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药物联合rTMS对帕金森病临床症状及血清学指标改善的Meta分析
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Abstract:
目的：针对药物联合rTMS治疗帕金森病的临床疗效进行文献Meta分析，为优化帕金森病治疗方案提供数据支持。方法：检索英文及中文数据库，收集rTMS联合药物治疗PD临床效果的相关文献，采集核心数据，进行Meta分析。结果：与单纯普拉克索组相比，rTMS联合普拉克索治疗PD后患者精神行为情绪[WMD = ？0.37, 95% CI = (？0.47, ？0.26)]，日常生活活动能力[WMD = ？1.43, 95% CI = (？2.15, ？0.70)]，运动功能[WMD = ？2.13, 95% CI = (？2.74, ？1.51)]，抑郁评分[WMD = ？2.31, 95% CI = (？2.84, ？1.78)]，简易智能精神状态[WMD = 2.23, 95%CI = (1.91, 2.54)]均得到改善，且两组间存在统计学差异(p < 0.05)。氧化应激反应指标均降低，Cys-C [WMD = ？0.25, 95% CI = (？0.31, ？0.19)]、NES [WMD = ？2.75, 95% CI = (？3.50, ？2.00)]、S100B [WMD = ？4.88, 95% CI = (？6.03, ？3.74)]，两组间存在统计学意义(p < 0.05)。与单纯多巴丝肼组相比，rTMS联合多巴丝肼治疗PD后患者精神行为情绪[WMD = ？2.13, 95% CI = (？2.99, ？1.27)]，日常生活活动能力[WMD = ？6.11, 95% CI = (？7.05, ？5.16)]，运动功能[WMD = ？4.87, 95%CI = (？6.05, ？3.69)]，自主神经症状[WMD = ？6.85, 95% CI = (？7.96, ？5.74)]均得到改善，且两组间存在统计学差异(p < 0.05)。神经递质水平得到改善，乙酰胆碱[WMD = ？2.74, 95% CI = (？4.05, ？1.44)]、多巴胺[WMD = 13.81, 95% CI = (11.02, 16.61)]，两组间存在统计学意义(p < 0.05)。结论：rTMS联合药物治疗可有效改善PD患者临床疗效，并对血清氧化应激及神经递质水平也存在调整作用。
Objective: To conduct a literature Meta-analysis on the clinical efficacy of drug combined with rTMS in the treatment of Parkinson’s disease, providing data support for optimizing the treatment plan of Parkinson’s disease. Method: Retrieve English and Chinese databases, collect relevant literature on the clinical efficacy of rTMS combined with drug therapy for PD, collect core data, and conduct Meta-analysis. Result: Compared with the Pramipexole alone group, patients with Parkinson’s disease treated with the combination of rTMS and Pramipexole had psychology, behavior and emotional [WMD = ？0.37, 95% CI = (？0.47, ？0.26)], activities of daily living [WMD = ？1.43, 95% CI = (？2.15, ？0.70)], motor function [WMD = ？2.13, 95% CI = (？2.74, ？1.51)], depression score [WMD = ？2.31, 95% CI = (？2.84, ？1.78)], and simplified mental state [WMD = 2.23, 95% CI = (1.91, 2.54)] showed varying degress of improvement, and there was a statistical difference between the two groups (p < 0.05). The oxidative stress response indicators were all reduced, with Cys-C [WMD = ？0.25, 95% CI = (？0.31, ？0.19)], NES
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