Central Hospital from January 2022 to January 2025 were enrolled and randomly assigned using a random number table. The control group (n=123) received levodopa and benserazide hydrochloride tablets, while the experimental group (n=123) received rTMS in combination with levodopa and benserazide hydrochloride tablets. The two groups were compared in terms of the Unified Parkinson’s Disease Rating Scale (UPDRS), serum indicators before and after treatment (EGF and NSE), gait-related indicators (Simple Test for Evaluating Hand Function [STEF], Modified Barthel Index [MBI], and Modified Ashworth Scale [MAS]), quality of life (Generic Quality of Life Inventory-74 [GQOLI-74]), and adverse reactions. Results After treatment, the UPDRS score in the experimental group was significantly lower than that in the control group (P<0.05). The experimental group had higher STEF and MBI scores and higher EGF levels, but lower NSE levels and MAS scores than the control group (P<0.05). The GQOLI-74 score in the experimental group was higher than that in the control group (P<0.05). A total of 16 patients (13.01%) in the experimental group and 14 patients (11.38%) in the control group experienced adverse reactions, with no statistically significant difference between the two groups (P>0.05). Conclusion The combination of rTMS and levodopa and benserazide hydrochloride tablets is effective in improving motor dysfunction and activities of daily living in patients with PD. Its mechanism may be related to upregulation of serum EGF and downregulation of NSE, thereby promoting neural repair. This regimen significantly improves quality of life without increasing the incidence of adverse reactions.

Key words: Parkinson's disease, repetitive transcranial magnetic stimulation, levodopa and benserazide hydrochloride tablets, epidermal growth factor, neuron-specific enolase

中图分类号:

R742.5

许崇丽, 张小颖, 王迎亚, 赵静. 重复经颅磁刺激联合多巴丝肼片治疗帕金森病的疗效分析[J]. 临床荟萃, 2026, 41(7): 626-631.

Xu Chongli, Zhang Xiaoying, Wang Yingya, Zhao Jing. Efficacy of repetitive transcranial magnetic stimulation combined with levodopa and benserazide hydrochloride tablets in the treatment of Parkinson’s disease[J]. Clinical Focus, 2026, 41(7): 626-631.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.07.008

https://www.lchc.cn/CN/Y2026/V41/I7/626

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参考文献 23

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指标	例数	性别 (男/女)		年龄 (岁)		病程 (年)		Hoehn-Yahr分期[例(%)]
指标	例数	性别 (男/女)		年龄 (岁)		病程 (年)		Ⅰ期		Ⅱ期		Ⅲ期		Ⅳ期
试验组	123	61/62		70.47±4.34		2.78±0.34		28(22.76)		45(36.59)		32(26.02)		18(14.63)
对照组	123	60/63		71.12±4.28		2.71±0.36		30(24.39)		43(34.96)		31(25.20)		19(15.45)
t/χ²值		0.033		1.073		1.562		0.268
P值		0.856		0.284		0.120		0.966
指标	UPDRS- 精神行为(分)		UPDRS- 运动功能(分)		UPDRS-日常生活能力(分)		MMSE (分)		HAMD (分)		HAMA (分)		LED (mg/d)
试验组	12.36±1.12		46.87±3.91		57.56±5.12		26.34±2.21		18.23±3.45		17.89±3.21		412.35±45.67
对照组	12.21±1.04		46.50±3.46		58.05±4.34		26.51±2.08		18.09±3.52		18.02±3.34		408.92±46.23
t/χ²值	1.073		0.796		0.810		0.620		0.319		0.316		0.589
P值	0.284		0.427		0.419		0.536		0.750		0.752		0.556

指标	例数	性别 (男/女)		年龄 (岁)		病程 (年)		Hoehn-Yahr分期[例(%)]
指标	例数	性别 (男/女)		年龄 (岁)		病程 (年)		Ⅰ期		Ⅱ期		Ⅲ期		Ⅳ期
试验组	123	61/62		70.47±4.34		2.78±0.34		28(22.76)		45(36.59)		32(26.02)		18(14.63)
对照组	123	60/63		71.12±4.28		2.71±0.36		30(24.39)		43(34.96)		31(25.20)		19(15.45)
t/χ²值		0.033		1.073		1.562		0.268
P值		0.856		0.284		0.120		0.966
指标	UPDRS- 精神行为(分)		UPDRS- 运动功能(分)		UPDRS-日常生活能力(分)		MMSE (分)		HAMD (分)		HAMA (分)		LED (mg/d)
试验组	12.36±1.12		46.87±3.91		57.56±5.12		26.34±2.21		18.23±3.45		17.89±3.21		412.35±45.67
对照组	12.21±1.04		46.50±3.46		58.05±4.34		26.51±2.08		18.09±3.52		18.02±3.34		408.92±46.23
t/χ²值	1.073		0.796		0.810		0.620		0.319		0.316		0.589
P值	0.284		0.427		0.419		0.536		0.750		0.752		0.556

组别	例数	精神行为		运动功能		日常生活能力
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
试验组	123	12.36±1.12	5.34±1.06^*	46.87±3.91	30.01±4.06^*	57.56±5.12	37.57±5.17^*
对照组	123	12.21±1.04	7.51±1.48^*	46.50±3.46	34.98±5.64^*	58.05±4.34	42.54±6.74^*
t值		1.073	13.328	0.796	7.764	0.810	6.618
P值		0.284	<0.01	0.427	<0.01	0.419	<0.01

组别	例数	精神行为		运动功能		日常生活能力
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
试验组	123	12.36±1.12	5.34±1.06^*	46.87±3.91	30.01±4.06^*	57.56±5.12	37.57±5.17^*
对照组	123	12.21±1.04	7.51±1.48^*	46.50±3.46	34.98±5.64^*	58.05±4.34	42.54±6.74^*
t值		1.073	13.328	0.796	7.764	0.810	6.618
P值		0.284	<0.01	0.427	<0.01	0.419	<0.01

组别	例数	EGF(ng/L)		NSE(μg/L)
组别	例数	治疗前	治疗后	治疗前	治疗后
试验组	123	4.34±0.55	7.03±0.77^*	18.42±2.31	7.76±1.39^*
对照组	123	4.37±0.52	6.24±0.71^*	18.24±4.34	9.05±1.34^*
t值		0.521	9.428	0.472	8.937
P值		0.603	<0.01	0.637	<0.01