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康复疗法治疗帕金森病患者的效果及对磁共振波谱的影响
沈骏周仁华侍永伟姜宇鞠强国田为中徐建红夏建国
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摘要:
目的 研究自拟康复疗法治疗帕金森病患者的疗效以及对患者磁共振波谱的影响。方 法 选取本院2015 年1 月—2016 年12 月间收治的78 例帕金森病患者作为研究对象,将全部入选患者 随机均分为对照组与研究组,对照组采取单纯药物治疗,观察组在此基础上运用本院自拟康复疗法治 疗,治疗一疗程后以运动与非运动症状程度(帕金森综合评分量表,UPDRS)、平衡能力(Berg 平衡量表)、 生活活动能力(日常生活活动功能量表,ADL)、智能精神状态(MMSE)、抑郁状态(HAMD)及睡眠质量(帕 金森病睡眠量表,PDSS)各项临床指标评估两组患者的治疗效果,同时观察治疗前后两组患者四项血清 酶的变化情况,以氢质子磁共振波谱(1H-MRS)检查观察患者黑质代谢的变化情况,分析患者运动、非 运动症状与1H-MRS 的相关性。结果 治疗后两组患者UPDRS、Berg 平衡量表、ADL、MMSE、HAMD、 PDSS评分较本组治疗前均有所改善(P<0.05),1H-MRS检查指标NAA/Cr、Cho/Cr 均有所改善(P<0.05), SOD、GSH-PX、CAT、MDA 表达水平均较本组治疗前有所改善(P< 0.05);并且以上所有指标研究组均优 于对照组(P < 0.05)。NAA/Cr、Cho/Cr 与UPDRS 评分均呈负相关(|r| ≥ 0.7,P < 0.05)。结论 康复疗法 可提高帕金森病患者的治疗效果,改善患者血清酶的表达水平、生活活动能力、睡眠质量、智能心理状 态,升高黑质区NAA/Cr 及Cho/Cr 值,值得推广应用与深入研究。
关键词:  帕金森病  磁共振波谱  康复疗法  相关性
DOI:10.3969/j.issn.1009-6574.2018.01.005
基金项目:泰州市科技支撑计划(社会发展)项目(TSD201541, TS201527);江苏省第五期“333 工程” 科研项目(BRA2017175);江苏省“六大人才高峰”资助项目(2015-WSN-119)
Effects of rehabilitation therapy on Parkinson disease and its influence on patients' magnetic resonancespectroscopy
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Abstract:
Objective To study the curative effect of the self-designed rehabilitation therapy on Parkinson disease and its effects on magnetic resonance spectroscopy( MRS) in patients. Methods A total of 78 patients with Parkinson disease who were admitted in our hospital from January 2015 to December 2016 were selected as the research objects and randomly divided into control group and study group. The patients in the control group were treated with simple drug treatment. While on the basis of the control group, the study group adopted the self-designed rehabilitation therapy. After a course of treatment, the curative effect of the two groups were evaluated with Unified Parkinson's Disease Rating Scale( UPDRS) for exercise and non-motor symptoms, Berg Balance Scale( BBS) for balance abilities, Activities of Daily Living( ADL) for the ability of living, Minimental State Examination( MMSE) for mental status, Hamilton Depression Scale( HAMD) for depression status and Parkinson Disease Sleep Scale( PDSS) for the quality of sleep. At the same time, the changes of four serum enzymes were monitored before and after the treatment in the two groups. The proton magnetic resonance spectroscopy( 1H-MRS) was applied to check the changes of substantia nigra metabolism, and the correlation between 1H-MRS and Parkinson patients' exercise and non-motor symptoms. Results After the treatment, the scores of UPDRS, BBS, ADL, MMSE, HAMD and PDSS were all improved in both groups( P < 0.05).After treatment, the 1H-MRS indicators, including NAA/Cr and Cho/Cr, were improved( P < 0.05), and the expression levels of SOD, GSH-PX, CAT, MDA were improved as well( P<0.05). All the indicators mentioned above of the study group were superior to the control group( P<0.05). In addition, NAA/Cr and Cho/Cr were negatively correlated with UPDRS( |r|≥0.7, P<0.05). Conclusions The rehabilitation therapy can improve the curative effect in patients with Parkinson disease, improve the serum enzyme expression levels, patients' activities of daily living, sleep quality, intelligent mental state. It also increase the value of NAA/Cr and Cho/Cr in substantia nigra( 1H-MRS index), which is worthy of popularization and further research.
Key words:  Parkinson disease  Magnetic resonance spectroscopy  Rehabilitation therapy  Correlation

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