新型康复管理模式对帕金森病患者运动症状的影响

doi:10.3969/j.issn.2095-9400.2020.09.010

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摘要目的：观察帕金森病（PD）新型管理模式对早期PD患者运动症状的影响。方法：将符合纳入标准的120例PD患者（Hoehn-Yahr分级标准为I期、II期），随机分为治疗组和对照组各60例，对照组单纯西药（美多芭125 mg，3次/d，餐前1 h口服）治疗，治疗组在对照组基础上采用PD新型康复管理模式（加用PD康复操治疗，每次训练30 min，5次/周；并使患者成为PD康复俱乐部会员，定期参加俱乐部活动）；2组患者均治疗12周，所有患者均于治疗前后分别采用统一PD评定量表（UPDRS III）、Berg平衡量表进行效果评定。结果：治疗组UPDRS III、Berg平衡量表评分均较治疗前显著改善（P＜0.01），对照组UPDRS III评分和Berg评分与治疗前比较差异有统计学意义（P＜0.05）；组间比较，治疗后治疗组UPDRS III评分优于对照组（P＜0.05），治疗后治疗组Berg评分与对照组比较差异有统计学意义（P＜0.01）。进一步对治疗前后UPDRS III分项进行比较，结果显示，2组治疗后言语表达、面部表情、强直评分与治疗前比较差异无统计学意义（P＞0.05），而治疗组静止性震颤、手部动作性或姿势性震颤、手指拍打试验、手运动、轮替运动、腿部灵活性、起立、姿势、步态、姿势稳定性、躯体少动评分优于治疗前及对照组，差异有统计学意义（P＜0.05）。结论：PD新型康复管理模式可有效提高早期PD患者的手部及下肢运动控制能力和平衡能力，提高患者的姿势稳定性。

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关键词 ：帕金森病, 帕金森病康复操, 康复, 运动症状

Abstract：Objective: To observe the effect of the new management model on the motor symptoms of early Parkinson’s disease patients. Methods: Totally 120 patients with Parkinson’s disease who met the criteria (Hoehn-Yahr classification criteria of Phase I and II) were randomly divided into the treatment group and the control group, with 60 cases in each. The control group was treated with pure western medicine (Madopar 125 mg, 3/Day, 1 h oral treatment before meals), while the treatment group adopted a new Parkinson’s disease rehabilitation management model on the basis of the control group (plus Parkinson’s disease rehabilitation exercise treatment, 30 min, 5/week each training; to recruit these patients into Parkinson’s disease rehabilitation club and involve them in club activities regularly). Both groups were treated for 12 weeks. All patients were assessed before and after treatment using the Unified Parkinson’s Disease Assessment Scale (UPDRS, III) and Berg Balance Scale. Results: The score of UPDRS III and Berg in the treatment group was significantly improved (P<0.01), and the score of UPDRS III in the control group was significantly different from that before treatment (P<0.01), with the score of Berg significantly improved (P<0.05). The UPDRS III score was better than that of the control group (P<0.05), and the Berg score was significantly different from that before treatment (P<0.01). The results of further comparison between the scores of UPDRSIII items before and after treatment showed that there was no statistical differences in verbal expression, facial expression, and rigidity score between the treatment groups before and after treatment (P>0.05). In the treatment group, however, resting tremor, hand movement or posture tremor, finger tapping test, hand movement, rotation movement, leg flexibility, standing, posture, gait, posture stability, and body movement scores were better than those of the pre-treatment with significant differences (P<0.05). Conclusion: The new management model of Parkinson’s disease rehabilitation can improve the PD patients’ motion control ability, balance ability and the posture stability.

Key words： Parkinson’s disease Parkinson’s disease rehabilitation exercise rehabilitation exercise symptoms

收稿日期: 2019-06-13

基金资助:浙江省科技计划项目（2015C33156）；第四批全国中医（临床、基础）优秀人才研修项目（国中医药人教发［2017］24号）。

通讯作者: 汪亚群，主任中医师，Email：Dr_yqwang@126.com。

作者简介: 杨桂芬（1983-），女，山东济南人，主治中医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/10.3969/j.issn.2095-9400.2020.09.010 或 https://xb.wmu.edu.cn/CN/Y2020/V50/I9/738

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