帕金森病患者苍白球内核与眼下核的脑深部刺激疗效比较

IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE
Su Mingming, Zheng Zhaohui, Qu Lihong, Wang Xin, Wang Bao, Li Nan, Wang Xuelian
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引用次数: 0

摘要

研究背景近年来,帕金森病的发病率逐渐增高,而多巴胺类药物的应用已受到限制,因此迫切需要探索一种更有效的治疗方法来有效治疗帕金森病。眼下核-深部脑刺激和苍白球-深部脑刺激 眼下核-深部脑刺激和苍白球-深部脑刺激是治疗帕金森病的两种方法。然而,这两种方法哪种更有效,目前尚无明确结论:比较苍白球内深部脑刺激和眼下核深部脑刺激分别与药物联合治疗帕金森病的效果:为了比较两组患者的运动功能、神经功能和日常生活活动评分、等动症状和运动症状的波动发生率、药物剂量的变化以及并发症的发生率,纳入了52名接受苍白球内侧深部脑刺激治疗的患者和52名接受眼下核深部脑刺激治疗的患者:使用帕金森病统一评定量表的运动功能检查量表,对患者术前、术后一个月、术后三个月和术后六个月的运动功能进行评估。在手术前和手术后三个月,使用蒙特利尔认知评估、迷你精神状态检查和日常生活活动量表评估患者的认知功能。此外,还对患者的用药剂量和并发症等进行了统计:结果:两组患者术后帕金森病统一评定量表-Ⅲ评分均下降,蒙特利尔认知评估、迷你精神状态检查和日常生活活动量表评分均上升,两组间无差异(P > .05)。两组患者的异动症和运动症状变化频率没有差异(P > .05)。与丘脑下核组相比,苍白球内侧组术后用药剂量更低,并发症发生率更低(P < .05):结论:GPi-DBS和STN-DBS治疗帕金森病的效果均较显著,且两者无差异,但GPi-DBS可减少并发症和药物剂量,安全性更高,表明GPi-DBS更适合临床应用和推广。未来的研究需要进一步探讨GPi-DBS治疗帕金森病减少并发症和用药剂量的机制,为GPi-DBS的临床应用提供更好的支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative Efficacy of Deep Brain Stimulation to the Globus Pallidus Internus Versus the Subthalamic Nucleus in Parkinson's Disease.

Background: In recent years, the incidence of Parkinson's disease has gradually increased, and the application of dopamine drugs has been limited, so there is an urgent need to explore a more effective treatment method to treat Parkinson's disease effectively treated. Subthalamic nucleus-deep brain stimulation and globus pallidus internus-deep brain Subthalamic nucleus-deep brain stimulation and globus pallidus internus-deep brain stimulation are the two treatments for Parkinson's disease. However, there is no clear conclusion as to which of these two methods is more effective.

Primary study objective: To compare the effects of deep brain stimulation in the globus pallidus internus and deep brain stimulation in the subthalamic nucleus combined with drugs for Parkinson's disease, respectively.

Methods: In order to compare the motor function, neurological function, and activities of daily living scores, the incidence of fluctuations in isokinetic and motor symptoms, changes in medication doses, and the incidence of complications between the two groups, 52 patients treated with globus pallidus internus-deep brain stimulation and 52 patients treated with subthalamic nucleus-deep brain stimulation were included.

Primary outcome measures: Using the Motor Function Examination scale of the Unified Parkinson's Disease Rating Scale, patients' motor function was evaluated prior to surgery, one month after surgery, three months after surgery, and six months following surgery. The Montreal Cognitive Assessment, the Mini-mental State Examination, and the Activity of Daily Living scale were used to evaluate patients' cognitive function before and three months after surgery. The patient's dose of medication and complications were also counted, among other things.

Results: The Unified Parkinson's Disease Rating Scale-Ⅲ scores decreased, and the Montreal Cognitive Assessment, Mini-mental State Examination, and Activity of Daily Living scales increased in both groups after surgery, with no difference between the two groups (P > .05). Between the two groups, there was no difference in the frequency of allodynia and motor symptom variations (P > .05). Postoperatively, the Group globus pallidus internus experienced lower medication doses and a reduced incidence of complications than the Group subthalamic nucleus (P < .05).

Conclusion: The effects of GPi-DBS and STN-DBS in treating PD are both more significant and there is no difference between them, but GPi-DBS reduces complications and medication dose, and has a higher safety profile, indicating that GPi-DBS is more suitable for clinical application and promotion. Future studies need to further explore the mechanism behind the reduction of complications and medication dose of GPi-DBS in Parkinson's disease, in order to provide better support for the clinical application of GPi-DBS.

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来源期刊
Alternative therapies in health and medicine
Alternative therapies in health and medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
0.90
自引率
0.00%
发文量
219
期刊介绍: Launched in 1995, Alternative Therapies in Health and Medicine has a mission to promote the art and science of integrative medicine and a responsibility to improve public health. We strive to maintain the highest standards of ethical medical journalism independent of special interests that is timely, accurate, and a pleasure to read. We publish original, peer-reviewed scientific articles that provide health care providers with continuing education to promote health, prevent illness, and treat disease. Alternative Therapies in Health and Medicine was the first journal in this field to be indexed in the National Library of Medicine. In 2006, 2007, and 2008, ATHM had the highest impact factor ranking of any independently published peer-reviewed CAM journal in the United States—meaning that its research articles were cited more frequently than any other journal’s in the field. Alternative Therapies in Health and Medicine does not endorse any particular system or method but promotes the evaluation and appropriate use of all effective therapeutic approaches. Each issue contains a variety of disciplined inquiry methods, from case reports to original scientific research to systematic reviews. The editors encourage the integration of evidence-based emerging therapies with conventional medical practices by licensed health care providers in a way that promotes a comprehensive approach to health care that is focused on wellness, prevention, and healing. Alternative Therapies in Health and Medicine hopes to inform all licensed health care practitioners about developments in fields other than their own and to foster an ongoing debate about the scientific, clinical, historical, legal, political, and cultural issues that affect all of health care.
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